Role of pretreatment diffusion-weighted magnetic resonance imaging-derived apparent diffusion coefficient (ADC) as predictive biomarker of response to radiotherapy in locally advanced head and neck cancer: Result of a prospective study
Aravind Padmanabhan, Radha Sarawagi Gupta, Vipin Kharade, Manish Gupta, Rajesh Pasricha, Saikat DasABSTRACT
Purpose:
Locoregional control is crucial for improving the outcome of head and neck squamous cell carcinoma (HNSCC). The present study evaluated the role of apparent diffusion coefficient (ADC) derived from diffusion-weighted magnetic resonance imaging as potential predictive biomarkers for assessing radiotherapy response in HNSCC.
Materials and Methods:
This prospective study included patients with HNSCC of nonnasopharyngeal sites who underwent definitive radiotherapy/chemoradiotherapy (n = 51). Pretreatment magnetic resonance imaging (MRI) was performed and ADC values were computed from diffusion-weighted images from the region of interest in the primary tumor and lymph node. Kaplan–Meier analysis was performed to assess the role of ADC on locoregional failure and overall survival. Cox proportional hazards model was used to estimate the hazard ratio (HR).
Results:
The mean pretreatment primary ADC of the cohort was 1046.73 ± 308.16 (range: 534–1924). The primary ADC value was significantly higher for patients who had a recurrence in the primary site compared to the nonrecurrence group (
Conclusion:
Higher pretreatment ADC values are associated with an increased risk of local recurrence, indicating their potential use in personalized radiotherapy treatment planning. Pretreatment ADC would be helpful in recurrence prediction, especially in resource-constrained or high-volume centers where repeat MRI for all patients may not be logistically feasible.