Japanese Journal of Radiology

, Volume 32, Issue 2, pp 80–89 | Cite as

Apparent diffusion coefficient is a prognostic factor of head and neck squamous cell carcinoma treated with radiotherapy

  • Masamitsu Hatakenaka
  • Katsumasa Nakamura
  • Hidetake Yabuuchi
  • Yoshiyuki Shioyama
  • Yoshio Matsuo
  • Takeshi Kamitani
  • Masato Yonezawa
  • Takashi Yoshiura
  • Torahiko Nakashima
  • Mitsuru Mori
  • Hiroshi Honda
Original Article

Abstract

Purpose

To evaluate the correlation between apparent diffusion coefficient (ADC) and prognosis in head and neck squamous cell carcinoma (HNSCC) treated with radiotherapy.

Materials and methods

We retrospectively studied 41 patients (38 male and 3 female, ages 37–85 years) diagnosed with HNSCC (14 oropharynx, 22 hypopharynx, 4 larynx, 1 oral cavity) and treated with radiotherapy, with radiation dose to gross tumor volume over 60 Gy. The association between age, gender, performance status, tumor location, T stage, N stage, stage, dose, overall treatment time, treatment method, adjuvant therapy, or ADC and prognosis was analyzed using a Cox proportional hazard test.

Results

ADC calculated with b-values of 300, 500, 750, and 1,000 s/mm2 (ADC 300–1,000) alone showed a significant correlation with all of the analyses (p = 0.022 for local control, p = 0.0109 for regional control, p = 0.0041 for disease-free survival, and p = 0.0014 for overall survival). ADC calculated with b-values of 0, 100, and 200 s/mm2 (ADC 0–200) showed a significant correlation with overall survival (p = 0.0012). N stage showed a significant correlation with regional control (p = 0.0241). Performance status showed significant association with local control (p = 0.0459), disease-free survival (p = 0.023), and overall survival (p = 0.0151), respectively.

Conclusion

ADC is an independent predictor of prognosis in HNSCC treated with radiotherapy.

Keywords

Apparent diffusion coefficient Bystander effect Head and neck cancer Prognosis Radiotherapy 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer. 2001;94(2):153–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371(9625):1695–709.PubMedCrossRefGoogle Scholar
  3. 3.
    Tanner JE. Intracellular diffusion of water. Arch Biochem Biophys. 1983;224(2):416–28.PubMedCrossRefGoogle Scholar
  4. 4.
    Hatakenaka M, Matsuo Y, Setoguchi T, Yabuuchi H, Okafuji T, Kamitani T, et al. Alteration of proton diffusivity associated with passive muscle extension and contraction. J Magn Reson Imaging. 2008;27(4):932–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Mardor Y, Roth Y, Ochershvilli A, Spiegelmann R, Tichler T, Daniels D, et al. Pretreatment prediction of brain tumors’ response to radiation therapy using high b-value diffusion-weighted MRI. Neoplasia. 2004;6(2):136–42.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Higano S, Yun X, Kumabe T, Watanabe M, Mugikura S, Umetsu A, et al. Malignant astrocytic tumors: clinical importance of apparent diffusion coefficient in prediction of grade and prognosis. Radiology. 2006;241(3):839–46.PubMedCrossRefGoogle Scholar
  7. 7.
    Murakami R, Sugahara T, Nakamura H, Hirai T, Kitajima M, Hayashida Y, et al. Malignant supratentorial astrocytoma treated with postoperative radiation therapy: prognostic value of pretreatment quantitative diffusion-weighted MR imaging. Radiology. 2007;243(2):493–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Jingu K, Kishimoto R, Mizoe JE, Hasegawa A, Bessho H, Tsuji H, et al. Malignant mucosal melanoma treated with carbon ion radiotherapy with concurrent chemotherapy: prognostic value of pretreatment apparent diffusion coefficient (ADC). Radiother Oncol. 2011;98(1):68–73.PubMedCrossRefGoogle Scholar
  9. 9.
    Chenevert TL, Stegman LD, Taylor JM, Robertson PL, Greenberg HS, Rehemtulla A, et al. Diffusion magnetic resonance imaging: an early surrogate marker of therapeutic efficacy in brain tumors. J Natl Cancer Inst. 2000;92(24):2029–36.PubMedCrossRefGoogle Scholar
  10. 10.
    Hamstra DA, Chenevert TL, Moffat BA, Johnson TD, Meyer CR, Mukherji SK, et al. Evaluation of the functional diffusion map as an early biomarker of time-to-progression and overall survival in high-grade glioma. Proc Natl Acad Sci USA. 2005;102(46):16759–64.PubMedCrossRefGoogle Scholar
  11. 11.
    Koh DM, Scurr E, Collins D, Kanber B, Norman A, Leach MO, et al. Predicting response of colorectal hepatic metastasis: value of pretreatment apparent diffusion coefficients. Am J Roentgenol. 2007;188(4):1001–8.CrossRefGoogle Scholar
  12. 12.
    Mardor Y, Pfeffer R, Spiegelmann R, Roth Y, Maier SE, Nissim O, et al. Early detection of response to radiation therapy in patients with brain malignancies using conventional and high b-value diffusion-weighted magnetic resonance imaging. J Clin Oncol. 2003;21(6):1094–100.PubMedCrossRefGoogle Scholar
  13. 13.
    Moffat BA, Chenevert TL, Lawrence TS, Meyer CR, Johnson TD, Dong Q, et al. Functional diffusion map: a noninvasive MRI biomarker for early stratification of clinical brain tumor response. Proc Natl Acad Sci USA. 2005;102(15):5524–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Kato H, Kanematsu M, Tanaka O, Mizuta K, Aoki M, Shibata T, et al. Head and neck squamous cell carcinoma: usefulness of diffusion-weighted MR imaging in the prediction of a neoadjuvant therapeutic effect. Eur Radiol. 2009;19(1):103–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Kim S, Loevner L, Quon H, Sherman E, Weinstein G, Kilger A, et al. Diffusion-weighted magnetic resonance imaging for predicting and detecting early response to chemoradiation therapy of squamous cell carcinomas of the head and neck. Clin Cancer Res. 2009;15(3):986–94.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Galban CJ, Mukherji SK, Chenevert TL, Meyer CR, Hamstra DA, Bland PH, et al. A feasibility study of parametric response map analysis of diffusion-weighted magnetic resonance imaging scans of head and neck cancer patients for providing early detection of therapeutic efficacy. Transl Oncol. 2009;2(3):184–90.PubMedCentralPubMedGoogle Scholar
  17. 17.
    Hatakenaka M, Nakamura K, Yabuuchi H, Shioyama Y, Matsuo Y, Ohnishi K, et al. Pretreatment apparent diffusion coefficient of the primary lesion correlates with local failure in head-and-neck cancer treated with chemoradiotherapy or radiotherapy. Int J Radiat Oncol Biol Phys. 2011;81(2):339–45.PubMedCrossRefGoogle Scholar
  18. 18.
    Hatakenaka M, Shioyama Y, Nakamura K, Yabuuchi H, Matsuo Y, Sunami S, et al. Apparent diffusion coefficient calculated with relatively high b-values correlates with local failure of head and neck squamous cell carcinoma treated with radiotherapy. Am J Neuroradiol. 2011;32(10):1904–10.PubMedCrossRefGoogle Scholar
  19. 19.
    Vandecaveye V, Dirix P, De Keyzer F, Op de Beeck K, Vander Poorten V, Hauben E, et al. Diffusion-weighted magnetic resonance imaging early after chemoradiotherapy to monitor treatment response in head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2012;82(3):1098–107.PubMedCrossRefGoogle Scholar
  20. 20.
    Hauser T, Essig M, Jensen A, Gerigk L, Laun FB, Munter M, et al. Characterization and therapy monitoring of head and neck carcinomas using diffusion-imaging-based intravoxel incoherent motion parameters—preliminary results. Neuroradiology. 2013;55(5):527–36.PubMedCrossRefGoogle Scholar
  21. 21.
    Ohnishi K, Shioyama Y, Hatakenaka M, Nakamura K, Abe K, Yoshiura T, et al. Prediction of local failures with a combination of pretreatment tumor volume and apparent diffusion coefficient in patients treated with definitive radiotherapy for hypopharyngeal or oropharyngeal squamous cell carcinoma. J Radiat Res. 2011;52(4):522–30.PubMedCrossRefGoogle Scholar
  22. 22.
    Hatakenaka M, Shonai T, Aratani K, Onodera M, Nakamura K, Yabuuchi H, et al. The calculation method of ADC affects the correlation between prognosis and ADC (in Japanese). Jpn J Magn Reson Med. 2012;32(Supplement):327. http://www.jsmrm.jp/modules/en/index.php?content_id=1.Google Scholar
  23. 23.
    Hatakenaka M, Soeda H, Yabuuchi H, Matsuo Y, Kamitani T, Oda Y, et al. Apparent diffusion coefficients of breast tumors: clinical application. Magn Reson Med Sci. 2008;7(1):23–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Rzeszowska-Wolny J, Przybyszewski WM, Widel M. Ionizing radiation-induced bystander effects, potential targets for modulation of radiotherapy. Eur J Pharmacol. 2009;625(1–3):156–64.PubMedCrossRefGoogle Scholar
  25. 25.
    Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology. 1988;168(2):497–505.PubMedGoogle Scholar
  26. 26.
    Yamada I, Aung W, Himeno Y, Nakagawa T, Shibuya H. Diffusion coefficients in abdominal organs and hepatic lesions: evaluation with intravoxel incoherent motion echo-planar MR imaging. Radiology. 1999;210(3):617–23.PubMedCrossRefGoogle Scholar
  27. 27.
    Oppo K, Leen E, Angerson WJ, Cooke TG, McArdle CS. Doppler perfusion index: an interobserver and intraobserver reproducibility study. Radiology. 1998;208(2):453–7.PubMedGoogle Scholar
  28. 28.
    Bou-Assaly W, Srinivasan A, Mukherji SK. Head and neck high-field imaging: oncology applications. Neuroimaging Clin N Am. 2012;22(2):285–96 (xi).PubMedCrossRefGoogle Scholar

Copyright information

© Japan Radiological Society 2014

Authors and Affiliations

  • Masamitsu Hatakenaka
    • 1
  • Katsumasa Nakamura
    • 2
  • Hidetake Yabuuchi
    • 3
  • Yoshiyuki Shioyama
    • 4
  • Yoshio Matsuo
    • 2
  • Takeshi Kamitani
    • 2
  • Masato Yonezawa
    • 2
  • Takashi Yoshiura
    • 2
  • Torahiko Nakashima
    • 5
  • Mitsuru Mori
    • 6
  • Hiroshi Honda
    • 2
  1. 1.Department of Diagnostic Radiology, School of MedicineSapporo Medical UniversitySapporoJapan
  2. 2.Department of Clinical Radiology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  3. 3.Department of Health Sciences, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  4. 4.Department of Heavy Particle Therapy and Radiation Oncology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  5. 5.Department of Otorhinolaryngology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  6. 6.Department of Public Health, School of MedicineSapporo Medical UniversitySapporoJapan

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