Functional MRI for the prediction of treatment response in head and neck squamous cell carcinoma: potential and limitations

Abstract

Pre-treatment or early intra-treatment prediction of patients with head and neck squamous cell carcinomas (HNSCC) who are likely to have tumours that are resistant to chemoradiotherapy (CRT) would enable treatment regimens to be changed at an early time point, or allow patients at risk of residual disease to be targeted for more intensive post-treatment investigation. Research into the potential advantages of using functional-based magnetic resonance imaging (MRI) sequences before or during cancer treatments to predict treatment response has been ongoing for several years. In regard to HNSCC, the reported results from functional MRI research are promising but they have yet to be transferred to the clinical domain. This article will review the functional MRI literature in HNSCC to determine the current status of the research and try to identify areas that are close to application in clinical practice. This review will focus on diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE–MRI) and briefly include proton magnetic resonance spectroscopy (1H-MRS)and blood oxygen level dependent (BOLD) MRI.

Integrating dynamic contrast‐enhanced magnetic resonance imaging and diffusion kurtosis imaging for neoadjuvant chemotherapy assessment of nasopharyngeal carcinoma

“…The K trans was the most powerful predictor in DCE‐MRI modality. The results of the present study were in accord with the findings of some previous studies on HNSCC, rectal cancer, and cervical cancer …”

“…Some special physiological parameters can be gained using the pharmacokinetic model analysis, which provides different information about cancerous angiogenesis or response to the prescribed CRT agent. Despite a few controversies in the literature as to whether these parameters are useful in monitoring tumor response, many studies have obtained similar results: K trans , k ep , and v e values helped to predict tumor response before treatment and always presented an obvious change during the therapy course in responders but not in nonresponders . This study compared K trans , k ep , v e , and v p values and their ultra‐early changes right after 4 days of NAC treatment between responders and nonresponders who were categorized right after one or two NAC cycle treatments to determine any differences between these metrics.…”

“…DCE‐MRI is a promising technique for predicting treatment outcome in a large number of malignancies . It depends on DCE‐MRI's ability to evaluate permeability and corresponding changes during the course of therapy.…”

Multiparametric magnetic resonance imaging in mucosal primary head and neck cancer: a prospective imaging biomarker study

“…Its applications in the upper aerodigestive tract were previously limited by technical factors such as susceptibility artefact from air-tissue interfaces and low signal-to-noise ratio. Modern scanning techniques have been able to overcome many of these issues, and DWI measurements before, during and following RT have been investigated as a diagnostic and prognostic tool [13][14][15][16][17][18].…”

Meta‑analysis of diffusion‑weighted imaging for predicting locoregional failure of chemoradiotherapy in patients with head and neck squamous cell carcinoma

“…Currently, chemoradiotherapy (CRT) is considered as a good approach to the treatment of locally advanced HNSCC. However, ~25-30% of patients have local residual disease or develop relapse at the primary or lymph node sites after treatment (2), which represents a challenge in the management of HNSCC. Therefore, there is a need for biomarkers that can provide accurate and timely prediction of therapeutic outcome prior to treatment or in the early stages of treatment, with discontinuation of ineffective approaches and timely application of alternative therapeutic strategies.…”