Predictive value of diffusion-weighted imaging without and with including contrast-enhanced magnetic resonance imaging in image analysis of head and neck squamous cell carcinoma. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Noij, Daniel P.; Pouwels, Petra J.W.; Ljumanovic, Redina; Knol, Dirk L.; Doornaert, Patricia; de Bree, Remco; Castelijns, Jonas A.; de Graaf, Pim
• Is Part Of: European journal of radiology. Volume 84:Issue 1(2015)
• Page Start: 108
• Page End: 116
• Publication Date: 2015-01
• Subjects: Diffusion weighted imaging -- Head and neck neoplasms -- Magnetic resonance imaging -- Observer variation -- Prognosis; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2014.10.015
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Primary tumor volume and lymph node ADC1000 are predictors of survival. CE-T1WI does not improve the prognostic capacity of DWI. Using CE-T1WI for ROI placement results in lower interobserver agreement. Abstract: Objectives: To assess disease-free survival (DFS) in head and neck squamous cell carcinoma (HNSCC) treated with (chemo)radiotherapy ([C]RT). Methods: Pretreatment MR-images of 78 patients were retrospectively studied. Apparent diffusion coefficients (ADC) were calculated with two sets of two b -values: 0–750 s/mm 2 (ADC750 ) and 0–1000 s/mm 2 (ADC1000 ). One observer assessed tumor volume on T1-WI. Two independent observers assessed ADC-values of primary tumor and largest lymph node in two sessions (i.e. without and with including CE-T1WI in image analysis). Interobserver and intersession agreement were assessed with intraclass correlation coefficients (ICC) separately for ADC750 and ADC1000 . Lesion volumes and ADC-values were related to DFS using Cox regression analysis. Results: Median follow-up was 18 months. Interobserver ICC was better without than with CE-T1WI (primary tumor: 0.92 and 0.75–0.83, respectively; lymph node: 0.81–0.83 and 0.61–0.64, respectively). Intersession ICC ranged from 0.84 to 0.89. With CE-T1WI, mean ADC-values of primary tumor and lymph node were higher at both b -values than without CE-T1WI ( P < 0.001). Tumor volume (sensitivity: 73%; specificity: 57%) and lymph node ADC1000 (sensitivity: 71–79%; specificity: 77–79%) were independent significant predictors of DFS without and with including CE-T1WI ( P < 0.05). Conclusions: Pretreatment primary tumor volume and lymph node ADC1000 were significant independent predictors of DFS in HNSCC treated with (C)RT. DFS could be predicted from ADC-values acquired without and with including CE-T1WI in image analysis. The inclusion of CE-T1WI did not result in significant improvements in the predictive value of DWI. DWI without including CE-T1WI was highly reproducible.