Diffusion Weighted Imaging in Predicting Progression Free Survival in Patients with Squamous Cell Carcinomas of the Head and Neck Treated with Induction Chemotherapy

Rationale and Objectives: The aim of this study was to assess the role of diffusion-weighted imaging in predicting progression-free survival in patients with head and neck squamous cell carcinoma (HNSCC) treated with induction chemotherapy. Materials and Methods: Eighteen patients with HNSCC underwent diffusion-weighted imaging studies prior to treatment and within 3 weeks after completion of induction chemotherapy. Median apparent diffusion coefficient (ADC) values were computed from the largest cervical metastatic lymph node. Percentage changes in ADC values from pretreatment to posttreatment time points were compared between alive and dead patients using the Mann-Whitney U test. P values < .05 were considered statistically significant. Results: A 22% increase in ADC was observed after induction chemotherapy in alive patients (n = 15), while patients who died from HNSCC (n = 3) demonstrated a 33% decrease in ADC. The difference in percentage change in ADC between alive and dead patients was significant (P = .039). Conclusions: ADC may be a useful marker in predicting progression-free survival in patients with HNSCC undergoing induction chemotherapy.