Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
Eur Radiol. 2010 Jul;20(7):1703-14. doi: 10.1007/s00330-010-1734-6. Epub 2010 Feb 24.
To evaluate diffusion-weighted (DWI) magnetic resonance imaging (MRI) for treatment prediction during chemoradiotherapy (CRT) of head and neck squamous cell carcinoma (HNC).
Thirty patients with HNC underwent echo-planar DWI and anatomical MRI before and 2 and 4 weeks into CRT. Patient follow-up lasted 2 years post-CRT. Tumour ADC (DeltaADC) and volume changes (DeltaV) between baseline, and 2 and 4 weeks' follow-up were compared for lesions with recurrence versus complete remission (CR) using a Mann-Whitney U test. The predictive value of the DeltaADC and DeltaV for locoregional control (LRC) was examined with the Kaplan-Meier method. The study was approved by the local ethics committee. All patients gave written informed consent.
The DeltaADC in primary tumours and nodal metastases, 2 and 4 weeks after the start of CRT, was significantly lower in lesions with post-CRT recurrence than in lesions with CR (DeltaADC(2 weeks) and DeltaADC(4 weeks) for primary tumours, relative to nodal metastases: p < 0.0001). The DeltaV only showed a significant difference for primary tumours at 2 weeks (DeltaV(2 weeks): p = 0.03). The DeltaADC correlated significantly with 2-year LRC (p < 0.001); the DeltaV did not (p > 0.05).
DWI during CRT for HNC allows more accurate response prediction than anatomical imaging, correlating significantly with 2-year LRC.
评估弥散加权（DWI）磁共振成像（MRI）对头颈部鳞状细胞癌（HNC）放化疗期间的治疗预测作用。
30 例 HNC 患者在放化疗前及 2 周和 4 周时进行了 echo-planar DWI 和解剖学 MRI。患者的随访时间为放化疗后 2 年。采用 Mann-Whitney U 检验比较复发与完全缓解（CR）患者的基线、2 周和 4 周时的肿瘤 ADC（DeltaADC）和体积变化（DeltaV）。用 Kaplan-Meier 法检验 DeltaADC 和 DeltaV 对局部区域控制（LRC）的预测价值。本研究经当地伦理委员会批准，所有患者均签署了书面知情同意书。
放化疗开始后 2 周和 4 周时，原发灶和淋巴结转移灶的 DeltaADC 在复发组明显低于 CR 组（原发灶的 DeltaADC（2 周）和 DeltaADC（4 周），相对于淋巴结转移灶：p < 0.0001）。DeltaV 仅在 2 周时原发灶有显著差异（DeltaV（2 周）：p = 0.03）。DeltaADC 与 2 年 LRC 显著相关（p < 0.001）；DeltaV 无相关性（p > 0.05）。
HNC 放化疗期间的 DWI 比解剖学成像能更准确地预测反应，与 2 年 LRC 显著相关。
