RT Journal Article
SR Electronic
T1 Apparent Diffusion Coefficient Calculated with Relatively High b-Values Correlates with Local Failure of Head and Neck Squamous Cell Carcinoma Treated with Radiotherapy
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1904
OP 1910
DO 10.3174/ajnr.A2610
VO 32
IS 10
A1 M. Hatakenaka
A1 Y. Shioyama
A1 K. Nakamura
A1 H. Yabuuchi
A1 Y. Matsuo
A1 S. Sunami
A1 T. Kamitani
A1 T. Yoshiura
A1 T. Nakashima
A1 K. Nishikawa
A1 H. Honda
YR 2011
UL http://www.ajnr.org/content/32/10/1904.abstract
AB BACKGROUND AND PURPOSE: Few studies have investigated the relationship between ADC and clinical outcome in HNSCC. Our hypothesis has that relatively high pretreatment ADC would correlate with local failure of HNSCC treated with radiation therapy. MATERIALS AND METHODS: This includes prospective and validation studies. Seventeen patients treated with radiation therapy for primary HNSCC completed the prospective study. Variables considered to affect local failure including MR imaging–related parameters such as ADC and its change ratio were compared between patients with local failure and controls, and those showing difference or association with local failure were further tested by survival analysis. Furthermore, variables were analyzed in 40 patients enrolled in the validation study. RESULTS: Relatively high ADC calculated with b-values (300, 500, 750, and 1000 s/mm2) before treatment, high ADC increase ratio, and treatment method (chemoradiotherapy versus radiation therapy alone) revealed significant difference between patients with local failure and controls or association with local failure. In Cox proportional hazard testing, high ADC before treatment alone showed significant association with local failure (P = .0186). In the validation study, tumor volume before treatment, high ADC before treatment, T stage (T12 versus T34), and treatment method showed significance. Tumor volume before treatment (P = .0217) and high ADC before treatment (P = .0001) revealed significant association with local failure in Cox proportional hazard testing. High ADC before treatment was superior to tumor volume before treatment regarding association with local failure. CONCLUSIONS: These results suggest pretreatment ADC obtained at high b-values as well as tumor volume correlate with local failure of HNSCC treated with radiation therapy. ADCapparent diffusion coefficientAUCarea under the curveDWIdiffusion-weighted imagingGTVgross tumor volumeHNSCChead and neck squamous cell carcinomaNPVnegative predictive valuePPVpositive predictive valueROCreceiver operating characteristicROIregion of interestSIsignal intensity