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      Predictive value of diffusion-weighted magnetic resonance imaging during chemoradiotherapy for head and neck squamous cell carcinoma.

      European Radiology

      Adult, Aged, Carcinoma, Squamous Cell, drug therapy, radiotherapy, Diffusion Magnetic Resonance Imaging, Female, Head and Neck Neoplasms, Humans, Male, Middle Aged, Predictive Value of Tests, Treatment Outcome, Tumor Burden

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          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.

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