Diffusion-weighted magnetic resonance imaging (DWMRI) of head and neck squamous cell carcinoma: could it be an imaging biomarker for prediction of response to chemoradiation therapy
Abstract Background Chemoradiation therapy (CRT) has become a primary definitive treatment modality for head and neck squamous cell carcinoma (HNSCC); however, not all patients respond completely to treatment. Ability to identify those patients, who would not achieve complete response, before or ear...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-10-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s43055-020-00323-x |
| _version_ | 1828895155940229120 |
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| author | Hanan Mohamed Khattab Moataz Mohamed Montasser Mohamed Eid Alaa Kandil Salah El-Din Desouky |
| author_facet | Hanan Mohamed Khattab Moataz Mohamed Montasser Mohamed Eid Alaa Kandil Salah El-Din Desouky |
| author_sort | Hanan Mohamed Khattab |
| collection | DOAJ |
| description | Abstract Background Chemoradiation therapy (CRT) has become a primary definitive treatment modality for head and neck squamous cell carcinoma (HNSCC); however, not all patients respond completely to treatment. Ability to identify those patients, who would not achieve complete response, before or early during the course of CRT will allow treatment modifications to improve outcome and overall survival. The aim of this prospective study was to assess the usefulness of diffusion-weighted imaging (DWI) in prediction of early therapeutic response of HNSCC after CRT. Results Local control was achieved in 22 patients out of 46 patients with pathologically proven HNSCC treated by chemoradiation therapy and local failure was detected in 24 patients out of 46 patients. Pretreatment mean apparent diffusion coefficient (ADCpre) was significantly higher in local failure group (1.1 ± 0.2 × 10−3 mm2/s) than local control group (0.89 ± 0.1 × 10−3 mm2/s). An optimal cut-off value of more than 0.94 × 10−3 mm2/s was predictive of local failure with sensitivity 83.33%, specificity 59.9%, PPV 69%, NPV 76.5%. Early intra-treatment percentage change of ADC (ΔADC) was significantly lower in local failure group (21.8% ± 21.3) than in local control group (45.2% ± 27.8). An optimal cut-off value of ≤ 33% was predictive of local failure after CRT with sensitivity of 71.34%, specificity of 60%, PPV of 62.5%, and NPV of 69.2%. Conclusions Diffusion-weighted MRI could be a potential predictive biomarker for therapeutic response of HNSCC to CRT. Primary tumors with higher pretreatment mean ADC, and a smaller early intratreatment percentage increase of mean ADC would be more likely to fail treatment. |
| first_indexed | 2024-12-13T14:23:59Z |
| format | Article |
| id | doaj.art-6f74ff67084e4d8ab7daa386d2dff8c6 |
| institution | Directory Open Access Journal |
| issn | 2090-4762 |
| language | English |
| last_indexed | 2024-12-13T14:23:59Z |
| publishDate | 2020-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-6f74ff67084e4d8ab7daa386d2dff8c62022-12-21T23:41:59ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622020-10-0151111410.1186/s43055-020-00323-xDiffusion-weighted magnetic resonance imaging (DWMRI) of head and neck squamous cell carcinoma: could it be an imaging biomarker for prediction of response to chemoradiation therapyHanan Mohamed Khattab0Moataz Mohamed Montasser1Mohamed Eid2Alaa Kandil3Salah El-Din Desouky4Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Alexandria UniversityDepartment of Diagnostic and Interventional Radiology, Faculty of Medicine, Alexandria UniversityDepartment of Diagnostic and Interventional Radiology, Faculty of Medicine, Alexandria UniversityDepartment of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Alexandria UniversityDepartment of Diagnostic and Interventional Radiology, Faculty of Medicine, Alexandria UniversityAbstract Background Chemoradiation therapy (CRT) has become a primary definitive treatment modality for head and neck squamous cell carcinoma (HNSCC); however, not all patients respond completely to treatment. Ability to identify those patients, who would not achieve complete response, before or early during the course of CRT will allow treatment modifications to improve outcome and overall survival. The aim of this prospective study was to assess the usefulness of diffusion-weighted imaging (DWI) in prediction of early therapeutic response of HNSCC after CRT. Results Local control was achieved in 22 patients out of 46 patients with pathologically proven HNSCC treated by chemoradiation therapy and local failure was detected in 24 patients out of 46 patients. Pretreatment mean apparent diffusion coefficient (ADCpre) was significantly higher in local failure group (1.1 ± 0.2 × 10−3 mm2/s) than local control group (0.89 ± 0.1 × 10−3 mm2/s). An optimal cut-off value of more than 0.94 × 10−3 mm2/s was predictive of local failure with sensitivity 83.33%, specificity 59.9%, PPV 69%, NPV 76.5%. Early intra-treatment percentage change of ADC (ΔADC) was significantly lower in local failure group (21.8% ± 21.3) than in local control group (45.2% ± 27.8). An optimal cut-off value of ≤ 33% was predictive of local failure after CRT with sensitivity of 71.34%, specificity of 60%, PPV of 62.5%, and NPV of 69.2%. Conclusions Diffusion-weighted MRI could be a potential predictive biomarker for therapeutic response of HNSCC to CRT. Primary tumors with higher pretreatment mean ADC, and a smaller early intratreatment percentage increase of mean ADC would be more likely to fail treatment.http://link.springer.com/article/10.1186/s43055-020-00323-xHead and neck squamous cell carcinomaDiffusion-weighted MRIChemoradiation therapy |
| spellingShingle | Hanan Mohamed Khattab Moataz Mohamed Montasser Mohamed Eid Alaa Kandil Salah El-Din Desouky Diffusion-weighted magnetic resonance imaging (DWMRI) of head and neck squamous cell carcinoma: could it be an imaging biomarker for prediction of response to chemoradiation therapy The Egyptian Journal of Radiology and Nuclear Medicine Head and neck squamous cell carcinoma Diffusion-weighted MRI Chemoradiation therapy |
| title | Diffusion-weighted magnetic resonance imaging (DWMRI) of head and neck squamous cell carcinoma: could it be an imaging biomarker for prediction of response to chemoradiation therapy |
| title_full | Diffusion-weighted magnetic resonance imaging (DWMRI) of head and neck squamous cell carcinoma: could it be an imaging biomarker for prediction of response to chemoradiation therapy |
| title_fullStr | Diffusion-weighted magnetic resonance imaging (DWMRI) of head and neck squamous cell carcinoma: could it be an imaging biomarker for prediction of response to chemoradiation therapy |
| title_full_unstemmed | Diffusion-weighted magnetic resonance imaging (DWMRI) of head and neck squamous cell carcinoma: could it be an imaging biomarker for prediction of response to chemoradiation therapy |
| title_short | Diffusion-weighted magnetic resonance imaging (DWMRI) of head and neck squamous cell carcinoma: could it be an imaging biomarker for prediction of response to chemoradiation therapy |
| title_sort | diffusion weighted magnetic resonance imaging dwmri of head and neck squamous cell carcinoma could it be an imaging biomarker for prediction of response to chemoradiation therapy |
| topic | Head and neck squamous cell carcinoma Diffusion-weighted MRI Chemoradiation therapy |
| url | http://link.springer.com/article/10.1186/s43055-020-00323-x |
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