Intravoxel incoherent motion diffusion-weighted MRI during chemoradiation therapy to characterize and monitor treatment response in human papillomavirus head and neck squamous cell carcinoma Journal Article
| Authors: | Paudyal, R.; Oh, J. H.; Riaz, N.; Venigalla, P.; Li, J.; Hatzoglou, V.; Leeman, J.; Nunez, D. A.; Lu, Y.; Deasy, J. O.; Lee, N.; Shukla-Dave, A. |
| Article Title: | Intravoxel incoherent motion diffusion-weighted MRI during chemoradiation therapy to characterize and monitor treatment response in human papillomavirus head and neck squamous cell carcinoma |
| Abstract: | Purpose: Characterize and monitor treatment response in human papillomavirus (HPV) head and neck squamous cell carcinoma (HNSCC) using intra-treatment (intra-TX) imaging metrics derived from intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (DW-MRI). Materials and Methods: Thirty-four (30 HPV positive [+] and 4 HPV negative [-]) HNSCC patients underwent a total of 136 MRI including multi-b value DW-MRI (pretreatment [pre-TX] and intra-TX weeks 1, 2, and 3) at 3.0 Tesla. All patients were treated with chemo-radiation therapy. Monoexponential (yielding apparent diffusion coefficient [ADC]) and bi-exponential (yielding perfusion fraction [f], diffusion [D], and pseudo-diffusion [D*] coefficients) fits were performed on a region of interest and voxel-by-voxel basis, on metastatic neck nodes. Response was assessed using RECISTv1.1. The relative percentage change in D, f, and D* between the pre- and intra-TX weeks were used for hierarchical clustering. A Wilcoxon rank-sum test was performed to assess the difference in metrics within and between the complete response (CR) and non-CR groups. Results: The delta (Δ) change in volume (V)1wk-0wk for the CR group differed significantly (P = 0.016) from the non-CR group, while not for V2wk-0wk and V3wk-0wk (P > 0.05). The mean increase in ΔD3wk-0wk for the CR group was significantly higher (P = 0.017) than the non-CR group. ADC and D showed an increasing trend at each intra-TX week when compared with pre-TX in CR group (P < 0.003). Hierarchical clustering demonstrated the existence of clusters in HPV + patients. Conclusion: After appropriate validation in a larger population, these IVIM imaging metrics may be useful for individualized treatment in HNSCC patients. Level of Evidence: 2. J. Magn. Reson. Imaging 2017;45:1013–1023. © 2016 The Authors Journal of Magnetic Resonance Imaging published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine |
| Keywords: | head and neck squamous cell carcinoma; human papillomavirus; intravoxel incoherent motion; multi b-value diffusion-weighted mri |
| Journal Title: | Journal of Magnetic Resonance Imaging |
| Volume: | 45 |
| Issue: | 4 |
| ISSN: | 1053-1807 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2017-04-01 |
| Start Page: | 1013 |
| End Page: | 1023 |
| Language: | English |
| DOI: | 10.1002/jmri.25523 |
| PROVIDER: | scopus |
| PUBMED: | 27862553 |
| PMCID: | PMC5363344 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 April 2017 -- Source: Scopus |
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