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Intravoxel incoherent motion imaging kinetics during chemoradiotherapy for human papillomavirus-associated squamous cell carcinoma of the oropharynx: preliminary results from a prospective pilot study.

ABSTRACT: This study aims to identify the temporal kinetics of intravoxel incoherent motion (IVIM) MRI in patients with human papillomavirus-associated (HPV+) oropharyngeal squamous cell carcinoma. Patients were enrolled under an Institutional Review Board (IRB)-approved protocol as part of an ongoing prospective clinical trial. All patients underwent two MRI studies: a baseline scan before chemoradiotherapy and a mid-treatment scan 3-4 weeks after treatment initiation. Parametric maps representing pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f) and apparent diffusion coefficient (ADC) were generated. The Mann-Whitney U-test was used to assess the temporal variation of IVIM metrics. Bayesian quadratic discriminant analysis (QDA) was used to evaluate the extent to which mid-treatment changes in IVIM metrics could be combined to predict sites that would achieve complete response (CR) in multivariate analysis. Thirty-one patients were included in the final analysis with 59 lesions. Pretreatment ADC and D values of the CR lesions (n = 19) were significantly lower than those of non-CR lesions (n = 33). Mid-treatment ADC, D and f values were significantly higher (p < 0.0001) than pretreatment values for all lesions. Each increase in normalized ΔADC of size 0.1 yielded a 1.45-fold increase in the odds of CR (p < 0.0003), each increase in normalized ΔD of size 0.1 yielded a 1.53-fold increase in the odds of CR (p < 0.0002), and each unit increase in Δf yielded a 2.29-fold increase in the odds of CR (p < 0.02). Combined ΔD and ΔADC were integrated into a multivariate prediction model and attained an AUC of 0.87 (95% confidence interval: 0.79, 0.96), as well as a sensitivity of 0.63, specificity of 0.85 and accuracy of 0.78, under leave-one-out cross-validation. In conclusion, IVIM is feasible and potentially useful in the prediction and assessment of the early response of HPV+ oropharyngeal squamous cell carcinoma to chemoradiotherapy.

SUBMITTER: Ding Y

PROVIDER: S-EPMC4715635 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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Intravoxel incoherent motion imaging kinetics during chemoradiotherapy for human papillomavirus-associated squamous cell carcinoma of the oropharynx: preliminary results from a prospective pilot study.

Ding Yao Y Hazle John D JD Mohamed Abdallah S R AS Frank Steven J SJ Hobbs Brian P BP Colen Rivka R RR Gunn G Brandon GB Wang Jihong J Kalpathy-Cramer Jayashree J Garden Adam S AS Lai Stephen Y SY Rosenthal David I DI Fuller Clifton D CD

NMR in biomedicine 20151009 12

This study aims to identify the temporal kinetics of intravoxel incoherent motion (IVIM) MRI in patients with human papillomavirus-associated (HPV+) oropharyngeal squamous cell carcinoma. Patients were enrolled under an Institutional Review Board (IRB)-approved protocol as part of an ongoing prospective clinical trial. All patients underwent two MRI studies: a baseline scan before chemoradiotherapy and a mid-treatment scan 3-4 weeks after treatment initiation. Parametric maps representing pure d ...[more]

PMID: 26451969

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Project description:IntroductionThe intravoxel incoherent motion (IVIM) model of diffusion weighted imaging (DWI) provides imaging biomarkers for breast tumor characterization. It has been extensively applied for both diagnostic and prognostic goals in breast cancer, with increasing evidence supporting its clinical relevance. However, variable performance exists in literature owing to the heterogeneity in datasets and quantification methods.MethodsThis work used retrospective anonymized breast MRI data (302 patients) from three sites employing three different software utilizing least-squares segmented algorithms and Bayesian fit to estimate 1st order radiomics of IVIM parameters perfusion fraction (fp ), pseudo-diffusion (Dp ) and tissue diffusivity (Dt ). Pearson correlation (r) coefficients between software pairs were computed while logistic regression model was implemented to test malignancy detection and assess robustness of the IVIM metrics.ResultsDt and fp maps generated from different software showed consistency across platforms while Dp maps were variable. The average correlation between the three software pairs at three different sites for 1st order radiomics of IVIM parameters were Dtmin/Dtmax/Dtmean/Dtvariance/Dtskew/Dtkurt: 0.791/0.891/0.98/0.815/0.697/0.584; fpmax/fpmean/fpvariance/fpskew/fpkurt: 0.615/0.871/0.679/0.541/0.433; Dpmax/Dpmean/Dpvariance/Dpskew/Dpkurt: 0.616/0.56/0.587/0.454/0.51. Correlation between least-squares algorithms were the highest. Dtmean showed highest area under the ROC curve (AUC) with 0.85 and lowest coefficient of variation (CV) with 0.18% for benign and malignant differentiation using logistic regression. Dt metrics were highly diagnostic as well as consistent along with fp metrics.DiscussionMultiple 1st order radiomic features of Dt and fp obtained from a heterogeneous multi-site breast lesion dataset showed strong software robustness and/or diagnostic utility, supporting their potential consideration in controlled prospective clinical trials.

Dataset Information

Intravoxel incoherent motion imaging kinetics during chemoradiotherapy for human papillomavirus-associated squamous cell carcinoma of the oropharynx: preliminary results from a prospective pilot study.

Publications

Intravoxel incoherent motion imaging kinetics during chemoradiotherapy for human papillomavirus-associated squamous cell carcinoma of the oropharynx: preliminary results from a prospective pilot study.

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