Prediction of treatment response in head and neck carcinomas using IVIM-DWI: Evaluation of lymph node metastasis
Prediction of treatment response in head and neck carcinomas using IVIM-DWI: Evaluation of lymph node metastasis
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DOI：
10.1016/j.ejrad.2014.02.013
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发表时间：
2014-05-01
影响因子：
3.3
通讯作者：
Stieltjes, Bram
中科院分区：
文献类型：
--
作者：
Hauser, Thomas;Essig, Marco;Stieltjes, Bram
目的：目的：应用体素内非相干运动（IVIM）成像技术获得头颈部鳞状细胞癌（HNSCC）淋巴结转移灶的弥散和微灌注参数。所获得的IVIM参数被用来表征淋巴结的分期阶段和纵向随访进行评估这些参数的潜在预测价值，考虑到therapeutic responsibility.Methods：15例淋巴结转移的组织学证实的局部晚期HNSCC进行了检查，使用扩散加权成像（DWI）前非手术器官保留治疗。在3 T下使用8个不同的b值（范围从0到800 s/mm）进行DWI成像（2）。使用IVIM方法，使用双指数拟合提取灌注分数f和扩散系数D。所有患者的随访期为13.5个月。1例肉眼可见淋巴结坏死的患者从分析中排除。所有患者均进行了感兴趣区域（ROI）分析。结果：15例患者中有3例在13.5个月的随访中出现局部失败（LRF）。LRF患者的初始f值（14.5 +/- 0.6% vs. 7.7 +/- 2.6%）显著高于局部区域对照（LRC）患者（p = 0.01）。初始扩散系数D没有显著差异（p = 0.30）两组之间（0.97 +/- 0.15 x 10（-3）mm（2）/s vs. 0.88 +/- 0.13 x 10（-3）mm（2）/s）。结论：我们的研究结果表明，淋巴结中较高的初始灌注分数f可能预示着HNSCC患者由于局部区域性肿瘤坏死而导致的不良治疗反应。失败(C)2014爱思唯尔爱尔兰有限公司版权所有。
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/mm(2). 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 x 10(-3) mm(2)/s vs. 0.88 +/- 0.13 x 10(-3) mm(2)/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. (C) 2014 Elsevier Ireland Ltd. All rights reserved.