XXXX of the Head and Neck: Comparison of Diffusion-weighted MRI at b-values of 1,000 and 2,000 s/mm(2) to Predict Response to Induction Chemotherapy.

@entity1 @entity957 @entity5 @entity213
PURPOSE: Recent publications have reported contradictory results of pretreatment diffusion-weighted magnetic resonance imaging (DWI) for the prediction of chemoradiotherapeutic response in primary @entity957 of the head and neck ( @entity213 ). Therefore, we evaluated the diagnostic performance of DWI obtained with both standard (b = 0 and 1,000 s/mm(2)) and high (b = 0 and 2,000 s/mm(2)) b-values for predicting response to induction chemotherapy in HNSCCs. METHODS: For 25 @entity1 with primary @entity213 who underwent DWI with both standard and high b-values prior to treatment, we calculated corresponding apparent diffusion coefficient (ADC) maps. Regions of interest containing the @entity5 were drawn on every section of ADC maps and summated to make volume-based data of the entire @entity5 . Histogram parameters (mean ADC, kurtosis, and skewness) were correlated with treatment response using unpaired Student t test. Univariate and multivariate analysis of the ADC parameters, @entity1 age, sex, whole @entity5 volume, and T stage were also performed to predict @entity5 response to induction chemotherapy. RESULTS: Response to induction chemotherapy was good in 13 of the 25 @entity1 and poor in 12. The mean ADC values of good responders at standard b-value (ADC1000), 1.23    0.34 (* 10(-3) mm(2)/s), and high b-value (ADC2000), 0.62    0.14 (* 10(-3) mm(2)/s), were lower than those of poor responders (ADC1000, 1.32    0.28 [* 10(-3) mm(2)/s]; ADC2000, 0.76    0.15 [* 10(-3) mm(2)/s]), but significant difference was achieved only at the ADC2000 map (P = 0.02). In addition, mean @entity5 volume prior to treatment of good responders was smaller than that of poor responders. However, at multiple logistic regression analysis, only the mean ADC2000 value remained as a significant predictor of response to induction chemotherapy. CONCLUSION: DWI with high b-values (b = 0 and 2,000 s/mm(2)) as an assessment of ADC values may help predict @entity5 response to neoadjuvant chemotherapy for primary HNSCCs.
