Changes in Apparent Diffusion Coefficient (ADC) in Serial Weekly MRI during Radiotherapy in Patients with Head and Neck Cancer: Results from the PREDICT-HN Study

Authors

Sweet Ping Ng
Carlos E Cardenas
Houda Bahig
Baher Elgohari
Jihong Wang
Jason M Johnson
Amy C Moreno
Shalin J Shah
Adam S Garden
Jack Phan
G Brandon Gunn
Steven J Frank
Yao Ding
Lumine Na
Ying Yuan
Diana Urbauer
Abdallah S R Mohamed
David I Rosenthal
William H Morrison
Michael P MacManus
Clifton D Fuller

Publication Date

8-31-2022

Journal

Current Oncology

Abstract

Background: The PREDICT-HN study aimed to systematically assess the kinetics of imaging MR biomarkers during head and neck radiotherapy.

Methods: Patients with intact squamous cell carcinoma of the head and neck were enrolled. Pre-, during, and post-treatment MRI were obtained. Serial GTV and ADC measurements were recorded. The correlation between each feature and the GTV was calculated using Spearman’s correlation coefficient. The linear mixed model was used to evaluate the change in GTV over time.

Results: A total of 41 patients completed the study. The majority (76%) had oropharyngeal cancer. A total of 36 patients had intact primary tumours that can be assessed on MRI, and 31 patients had nodal disease with 46 nodes assessed. Median primary GTV (GTVp) size was 14.1cc. The rate of GTVp shrinkage was highest between pre-treatment and week 4. Patients with T3-T4 tumours had a 3.8-fold decrease in GTVp compared to T1-T2 tumours. The ADC values correlated with residual GTVp. The median nodal volume (GTVn) was 12.4cc. No clinical features were found to correlate with GTVn reduction. The overall change in ADC for GTVn from pre-treatment was significant for 35th–95th percentiles in weeks 1–4 (p < 0.001).

Conclusion: A discrepancy in the trajectory of ADC between primary and nodal sites suggested that they exhibit different treatment responses and should be analysed separately in future studies.

Keywords

Biomarkers, Carcinoma, Squamous Cell, Diffusion Magnetic Resonance Imaging, Head and Neck Neoplasms, Humans, Magnetic Resonance Imaging, apparent diffusion coefficient, head and neck, radiotherapy, gross tumour volume

DOI

10.3390/curroncol29090495

PMID

36135064

PMCID

PMC9498049

PubMedCentral® Posted Date

8-31-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes