Prediction of treatment response in head and neck carcinomas using IVIM-DWI: Evaluation of lymph node metastasis

• Published in: European journal of radiology 2014-05, Vol.83 (5), p.783-787
• Main Authors: Hauser, Thomas, Essig, Marco, Jensen, Alexandra, Laun, Frederik B, Münter, Marc, Maier-Hein, Klaus H, Stieltjes, Bram
• Format: Article
• Language: English
• Subjects: Adult; Aged; Algorithms; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - therapy; Diffusion weighted imaging; Female; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - secondary; Head and Neck Neoplasms - therapy; Head and neck squamous cell carinoma; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Intravoxel incoherent motion; Lymph node metastsis; Lymph Nodes - pathology; Lymphatic Metastasis; Magnetic Resonance Imaging - methods; Male; Middle Aged; Neovascularization, Pathologic - pathology; Neovascularization, Pathologic - therapy; Perfusion fraction; Prognosis; Radiology; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Squamous Cell Carcinoma of Head and Neck; Treatment Outcome; Treatment response
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2014.02.013

Abstract Purpose To obtain diffusion and microperfusion measures in lymph node metastases of head and neck squamous cell carcinomas (HNSCC) using intravoxel incoherent motion (IVIM) imaging. The obtained IVIM parameters were used to characterize lymph nodes in the staging phase and longitudinal follow-up was performed to evaluate the potential predictive value of these parameters considering therapy response. Methods Fifteen patients with lymph node metastases of histologically confirmed locally advanced HNSCC were examined using diffusion weighted imaging (DWI) before a nonsurgical organ preserving therapy. DWI imaging was performed at 3 T using eight different b -values ranging from 0 to 800 s/mm2 . Using the IVIM-approach, the perfusion fraction f and the diffusion coefficient D were extracted using a biexponential fit. A follow-up period of 13.5 months was available for all patients. One patient with a macroscopically necrotic lymph node was excluded from analyses. A region of interest (ROI)-analysis was performed in all patients. Results Locoregional failure (LRF) was present in 3 of 15 patients within 13.5 months follow-up. The initial f -value was significantly higher ( p = 0.01) in patients with LRF (14.5 ± 0.6% vs. 7.7 ± 2.6%) compared to patients with locoregional control (LRC). The initial diffusion coefficient D did not differ significantly ( p = 0.30) between the two groups (0.97 ± 0.15 × 10−3 mm2 /s vs. 0.88 ± 0.13 × 10−3 mm2 /s). Conclusions Our results indicate that a high initial perfusion fraction f in lymph nodes may predict poor treatment response in patients with HNSCC due to locoregional failure.