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Transl Oncol. 2008 December; 1(4): 187–194.
PMCID: PMC2582167
Diffusion Magnetic Resonance Imaging: An Imaging Treatment Response Biomarker to Chemoradiotherapy in a Mouse Model of Squamous Cell Cancer of the Head and Neck1
Daniel A Hamstra,* Kuei C Lee, Bradford A Moffat, Thomas L Chenevert, Alnawaz Rehemtulla,* and Brian D Ross
*Department of Radiation Oncology, The University of Michigan Medical School, Biomedical Sciences Research Building, Room A528, Ann Arbor, MI 48109-2200, USA
Department of Radiology, The University of Michigan Medical School, Biomedical Sciences Research Building, Room A528, Ann Arbor, MI 48109-2200, USA
Address all correspondence to: Daniel A. Hamstra, MD, PhD, University of Michigan, Center for Molecular Imaging, 109 Zina Pitcher Place, Ann Arbor, MI 48109-2200. E-mail: dhamm/at/umich.edu
Received August 11, 2008; Revised September 19, 2008; Accepted September 22, 2008.
Abstract
For the treatment of squamous cell cancer of the head and neck (SCCHN), the assessment of treatment response is traditionally accomplished by volumetric measurements and has been suggested to be prognostic for an eventual response to treatment. An early evaluation response during the course of radiation therapy could provide an opportunity to tailor treatment to individual patients. Diffusion magnetic resonance imaging (MRI) allows for the quantification of tissue water diffusion values, thus treatment-induced loss of tumor cells will result in the increase in water mobility at the microscopic level, which can be detected as an increase in tumor diffusion values before any volumetric changes occur. We evaluated the use of diffusion MRI as an imaging biomarker of treatment response in an orthotopic mouse model of SCCHN. Mice with murine squamous cells expressing the yeast transgene cytosine deaminase were treated with 5-fluorocytosine (5FC), ionizing radiation, and combined therapy and were compared with control animals both during and after treatment for changes in tumor volumes, diffusion values, and survival. Radiation therapy had minimal effect on volumetric growth rate, diffusion, or survival. Although 5FC and combination treatment resulted in similar reductions in tumor volumes, the combination treatment elicited a much greater increase in tumor diffusion values, which correlated with improved survival. Thus, diffusion MRI as an imaging biomarker has a potential for early evaluation of the response to chemoradiation treatment in SCCHN.