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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleHead and Neck ImagingE
Open Access

Prediction of Response to Chemoradiation Therapy in Squamous Cell Carcinomas of the Head and Neck Using Dynamic Contrast-Enhanced MR Imaging

S. Kim, L.A. Loevner, H. Quon, A. Kilger, E. Sherman, G. Weinstein, A. Chalian and H. Poptani
American Journal of Neuroradiology February 2010, 31 (2) 262-268; DOI: https://doi.org/10.3174/ajnr.A1817
S. Kim
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L.A. Loevner
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H. Quon
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A. Kilger
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E. Sherman
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G. Weinstein
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A. Chalian
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H. Poptani
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    Fig 1.

    A, Representative regions of interest shown on a T1WI of the neck acquired 10 minutes after injection of the contrast agent. Regions of interest are drawn on a carotid artery (A) and a metastatic node (N). B, Mean time courses of estimated relaxation rates from the 2 regions of interest in A are plotted against time. Circles and crosses represent actual measurement data points from the selected artery and the node, with the lines connecting the points. Note the region of interest used for the node is only to demonstrate the typical enhancement pattern and temporal resolution of the data. The actual pharmacokinetic analysis was performed for each voxel.

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    Fig 2.

    Representative parametric maps of a CR patient who showed no viable tumor on pathology from the surgically removed nodes. The arrow on the T2WI image indicates the tumor node studied. The T2W, T1W, and CE images in the top row are windowed to have similar image contrast. The SSM parameter maps are shown by using overlaid color images on an area around the metastatic node indicated by the arrow in the T2WI. The background image of the color maps is a T1W CE image.

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    Fig 3.

    Scatterplots of volume and pharmacokinetic model parameters of 2 patient groups: CR (n = 24) and PR (n = 9). Individual parameters within each patient group are plotted in their own descending orders.

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    Fig 4.

    Comparison of patients scanned at 1.5T. There are 17 and 7 patients for the CR and PR groups, respectively. The bars represent the mean values and the error bars represent the standard errors. The asterisk represents a significant (P < .05, 2-tailed t test with unequal variance) difference from the CR mean value.

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    Fig 5.

    Comparison of pretreatment Ktrans values of the patients who received conventional chemotherapy (n = 17 and 7 for CR and PR, respectively) and those who received immunotherapy with an EGFR-targeting drug, cetuximab (n = 7 and 2 for CR and PR, respectively). The vertical bars represent the mean values, and the error bars represent the SDs.

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    Table 1:

    Patient information

    No.SexAge (yr)PrimaryTumor StagingInd. ChemoConc. ChemoSgPaRs6MFU
    1M31LarynxT4aN2bM0NoCPNCRNED
    2M72UnknownTxN2bM0CMNoNCRNED
    3F68TongueT4N2bM0NoCPNCRDM
    4M68TonsilT2N2bM0NoCPNCRNED
    5M70TonsilT4N1aM0NoCPNCRNED
    6M67TongueT4aN2cM0NoCPNCRNED
    7F79UnknownT4aN2bM0CMCM, CPNCRNED
    8M69LarynxT3N2cMXCP, DT, 5FUCMNCRNED
    9M72TongueT4N2cM0CP, DT, 5FUCMNCRNED
    10M67UnknownT0N2bM0CP, DT, 5FUCMNCRNED
    11M72TongueT2N2bM0NoCMNCRNED
    12M75TongueT4N2cM0TXTX, CPYNCRNED
    13M42TonsilT2N2bM0NoCPYNCRNED
    14F53TonsilTxN2bM0NoCPYNCRNED
    15M50TongueT2N2aM0CP, DT, 5FUCPYNCRNED
    16M59TongueT3N2cM0CP, DT, 5FUCPYNCRNED
    17M51TongueTxN2bM0CP, DT, 5FUCPYNCRDM
    18M55TonsilT3N2bM0CP, TXCPYNCRNED
    19F62TonsilT2N2cM0NoCPYNCRNED
    20M65UnknownTxN2bM0NoCPYNCRNED
    21M52TongueT1N2abM0CP, DT, 5FUCPYNCRNED
    22M59TongueT4N2bM0NoCPYNCRNED
    23M49TonsilT3N2aM0NoCMYNCRNED
    24M61TongueT3N2aM0CPCM, CPYNCRNED
    25M51EpiglottisT2N2cM0TXCPYPPRDM
    26M76TonsilTxN2bM0TXCP, TXYPPRDM
    27M77LarynxT2N2bM0NoCP, 5FUYPPRNED
    28M56LarynxT2N3M0NoCPYPPRDM
    29M64UnknownTxN3M0CP, DT, 5FUCPYPPRDM
    30M60TonsilT4N1M0NoCPYPPRNED
    31M63LarynxT2N2bM0CPCPYPPRDM
    32M45TongueT2N2aM0NoCM, CPYPPRDM
    33F48TonsilT4bN2bM0CP, DT, 5FUCM, CPNaPRRelapse
    • a Nodes were not removed because additional therapy was given due to disease progression.

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    Table 2:

    Comparison of pretreatment volume and pharmacokinetic parameters in HNSCCa

    GroupNo. of PatientsVolume (mL)Ktrans (min−1)veτI (s)
    CR2415.3 ± 3.20.64 ± 0.110.51 ± 0.040.21 ± 0.03
    PR927.5 ± 10.10.21 ± 0.050.48 ± 0.070.20 ± 0.04
    P valueb.276.001.721.760
    • a The reported values are mean and standard error.

    • b The P values were computed using a 2-tailed t test with unequal variance.

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American Journal of Neuroradiology: 31 (2)
American Journal of Neuroradiology
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Cite this article
S. Kim, L.A. Loevner, H. Quon, A. Kilger, E. Sherman, G. Weinstein, A. Chalian, H. Poptani
Prediction of Response to Chemoradiation Therapy in Squamous Cell Carcinomas of the Head and Neck Using Dynamic Contrast-Enhanced MR Imaging
American Journal of Neuroradiology Feb 2010, 31 (2) 262-268; DOI: 10.3174/ajnr.A1817

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Prediction of Response to Chemoradiation Therapy in Squamous Cell Carcinomas of the Head and Neck Using Dynamic Contrast-Enhanced MR Imaging
S. Kim, L.A. Loevner, H. Quon, A. Kilger, E. Sherman, G. Weinstein, A. Chalian, H. Poptani
American Journal of Neuroradiology Feb 2010, 31 (2) 262-268; DOI: 10.3174/ajnr.A1817
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  • Dynamic Contrast-Enhanced MRI-Derived Intracellular Water Lifetime ({tau}i): A Prognostic Marker for Patients with Head and Neck Squamous Cell Carcinomas
  • CT Texture Analysis Potentially Predicts Local Failure in Head and Neck Squamous Cell Carcinoma Treated with Chemoradiotherapy
  • Dynamic Contrast-Enhanced MR Imaging in Head and Neck Cancer: Techniques and Clinical Applications
  • Quantitative Diffusion-Weighted MRI Parameters and Human Papillomavirus Status in Oropharyngeal Squamous Cell Carcinoma
  • Neuroradiology Back to the Future: Head and Neck Imaging
  • Prospective Trial of Synchronous Bevacizumab, Erlotinib, and Concurrent Chemoradiation in Locally Advanced Head and Neck Cancer
  • Multiparametric MR Imaging of Sinonasal Diseases: Time-Signal Intensity Curve- and Apparent Diffusion Coefficient-Based Differentiation between Benign and Malignant Lesions
  • Prediction of Disease-Free Survival in Patients with Squamous Cell Carcinomas of the Head and Neck Using Dynamic Contrast-Enhanced MR Imaging
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