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Comparing Primary Tumors and Metastatic Nodes in Head and Neck Cancer Using Intravoxel Incoherent Motion Imaging: A Preliminary Experience

Lu, Yonggang PhD; Jansen, Jacobus F.A. PhD; Stambuk, Hilda E. MD; Gupta, Gaorav MD; Lee, Nancy MD; Gonen, Mithat PhD; Moreira, Andre MD; Mazaheri, Yousef PhD; Patel, Snehal G. MD; Deasy, Joseph O. PhD; Shah, Jatin P. MD; Shukla-Dave, Amita PhD

Journal of Computer Assisted Tomography: May/June 2013 - Volume 37 - Issue 3 - p 346–352
doi: 10.1097/RCT.0b013e318282d935

Objective This study aimed to use intravoxel incoherent motion (IVIM) imaging for investigating differences between primary head and neck tumors and nodal metastases and to evaluate IVIM efficacy in predicting outcome.

Methods Sixteen patients with head and neck cancer underwent IVIM diffusion-weighted imaging on a 1.5-T magnetic resonance imaging scanner. The significance of parametric difference between primary tumors and metastatic nodes were tested. Probabilities of progression-free survival and overall survival were estimated using the Kaplan-Meier method.

Results In comparison with metastatic nodes, the primary tumors had significantly higher vascular volume fraction (f) (P < 0.0009) and lower diffusion coefficient (D) (P < 0.0002). Patients with lower SD for D had prolonged progression-free survival and overall survival (P < 0.05).

Conclusions Pretreatment IVIM measures were feasible in investigating the physiologic differences between the 2 tumor tissues. After appropriate validation, these findings might be useful in optimizing treatment planning and improving patient care.

From the *Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY; †Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands; ‡Department of Radiology, §Department of Radiation Oncology, ∥Department of Biostatistics, ¶Department of Pathology, and #Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY.

Received for publication September 24, 2012; accepted December 12, 2012.

Reprints: Amita Shukla-Dave, PhD, Department of Medical Physics and Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065 (e-mail:

Supported by National Cancer Institute/National Institutes of Health (grant number 1 R01 CA115895).

All authors have no conflicts of interest with regard to this article.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.