Diffusion-weighted magnetic resonance imaging for predicting and detecting early response to chemoradiation therapy of squamous cell carcinomas of the head and neck.
Diffusion-weighted magnetic resonance imaging for predicting and detecting early response to chemoradiation therapy of squamous cell carcinomas of the head and neck.
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DOI：
10.1158/1078-0432.ccr-08-1287
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发表时间：
2009-02-01
期刊：
影响因子：
--
通讯作者：
Poptani H
中科院分区：
文献类型：
--
作者：
Kim S;Loevner L;Quon H;Sherman E;Weinstein G;Kilger A;Poptani H
本研究的目的是探讨表观扩散系数（ADC）用于预测和早期检测头颈部鳞状细胞癌（HNSCC）治疗反应的实用性。对40例新诊断的HNSCC患者在放化疗前、放化疗中和放化疗结束后进行弥散加权MRI研究。在排除7例数据不完整的患者后，对33例患者的数据进行了分析。完全缓解者治疗前ADC值（CR，1.04 ± 0.19 × 10−3 mm 2/s）显著低于部分缓解者（PR，1.35 ± 0.30 × 10−3 mm 2/s）（p < 0.05）。CR患者在治疗一周内观察到ADC显著增加（p < 0.01），其保持高水平直到治疗结束。放化疗后第1周，CR组ADC值较PR组明显增高（P < 0.01）。当治疗前ADC值用于预测治疗反应时，受试者工作特征曲线下面积（AUC）为0.80，敏感性为65%，特异性为86%。然而，放化疗第一周内ADC的变化导致AUC为0.88，预测治疗反应的灵敏度为86%，特异性为83%。这些结果表明，ADC值可作为预测和早期检测HNSCC对同步放化疗反应的指标。
The aim of this study was to investigate the utility of apparent diffusion coefficient (ADC) for prediction and early detection of treatment response in head and neck squamous cell carcinomas (HNSCC). Diffusion weighted MRI studies were performed on 40 patients with newly diagnosed HNSCC before, during, and after the end of chemoradiation therapy. Analysis was performed on data from 33 patients after exclusion of 7 patients that had incomplete data. Pre-treatment ADC value of complete responders (CR, 1.04 ± 0.19 × 10−3 mm2/s) was significantly lower (p < 0.05) than that from partial responders (PR, 1.35 ± 0.30 × 10−3 mm2/s). A significant increase in ADC was observed in CR patients within one week of treatment (p < 0.01), which remained high until the end of the treatment. The CR patients also showed significantly higher increase in ADC than the PR patients by the first week of chemoradiation (p < 0.01). When pre-treatment ADC value was used for predicting treatment response, the area under the receiver operating characteristics curve (AUC) was 0.80 with a sensitivity of 65% and a specificity of 86%. However, change in ADC within the first week of chemoradiation therapy resulted in an AUC of 0.88 with 86% sensitivity and 83% specificity for prediction of treatment response. These results suggest that ADC can be used as a marker for prediction and early detection of response to concurrent chemoradiation therapy in HNSCC.