Abstract
BACKGROUND AND PURPOSE: Differentiating recurrence from benign posttreatment changes has clinical importance in the imaging follow-up of head and neck cancer. This study aimed to investigate the utility of normalized dynamic contrast-enhanced MR imaging and ADC for their differentiation.
MATERIALS AND METHODS: This study included 51 patients with a history of head and neck cancer who underwent follow-up dynamic contrast-enhanced MR imaging with DWI-ADC, of whom 25 had recurrences and 26 had benign posttreatment changes. Quantitative and semiquantitative dynamic contrast-enhanced MR imaging parameters and ADC of the ROI and reference region were analyzed. Normalized dynamic contrast-enhanced MR imaging parameters and normalized DWI-ADC parameters were calculated by dividing the ROI by the reference region.
RESULTS: Normalized plasma volume, volume transfer constant between extravascular extracellular space and blood plasma per minute (Ktrans), area under the curve, and wash-in were significantly higher in patients with recurrence than in those with benign posttreatment change (P = .003 to <.001). The normalized mean ADC was significantly lower in patients with recurrence than in those with benign posttreatment change (P < .001). The area under the receiver operating characteristic curve of the combination of normalized dynamic contrast-enhanced MR imaging parameters with significance (normalized plasma volume, normalized extravascular extracellular space volume per unit tissue volume, normalized Ktrans, normalized area under the curve, and normalized wash-in) and normalized mean ADC was 0.97 (95% CI, 0.93–1).
CONCLUSIONS: Normalized dynamic contrast-enhanced MR imaging parameters, normalized mean ADC, and their combination were effective in differentiating recurrence and benign posttreatment changes in head and neck cancer.
ABBREVIATIONS:
- AUC
- area under the curve
- AUROCC
- area under the receiver operating characteristic curve
- DCE
- dynamic contrast-enhanced
- EES
- extravascular extracellular space
- Kep
- rate transfer constant between EES and blood plasma per minute
- Ktrans
- volume transfer constant between extravascular extracellular space and blood plasma per minute
- n-
- normalized
- Ve
- extravascular extracellular space volume per unit tissue volume
- Vp
- plasma volume
- WI
- wash-in
- WO
- washout
Footnotes
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- © 2022 by American Journal of Neuroradiology