Diffusion-weighted EPI- and HASTE-MRI and 18F-FDG-PET-CT early during chemoradiotherapy in advanced head and neck cancer

Quantitative Imaging in Medicine and Surgery

Lisa van der Putten⁴  Patricia A. Doornaert²  Charlotte S. Schouten⁴  C. René Leemans⁴  Otto S. Hoekstra¹  Remco de Bree⁴  Emile F.I. Comans¹  Birgit I. Witte³  Daniel P. Noij¹  Jonas A. Castelijns¹ 

[1] Department of Radiology and Nuclear Medicine,;Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands;Department of Epidemiology and Biostatistics,;Department of Otolaryngology-Head and Neck Surgery,

关键词: Chemoradiotherapy (CRT);    diffusion-weighted magnetic resonance imaging (DW-MRI);    head and neck squamous cell carcinoma (HNSCC);    positron emission tomography (PET);    treatment response;   

DOI  :  10.3978/j.issn.2223-4292.2014.07.15

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Main problem: Diffusion-weighted MRI (DW-MRI) has potential to predict chemoradiotherapy (CRT) response in head and neck squamous cell carcinoma (HNSCC) and is generally performed using echo-planar imaging (EPI). However, EPI-DWI is susceptible to geometric distortions. Half-fourier acquisition single-shot turbo spin-echo (HASTE)-DWI may be an alternative. This prospective pilot study evaluates the potential predictive value of EPI- and HASTE-DWI and 18F-fluorodeoxyglucose PET-CT (18F-FDG-PET-CT) early during CRT for locoregional outcome in HNSCC.

Methods: Eight patients with advanced HNSCC (7 primary tumors and 25 nodal metastases) scheduled for CRT, underwent DW-MRI (using both EPI- and HASTE-DWI) and 18F-FDG-PET(-CT) pretreatment, early during treatment and three months after treatment. Median follow-up time was 38 months.

Results: No local recurrences were detected during follow-up. Median Apparent Diffusion Coefficient (ADC)_EPI-values in primary tumors increased from 77×10^�?5 mm²/s pretreatment, to 113×10^�?5 mm²/s during treatment (P=0.02), whereas ADC_HASTE did not increase (74 and 74 mm²/s, respectively). Two regional recurrences were diagnosed. During treatment, ADC_EPI tended to be higher for patients with regional control [(117.3±12.1)×10^�?5 mm²/s] than for patients with a recurrence [(98.0±4.2)×10^�?5 mm²/s]. This difference was not seen with ADC_HASTE. No correlations between ΔADC_EPI and ΔSUV (Standardized Uptake Value) were found in the primary tumor or nodal metastases.

Conclusions: HASTE-DWI seems to be inadequate in early CRT response prediction, compared to EPI-DWI which has potential to predict locoregional outcome. EPI-DWI and 18F-FDG-PET-CT potentially provide independent information in the early response to treatment, since no correlations were found between ΔADC_EPI and ΔSUV.

【 授权许可】

Unknown