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Peltenburg B, Driessen JP, Vasmel JE, Pameijer FA, Janssen LM, Terhaard CHJ, de Bree R, Philippens MEP. Pretreatment ADC is not a prognostic factor for local recurrences in head and neck squamous cell carcinoma when clinical T-stage is known. Eur Radiol 2019; 30:1228-1231. [PMID: 31529258 PMCID: PMC6957548 DOI: 10.1007/s00330-019-06426-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/26/2019] [Accepted: 08/14/2019] [Indexed: 11/24/2022]
Abstract
Objectives Pretreatment identification of radio-insensitive head and neck squamous cell carcinomas (HNSCC) would affect treatment modality selection. The apparent diffusion coefficient (ADC) of a tumor could be a predictor of local recurrence. However, little is known about its prognostic value next to known factors such as clinical T-stage. The aim of the present study is to determine the added value of pretreatment ADC to clinical T-stage as a prognostic factor for local recurrence. Methods This retrospective cohort study included 217 patients with HNSCC treated with (chemo)radiotherapy between April 2009 and December 2015. All patients underwent diffusion-weighted MRI prior to treatment. Median ADC values of all tumors were obtained using a semi-automatic delineation method. Univariate models containing ADC and T-stage were compared with a multivariable model containing both variables. Results Fifty-eight patients experienced a local recurrence within 3 years. On average, the ADC value in the group of patients with a recurrence was 1.01 versus 1.00 (10−3 mm2/s) in the group without a recurrence. Univariate analysis showed no significant association between tumor ADC and local recurrence within 3 years after (chemo)radiotherapy (p = 0.09). Cox regression showed that clinical T-stage was an independent predictor of local recurrence and adding ADC to the model did not increase its performance. Conclusion Pretreatment ADC has no added value as a prognostic factor for local recurrence to clinical T-stage. Key Points • Pretreatment identification of head and neck squamous cell carcinoma patients who do not benefit from (chemo)radiotherapy could improve personalized cancer care. • The apparent diffusion coefficient (ADC) obtained from diffusion-weighted MRI has been reported to be a prognostic factor for local recurrence. • In this study, ADC has no added value as a prognostic factor compared with clinical T-stage. Electronic supplementary material The online version of this article (10.1007/s00330-019-06426-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Boris Peltenburg
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. .,Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Juliette P Driessen
- Department of Otorhinolaryngology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jeanine E Vasmel
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Frank A Pameijer
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Luuk M Janssen
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Chris H J Terhaard
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marielle E P Philippens
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Driessen JP, Peltenburg B, Philippens MEP, Huijbregts JE, Pameijer FA, de Bree R, Janssen LM, Terhaard CHJ. Prospective comparative study of MRI including diffusion-weighted images versus FDG PET-CT for the detection of recurrent head and neck squamous cell carcinomas after (chemo)radiotherapy. Eur J Radiol 2018; 111:62-67. [PMID: 30691667 DOI: 10.1016/j.ejrad.2018.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/18/2018] [Accepted: 12/04/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This prospective study aims to test if MRI including diffusion weighted images can replace FDG PET-CT in the diagnosis of patients with suspicion of local recurrent head and neck squamous cell carcinomas after (chemo)radiation. METHODS Seventy-five patients suspected of local recurrence underwent a MRI and a FDG PET-CT. Qualitative assessment of the images was performed. Reference standard was the results of biopsy or the absence of a recurrence during follow up. RESULTS Seventy patients were included. Fifty percent had local recurrence. FDG PET-CT had accuracy of 71% compared to 73% for MRI. The sensitivity and specificity were 97% compared to 69% and 46% compared to 77% for FDG PET-CT and MRI respectively. CONCLUSIONS MRI showed similar diagnostic accuracy, superior specificity but inferior sensitivity compared to FDG PET-CT. Based on current results, we consider MRI including diffusion weighted sequences unable to replace FDG PET-CT as a single imaging modality when local recurrent disease of HNSCC after (C)RT is suspected.
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Affiliation(s)
- Juliette P Driessen
- Department of Otorhinolaryngology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Boris Peltenburg
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands.
| | | | - Julia E Huijbregts
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Frank A Pameijer
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Luuk M Janssen
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Chris H J Terhaard
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands
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Driessen JP, van Bemmel AJM, van Kempen PMW, Janssen LM, Terhaard CHJ, Pameijer FA, Willems SM, Stegeman I, Grolman W, Philippens MEP. Correlation of human papillomavirus status with apparent diffusion coefficient of diffusion-weighted MRI in head and neck squamous cell carcinomas. Head Neck 2015; 38 Suppl 1:E613-8. [PMID: 25783872 DOI: 10.1002/hed.24051] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 12/28/2014] [Accepted: 03/05/2015] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Identification of prognostic patient characteristics in head and neck squamous cell carcinoma (HNSCC) is of great importance. Human papillomavirus (HPV)-positive HNSCCs have favorable response to (chemo)radiotherapy. Apparent diffusion coefficient, derived from diffusion-weighted MRI, has also shown to predict treatment response. The purpose of this study was to evaluate the correlation between HPV status and apparent diffusion coefficient. METHODS Seventy-three patients with histologically proven HNSCC were retrospectively analyzed. Mean pretreatment apparent diffusion coefficient was calculated by delineation of total tumor volume on diffusion-weighted MRI. HPV status was analyzed and correlated to apparent diffusion coefficient. RESULTS Six HNSCCs were HPV-positive. HPV-positive HNSCC showed significantly lower apparent diffusion coefficient compared to HPV-negative. This correlation was independent of other patient characteristics. CONCLUSION In HNSCC, positive HPV status correlates with low mean apparent diffusion coefficient. The favorable prognostic value of low pretreatment apparent diffusion coefficient might be partially attributed to patients with a positive HPV status. © 2015 Wiley Periodicals, Inc. Head Neck 38: E613-E618, 2016.
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Affiliation(s)
- Juliette P Driessen
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands
| | - Alexander J M van Bemmel
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands
| | - Pauline M W van Kempen
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands
| | - Luuk M Janssen
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Chris H J Terhaard
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank A Pameijer
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stefan M Willems
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands
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Driessen JP, Caldas-Magalhaes J, Janssen LM, Pameijer FA, Kooij N, Terhaard CHJ, Grolman W, Philippens MEP. Diffusion-weighted MR imaging in laryngeal and hypopharyngeal carcinoma: association between apparent diffusion coefficient and histologic findings. Radiology 2014; 272:456-63. [PMID: 24749712 DOI: 10.1148/radiol.14131173] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To investigate the relationship between the histologic characteristics of head and neck squamous cell carcinoma and apparent diffusion coefficient (ADC) at diffusion-weighted magnetic resonance (MR) imaging. MATERIALS AND METHODS The institutional ethics committee approved this study and waived informed consent. In head and neck squamous cell carcinoma, local failure after chemotherapy and/or radiation therapy correlates with pretreatment ADC. However, the histopathologic basis of this correlation remains unclear. In this study, 16 patients with head and neck squamous cell carcinoma were enrolled (median age, 60 years; range, 49-78 years). Before undergoing total laryngectomy, patients underwent 1.5-T diffusion-weighted MR imaging. After resection, whole-mount hematoxylin-eosin-stained sections were registered to the MR images. Cellular density; nuclear, cytoplasmic, and stromal area; and nuclear-cytoplasmic ratio within the tumor were calculated by using image-based segmentation on four consecutive slices. Mean ADC of the corresponding tumor region was calculated. Spearman correlations between ADC and histologic characteristics were calculated. RESULTS ADC was significantly and inversely correlated with cell density (n = 16, r = -0.57, P = .02), nuclear area (n = 12, r = -0.64, P = .03), and nuclear-cytoplasmic ratio (n = 12, r = -0.77, P ≤ .01). ADC was significantly and positively correlated with percentage area of stroma (n = 12, r = 0.69, P = .01). Additionally, the percentage area of stroma was strongly interdependent with the percentage area of nuclei (n = 12, r = -0.97, P ≤ .01). CONCLUSION ADC was significantly correlated with cellularity, stromal component, and nuclear-cytoplasmic ratio. The positive correlation of ADC and stromal component suggests that the poor prognostic value of high pretreatment ADC might partly be attributed to the tumor-stroma component, a known predictor of local failure.
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Affiliation(s)
- Juliette P Driessen
- From the Department of Otorhinolaryngology-Head and Neck Surgery (J.P.D., L.M.J., W.G.), Rudolf Magnus Institute of Neuroscience (J.P.D., W.G.), Department of Radiotherapy (J.C.M., C.H.J.T., M.E.P.P.), Department of Radiology (F.A.P.), and Department of Pathology (N.K.), University Medical Center Utrecht, hp G05.129, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
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Driessen JP, van Kempen PMW, van der Heijden GJ, Philippens MEP, Pameijer FA, Stegeman I, Terhaard CHJ, Janssen LM, Grolman W. Diffusion-weighted imaging in head and neck squamous cell carcinomas: A systematic review. Head Neck 2014; 37:440-8. [DOI: 10.1002/hed.23575] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 11/17/2013] [Accepted: 12/10/2013] [Indexed: 12/24/2022] Open
Affiliation(s)
- Juliette P. Driessen
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
- Rudolf Magnus Institute of Neuroscience; Utrecht The Netherlands
| | - Paulina M. W. van Kempen
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
| | - Geert J. van der Heijden
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
- Julius Center for Health Sciences and Primary Care; University Medical Center Utrecht; Utrecht The Netherlands
| | | | - Frank A. Pameijer
- Department of Radiology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
- Rudolf Magnus Institute of Neuroscience; Utrecht The Netherlands
| | - Chris H. J. Terhaard
- Department of Radiotherapy; University Medical Center Utrecht; Utrecht The Netherlands
| | - Luuk M. Janssen
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
- Rudolf Magnus Institute of Neuroscience; Utrecht The Netherlands
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Driessen JP, Vuyk H, Borgstein J. New insights into facial anthropometry in digital photographs using iris dependent calibration. Int J Pediatr Otorhinolaryngol 2011; 75:579-84. [PMID: 21329992 DOI: 10.1016/j.ijporl.2011.01.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 01/17/2011] [Accepted: 01/18/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND In facial and reconstructive surgery objective assessment of anatomy is crucial to evaluate surgical results. Photographic computer-assisted anthropometry substitutes clinical measurements. The constancy of the horizontal iris diameter (IDh) allows iris dependent calibration of photographs, replacing the need for a scale. METHODS We performed a prospective cohort study to assess the constancy of the IDh in children. Frontal and close-up digital photographs of the eyes were taken of 100 children aged 5-18 years. The IDh was measured twice; once with a scale positioned on the forehead (IDh*(forehead)) and once with a scale positioned next to the tragus (IDh*(ear)). RESULTS Our data confirms the constancy of the IDh in children from the age of 5, with a mean IDh*(forehead) of 11.22 ± 0.52 mm. We found no difference between gender and no variation with age. For structures that are not in the same coronal plane as the iris, an adjusted iris diameter is needed to compensate for the difference in distance from the camera. CONCLUSION We confirm the reliability of iris dependent calibration in frontal photographs from the age of 5. This technique allows evaluation of a wide variety of pre-existing photographs that do not have a scale included, simplifies photographic conditions and facilitates long-term follow-up.
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Affiliation(s)
- Juliette P Driessen
- Department of Otolaryngology, Head and Neck surgery, Sophia Children's Hospital, Erasmus University Rotterdam, The Netherlands
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Aardema TG, Knops RM, Nijsten SP, Driessen JP, Beijerinck HC. Transverse diffusion in isotropic light slowing. Phys Rev Lett 1996; 76:748-751. [PMID: 10061540 DOI: 10.1103/physrevlett.76.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Driessen JP, Smith CJ, Leone SR. Alignment effects of ||J=3> states prepared by three-photon excitation: Sixfold symmetry in collisional energy transfer, Ca(4s4f,1F3)+He-->Ca(4p2,1S0)+He. Phys Rev A 1991; 44:R1431-R1434. [PMID: 9906199 DOI: 10.1103/physreva.44.r1431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Driessen JP, Somers LM, Beijerinck HC, Verhaar BJ. Autoionization widths for Ne*(3s)-Ar and Ne**(3p)-Ar collisions. Phys Rev A 1991; 44:167-185. [PMID: 9905667 DOI: 10.1103/physreva.44.167] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Driessen JP, Zonneveld MJ, Somers LM, Janssens MF, Beijerinck HC, Verhaar BJ. Polarization effects in the ionization cross section of Ar, Kr, and Xe by laser-excited Ne**. Phys Rev A 1990; 42:4058-4076. [PMID: 9904508 DOI: 10.1103/physreva.42.4058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Driessen JP, Zonneveld MJ, Somers LM, Janssens MF, Beijerinck HC, Verhaar BJ. Polarization effects in the ionization cross section for collisions of Ne. Phys Rev Lett 1989; 62:2369-2372. [PMID: 10039968 DOI: 10.1103/physrevlett.62.2369] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Manders MP, Driessen JP, Beijerinck HC, Verhaar BJ. Collision-induced intramultiplet mixing for Ne. Phys Rev A Gen Phys 1988; 37:3237-3253. [PMID: 9900067 DOI: 10.1103/physreva.37.3237] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Manders MP, Driessen JP, Beijerinck HC, Verhaar BJ. Polarization effects in collision-induced intramultiplet mixing for Ne. Phys Rev Lett 1986; 57:1577-1580. [PMID: 10033489 DOI: 10.1103/physrevlett.57.1577] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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