Prognostic Value of Apparent Diffusion Coefficient in Oropharyngeal Carcinoma

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Sistonen , H J , Aro , K , Atula , T , Jouhi , L , Linden , R , Tapiovaara , L , Loimu , V & Markkola , A 2021 , ' Prognostic Value of Apparent Diffusion Coefficient in Oropharyngeal Carcinoma ' , Clinical Neuroradiology , vol. 31 , no. 4 , pp. 1037-1048 .

Title: Prognostic Value of Apparent Diffusion Coefficient in Oropharyngeal Carcinoma
Author: Sistonen, Heli J.; Aro, Katri; Atula, Timo; Jouhi, Lauri; Linden, Riikka; Tapiovaara, Laura; Loimu, Venla; Markkola, Antti
Contributor organization: Department of Diagnostics and Therapeutics
University of Helsinki
Helsinki University Hospital Area
HUS Head and Neck Center
Korva-, nenä- ja kurkkutautien klinikka
University Management
Department of Ophthalmology and Otorhinolaryngology
HUS Medical Imaging Center
HUS Comprehensive Cancer Center
Department of Oncology
Date: 2021-12
Language: eng
Number of pages: 12
Belongs to series: Clinical Neuroradiology
ISSN: 1869-1439
Abstract: Purpose To investigate clinical and radiological factors predicting worse outcome after (chemo)radiotherapy ([C]RT) in oropharyngeal squamous cell carcinoma (OPSCC) with a focus on apparent diffusion coefficient (ADC). Methods This retrospective study included 67 OPSCC patients, treated with (C)RT with curative intent and diagnosed during 2013-2017. Human papilloma virus (HPV) association was detected with p16 immunohistochemistry. Of all 67 tumors, 55 were p16 positive, 9 were p16 negative, and in 3 the p16 status was unknown. Median follow-up time was 38 months. We analyzed pretreatment magnetic resonance imaging (MRI) for factors predicting disease-free survival (DFS) and locoregional recurrence (LRR), including primary tumor volume and the largest metastasis. Crude and p16-adjusted hazard ratios were analyzed using Cox proportional hazards model. Interobserver agreement was evaluated. Results Disease recurred in 13 (19.4%) patients. High ADC predicted poor DFS, but not when the analysis was adjusted for p16. A break in RT (hazard ratio, HR = 3.972, 95% confidence interval, CI 1.445-10.917, p = 0.007) and larger metastasis volume (HR = 1.041, 95% CI 1.007-1.077, p = 0.019) were associated with worse DFS. A primary tumor larger than 7 cm(3) was associated with increased LRR rate (HR = 4.861, 1.042-22.667, p = 0.044). Among p16-positive tumors, mean ADC was lower in grade 3 tumors compared to lower grade tumors (0.736 vs. 0.883; p = 0.003). Conclusion Low tumor ADC seems to be related to p16 positivity and therefore should not be used independently to evaluate disease prognosis or to choose patients for treatment deintensification.
Subject: Human papilloma virus
Magnetic resonance imaging
Diffusion weighted imaging
Tumor volume
3112 Neurosciences
3124 Neurology and psychiatry
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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