Title: Diffusion-weighted MRI for nodal staging of head and neck squamous cell carcinoma: impact on radiotherapy planning
Authors: Dirix, Piet ×
Vandecaveye, Vincent
De Keyzer, Frederik
Op de beeck, Katya
Poorten, Vincent Vander
Delaere, Pierre
Verbeken, Eric
Hermans, Robert
Nuyts, Sandra #
Issue Date: Mar-2010
Publisher: Pergamon Press
Series Title: International Journal of Radiation Oncology, Biology, Physics vol:76 issue:3 pages:761-6
Abstract: PURPOSE: To evaluate the use of diffusion-weighted magnetic resonance imaging (DW-MRI) for nodal staging and its impact on radiotherapy (RT) planning. METHODS AND MATERIALS: Twenty-two patients with locally advanced head and neck squamous cell carcinoma underwent contrast-enhanced computed tomography (CT), as well as MRI (with routine and DW sequences) prior to neck dissection. After topographic correlation, lymph nodes were evaluated microscopically with prekeratin immunostaining. Pathology results were correlated with imaging findings and an RT planning study was performed for these surgically treated patients. One set of target volumes was based on conventional imaging only, and another set was based on the corresponding DW-MRI images. A third reference set was contoured based solely on pathology results. RESULTS: A sensitivity of 89% and a specificity of 97% per lymph node were found for DW-MRI. Nodal staging agreement between imaging and pathology was significantly stronger for DW-MRI (kappa = 0.97; 95% confidence interval [CI], 0.84-1.00) than for conventional imaging (kappa = 0.56; 95% CI, 0.16-0.96; p = 0.019, by McNemar's test). For both imaging modalities, the absolute differences between RT volumes and those obtained by pathology were calculated. Using an exact paired Wilcoxon test, the observed difference was significantly larger for conventional imaging than for DW-MRI for nodal gross tumor volume (p = 0.0013), as well as for nodal clinical target volume (p = 0.0415) delineation. CONCLUSIONS: These results suggest that DW-MRI is superior to conventional imaging for preradiotherapy nodal staging of head and neck squamous cell carcinoma, and provides a potential impact on organsparing and tumor control.
ISSN: 0360-3016
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Research Group Experimental Oto-rhino-laryngology
Translational Cell & Tissue Research
Laboratory of Experimental Radiotherapy
Laboratory of Experimental Transplantation
Translational MRI (+)
× corresponding author
# (joint) last author

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