Changes in serial DWI MRI imaging during radiation therapy can predict treatment response in patients with head and neck cancer
Yuvnik Trada1,2, Paul Keall2, Michael Jameson3, Daniel Moses4,5, Peter Lin6,7, Phillip Clap5,8, Lois Holloway8,9, Myo Min10,11, Dion Forstner3, Allan Fowler9, and Mark Lee5,9
1Radiation Oncology, Calvary Mater Newcastle, Waratah, Australia, 2The University of Sydney, Sydney, Australia, 3GenesisCare St Vincents Hospital, Sydney, Australia, 4Department of Medical Imaging, Prince of Wales Hospital, Sydney, Australia, 5University of New South Wales, Sydney, Australia, 6Department of Nuclear Medicine and PET, Sydney, Australia, 7Western Sydney University, Sydney, Australia, 8Ingham Institute of Applied Medical Research, Liverpool, Australia, 9Liverpool Hospital, Liverpool, Australia, 10Sunshine Coast University Hospital, Sunshine Coast, Australia, 11University of Sunshine Coast, Britinya, Australia
In head and cancer there is a need for a predictive biomarker for patients undergoing radiotherapy(RT) to allow personalisation of treatment.55 patients with HNSCC had DWI imaging performed at baseline, during (week 2, 3, 5 and 6) and post RT (1 and 3 months). Absolute and change in primary tumour ADCmean was correlated to local recurrence.Week 3 was the optimal timepoint for mid-treatment response assessment. Change in week 3 ADCmean of <24.4% predicted local recurrence; corresponding 2 year LRFS of 97% vs 42%.Changes in mid-treatment DWI imaging could be utilised in design of future adaptive clinical trials.
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