The distinction of residual metastatic lymph nodes from fibrous lymph nodes poses a common diagnostic dilemma for diagnostic CT and MRI,since both abnormalities may exhibit similar imaging characteristics. Imaging is important for the identification of residual cancer, butscarce data exist regarding the accuracy of MRimaging in the earlypost-treatment period and most of the current MR imaging research into treatment response to headand neck cancer is focusing on functional MR imaging techniquessuch as diffusion-weighted imaging and dynamic contrast-enhanced imaging.However alsothe T2signal has a potential value. The...

In a total of 35 patients with a primary HNSCC of the upper aerodigestive tract and with a total of 42residual lymph nodes after chemoradiation therapy, MRI obtained previously and 8 weeks after treatment have been retrospectively analyzed. The patientsrecruited undergonefunctional MR imagingstudies between 2010 and 2013 and a minimum of 12 months of follow-up has been taken into account as recruitment criteria forthis retrospective study. T2 ­signal intensity and apparent diffusion coefficient (ADC) have been evaluated. Referring toT2 ­signal intensity, residualfocal masses were divided...

Of 35 patients with residual lymph nodes, 17 patients undergone surgical emptying, 18 follow­-up, because of a negative PET­-CT 12 weeks after the end of CRT. T2 hypointensity was correlated with non pathological residual lymph nodes (sensitivity­ 88%, specificity­ 40%, accuracy ­65%, PPV­ 61%, NPV­ 75%). ADC maps had PPV of 86% and NPV of 77%. Median short axis in patients with pathological residual lymph nodes was 10.5 mm (range 10­13), in those with non pathological residual was 10 mm (range 7.3­16.4). Differences among lymph...

Management of head and neck cancer involves multidisciplinary approaches that includesurgery and chemoradiotherapy. A majority of the patients who develop advanced tumors are treated withinduction chemotherapy, and concurrent chemo-radiotherapy with surgery usually reservedfor salvage procedure. Effects of radiation therapy include edema in the acute phaseand a fibrous-inflammatory reaction, with formation of scar tissue in the adjacent normal softtissues in the chronic phase.Postirradiationbiopsies, performed for diagnosis of residual/recurrent disease, are frequently equivocal and surgeons are often reluctant to obtain multiple or deep biopsy specimens in previouslyirradiated...

Batnagar P. et al. Functional imaginf for radiation treatment planning, response assessmnet, and adaptive therapy in head and neck cancer. Radiographics. 2013 Nov-Dec; 33(7); 1909-29. Chawla et al. Diffusion-weighted imaging in head and neck cancers. Future Oncol. 2009 Sept; 5(7): 959-975. Hauser et al. Prediction of treatment response in head and neck carcinomas using IVIM-DWI: Evaluation of lymph node metastasis. European Journal of Radiology. 2014 May; 83 (5): 783-7. Kim et al.Diffusion weighted MRI for predicting and detecting early response to chemoradiation therapy of squamous...