TY - JOUR
T1 - Pre- and post-radiotherapy MRI results as a predictive model for response in laryngeal carcinoma
AU - Ljumanovic, Redina
AU - Langendijk, Johannes
AU - Hoekstra, Otto
AU - Knol, Dirk
AU - Leemans, C.
AU - Castelijns, Jonas
PY - 2008
Y1 - 2008
N2 - The purpose was to determine
if pre-radiotherapy (RT) and/or
post-radiotherapy magnetic resonance
(MR) imaging can predict response in
patients with laryngeal carcinoma
treated with RT. Pre- and post-RT MR
examinations of 80 patients were
retrospectively reviewed and associated
with regard to local control.
Pre-RT MR imaging parameters such
as tumor involvement of specific
laryngeal anatomic subsites including
laryngeal cartilages and post-RT
changes, i.e., complete resolution of
the tumor or focal mass/asymmetric
obliteration of laryngeal tissue and
signal pattern on T2-weighted images,
were evaluated. Local control was
defined as absence of a recurrence at
the primary site for 2 years. Local
control rates based on pretreatment
MR findings were 73% for low pre-
RT risk-profile and 29% for high pre-
RT risk-profile patients (p=0.0001).
Based on posttreatment MR findings,
local control rates were 100% score 1,
64% score 2, and 4% score 3 (p <
0.0001). Using post-RT T2-weighted
images, significant association was
found between differences in signal
pattern and local control: 77% hypointense,
54% isointense and 15%
hyperintense lesions (p <0.001). Differences
between means of delay of
post-MRI examination were significantly
associated with regard to local
control (p=0.003); recurrent tumors
followed 5 months after RT were more
easily detectable on MRI than recurrent
tumors within 4 months after RT.
Sensitivity, specificity, accuracy, negative
and positive predictive values of
post-RT score 3 were 96%, 76%, 83%,
98% and 66%. Pre- and post-RT MRI
evaluation of the larynx can identify
patients at high risk for developing
local failure.
AB - The purpose was to determine
if pre-radiotherapy (RT) and/or
post-radiotherapy magnetic resonance
(MR) imaging can predict response in
patients with laryngeal carcinoma
treated with RT. Pre- and post-RT MR
examinations of 80 patients were
retrospectively reviewed and associated
with regard to local control.
Pre-RT MR imaging parameters such
as tumor involvement of specific
laryngeal anatomic subsites including
laryngeal cartilages and post-RT
changes, i.e., complete resolution of
the tumor or focal mass/asymmetric
obliteration of laryngeal tissue and
signal pattern on T2-weighted images,
were evaluated. Local control was
defined as absence of a recurrence at
the primary site for 2 years. Local
control rates based on pretreatment
MR findings were 73% for low pre-
RT risk-profile and 29% for high pre-
RT risk-profile patients (p=0.0001).
Based on posttreatment MR findings,
local control rates were 100% score 1,
64% score 2, and 4% score 3 (p <
0.0001). Using post-RT T2-weighted
images, significant association was
found between differences in signal
pattern and local control: 77% hypointense,
54% isointense and 15%
hyperintense lesions (p <0.001). Differences
between means of delay of
post-MRI examination were significantly
associated with regard to local
control (p=0.003); recurrent tumors
followed 5 months after RT were more
easily detectable on MRI than recurrent
tumors within 4 months after RT.
Sensitivity, specificity, accuracy, negative
and positive predictive values of
post-RT score 3 were 96%, 76%, 83%,
98% and 66%. Pre- and post-RT MRI
evaluation of the larynx can identify
patients at high risk for developing
local failure.
M3 - Article
VL - 18
JO - European Radiology
JF - European Radiology
SN - 0938-7994
ER -