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Characterization and therapy monitoring of head and neck carcinomas using diffusion-imaging-based intravoxel incoherent motion parameters—preliminary results

  • Head and Neck Radiology
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An EDITORIAL to this article was published on 21 April 2013

Abstract

Introduction

Using the intravoxel incoherent motion (IVIM) model, diffusion-related coefficient (D) and perfusion-related parameter (f) can be measured. Here, we used IVIM imaging to characterize squamous cell carcinomas of head and neck (HNSCC) and evaluated its application in follow-up after nonsurgical organ preserving therapy.

Methods

Twenty-two patients with locally advanced HNSCC (clinical stage III to IVb) were examined before treatment using eight different b values (b = 0, 50, 100, 150, 200, 250, 700, 800 s/mm2). All patients were followed for at least 7.5 months after conclusion of therapy. In 16 of these patients, follow-up MRI was available. Using the IVIM approach, f and D were extracted using a bi-exponential fit. For comparison, ADC maps were calculated.

Results

The initial values of f before therapy were located between 5.9 % and 12.9 % (mean: 9.4 ± 2.4 %) except for two outliers (f = 17.9 % and 18.2 %). These two patients exclusively displayed poor initial treatment response. Overall, high initial f (13.1 ± 4.1 % vs. 9.1 ± 2.4 %) and ADC (1.17 ± 0.08 × 10−3 mm2/s vs. 0.98 ± 0.19 × 10−3 mm2/s) were associated with poor short term outcome (n = 6) after 7.5 months follow-up. D values before treatment were 0.98 × 10−3 ± 0.18 mm2/s and ADC values were 1.03 × 10−3 ± 0.18 mm2/s. At follow-up, in all primary responders, D (69 ± 52 %), f (65 ± 46 %), and ADC (68 ± 49%) increased.

Conclusions

Our preliminary evaluation indicates that an initial high f may predict poor prognosis in HNSCC. In responders, a significant increase of all IVIM parameters after therapy was demonstrated.

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We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology (E010), German Cancer Research Center, Heidelberg, Germany

    Thomas Hauser, Marco Essig & Lars Gerigk

  2. Department of Neuroradiology, Friedrich-Alexander-University, Erlangen, Germany

    Marco Essig

  3. Department of Radiation Therapy, Ruprecht-Karls University, Heidelberg, Germany

    Alexandra Jensen & Marc Münter

  4. Department of Diagnostic Radiology, Ruprecht-Karls University, Heidelberg, Germany

    Lars Gerigk

  5. Quantitative imaging based disease characterization (E011), German Cancer Research Center, Heidelberg, Germany

    Frederik Bernd Laun & Bram Stieltjes

  6. Department of Medical Physics in Radiology (E020), German Cancer Research Center, Heidelberg, Germany

    Frederik Bernd Laun

  7. Department of Radiation Therapy, Katharinenhospital, Stuttgart, Germany

    Marc Münter

  8. Department of Software Development for Integrated Diagnostic and Therapy (SIDT), German Cancer Research Center, Heidelberg, Germany

    Dirk Simon

  9. E010 Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany

    Thomas Hauser

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Correspondence to Thomas Hauser.

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Hauser, T., Essig, M., Jensen, A. et al. Characterization and therapy monitoring of head and neck carcinomas using diffusion-imaging-based intravoxel incoherent motion parameters—preliminary results. Neuroradiology 55, 527–536 (2013). https://doi.org/10.1007/s00234-013-1154-9

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