Relating pre-treatment non-Gaussian intravoxel incoherent motion diffusion-weighted imaging to human papillomavirus status and response in oropharyngeal carcinoma.

BACKGROUND AND PURPOSE

Diffusion-weighted imaging (DWI) is a promising technique for response assessment in head-and-neck cancer. Recently, we optimized Non-Gaussian Intravoxel Incoherent Motion Imaging (NG-IVIM), an extension of the conventional apparent diffusion coefficient () model, for the head and neck. In the current study, we describe the first application in a group of patients with human papillomavirus (HPV)-positive and HPV-negative oropharyngeal squamous cell carcinoma. The aim of this study was to relate and NG-IVIM DWI parameters to HPV status and clinical treatment response.

MATERIALS AND METHODS

Thirty-six patients (18 HPV-positive, 18 HPV-negative) were prospectively included. Presence of progressive disease was scored within one year. The mean pre-treatment and NG-IVIM parameters in the gross tumor volume were compared between HPV-positive and HPV-negative patients. In HPV-negative patients, and NG-IVIM parameters were compared between patients with and without progressive disease.

RESULTS

, the NG-IVIM diffusion coefficient , and perfusion fraction were significantly higher, while pseudo-diffusion coefficient and kurtosis were significantly lower in the HPV-negative compared to HPV-positive patients. In the HPV-negative group, a significantly lower was found for patients with progressive disease compared to complete responders. No relation with was observed.

CONCLUSION

The results of our single-center study suggest that is related to HPV status, but not an independent response predictor. The NG-IVIM parameter however, was independently associated to response in the HPV-negative group. Noteworthy in the opposite direction as previously thought based on .