Detection of head and neck squamous cell carcinoma with diffusion weighted MRI after (chemo)radiotherapy: Correlation between radiologic and histopathologic findings

被引:194
作者
Vandecaveye, Vincent
De Keyzer, Frederik
Nuyts, Sandra
Deraedt, Karen
Dirix, Piet
Hamaekers, Pascal
Vander Poorten, Vincent
Delaere, Pierre
Hermans, Robert
机构
[1] Katholieke Univ Leuven Hosp, Dept Radiol, B-3000 Louvain, Belgium
[2] Katholieke Univ Leuven Hosp, Dept Radiat Oncol, B-3000 Louvain, Belgium
[3] Katholieke Univ Leuven Hosp, Dept Pathol, B-3000 Louvain, Belgium
[4] Katholieke Univ Leuven Hosp, Dept Otorhinolaryngol Head & Neck Surg, B-3000 Louvain, Belgium
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2007年 / 67卷 / 04期
关键词
diffusion weighted MRI; tumor recurrence; (chemo)radiotherapy; head and neck; cancer; POSITRON-EMISSION-TOMOGRAPHY; DEFINITIVE RADIATION-THERAPY; LARYNGEAL-CANCER; RADIOTHERAPY; DISSECTION; CHEMOTHERAPY; CHEMORADIATION; ONCOLOGY; SURGERY; BRAIN;
D O I
10.1016/j.ijrobp.2006.09.020
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To investigate the value of diffusion weighted magnetic resonance imaging (DW-MRI) in differentiating persistent or recurrent head and neck squamous cell carcinoma (HNSCC) from nontumoral postradiotherapeutic alterations. Methods and Materials: In 26 patients with suspicion of persistent or recurrent HNSCC, MRI of the head and neck was performed, including routine turbo spin-echo (TSE) sequences and an additional echo-planar DW-MRI sequence, using a large range of b-values (0-1000 s/mm(2)). Apparent diffusion coefficient (ADC) maps were calculated. In the suspect areas at the primary site and in the suspect lymph nodes, signal intensity was measured on the native b0 and b1000 images and ADC values were calculated for these tissues. The same was done for surrounding irradiated normal tissue. Imaging results were correlated to histopathology. Results: Signal intensity on native b0 images was significantly lower for HNSCC than for nontumoral postradiotherapeutic tissue (p < 0.0001), resulting in a sensitivity of 66.2%, specificity of 60.8%, and accuracy of 62.4%. Signal intensity on native b1000 images was significantly higher for HNSCC than for nontumoral tissue (p < 0.0001), resulting in a sensitivity of 71.6%, specificity of 71.3%, and accuracy of 71.4%. ADC values were significantly lower for HNSCC than for nontumoral tissue (p < 0.0001), resulting in a sensitivity of 94.6%, specificity of 95.9%, and accuracy of 95.5%. When compared with computed tomography, TSE-MRI and fluorodeoxyglucose-positron emission tomography, DW-MRI yielded fewer false-positive results in persistent primary site abnormalities and in persistent adenopathies, and aided in the detection of subcentimetric nodal metastases. Conclusions: Diffusion weighted-MRI accurately differentiates persistent or recurrent HNSCC from nontumoral tissue changes after (chemo)radiotherapy. (c) 2007 Elsevier Inc.
引用
收藏
页码:960 / 971
页数:12
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