Juliette Driessen1, 2, Joanna Caldas-Magalhaes3, Chris Terhaard3, Luuk M. Janssen1, Wilko Grolman1, 2, Marielle E.P. Philippens3
1Otorhinolaryngology Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands; 2Rudolf Magnus Institute of Neuroscience, Utrecht, Netherlands; 3Radiotherapy, University Medical Center Utrecht, Utrecht, Netherlands
For head and neck squamous cell carcinoma, a correlation between local failure after (chemo)radiotherapy and diffusivity has been found . However, the pathohistological basis for this is not clear. Therefore, we performed imaging validation with whole-mount sections. We found a strong relationship between ADC and both cellularity and nuclear-to-cytoplasm ratio. Stromal ratio was indistinguishable from cellularity due to strong interdependence. Besides the association with higher ADC, local failure after chemoradiotherapy has also been related to higher stromal fractions. This suggests that the relationship between local failure and ADC might be partly attributed to the tumor-stroma component.