MR spectroscopy is used worldwide as an adjunct to MR imaging in several common neurologic diseases, including brain neoplasms, inherited metabolic disorders, demyelinating disorders, and infective... A large body of published work shows that proton (hydrogen 1 [1H]) magnetic resonance (MR) spectroscopy has evolved from a research tool into a clinical neuroimaging modality. Herein, the authors p...

Purpose: The aim of this study was to investigate the utility of apparent diffusion coefficient (ADC) for prediction and early detection of treatment response in head and neck squamous cell carcinomas (HNSCC). Experimental Design: Diffusion-weighted magnetic resonance imaging studies were performed on 40 patients with newly diagnosed HNSCC before, during, and after the end of chemoradiation therapy. Analysis was done on data from 33 patients after exclusion of 7 patients that had incomplete data. Results: Pretreatment ADC value of complete responders (1.04 ± 0.19 × 10⁻³ mm²/s) was significantly lower (P < 0.05) than that from partial responders (1.35 ± 0.30 × 10⁻³ mm²/s). A significant increase in ADC was observed in complete responders within 1 week of treatment (P < 0.01), which remained high until the end of the treatment. The complete responders also showed significantly higher increase in ADC than the partial responders by the first week of chemoradiation (P < 0.01). When pretreatment ADC value was used for predicting treatment response, the area under the receiver operating characteristic curve was 0.80 with a sensitivity of 65% and a specificity of 86%. However, change in ADC within the first week of chemoradiation therapy resulted in an area under the receiver operating characteristic curve of 0.88 with 86% sensitivity and 83% specificity for prediction of treatment response. Conclusions: These results suggest that ADC can be used as a marker for prediction and early detection of response to concurrent chemoradiation therapy in HNSCC.

S and full research articles published in SLEEP, the official journal of the APSS. Sleep and sleep disorder scientific findings.

To develop and retrospectively determine the accuracy of a magnetic resonance (MR) imaging strategy to differentiate intraaxial brain masses, with histologic findings or clinical diagnosis as the reference standard. The study was HIPAA compliant and was approved by the institutional review board. A waiver of informed consent was obtained. A strategy was developed on the basis of conventional MR imaging, diffusion-weighted MR imaging, perfusion MR imaging, and proton MR spectroscopy to classify intraaxial masses as low-grade primary neoplasms, high-grade primary neoplasms, metastatic neoplasms, abscesses, lymphomas, tumefactive demyelinating lesions (TDLs), or encephalitis. The strategy was evaluated by using data from 111 patients (46 women, 65 men; mean age, 48.9 years) with imaging results available on a departmental picture archiving and communication system from a 5-year search period. Bayesian statistics of the strategy elements and three clinical tasks were calculated. Search results identified 44 patients with high-grade and 14 with low-grade primary neoplasms, 24 with abscesses, 12 with lymphoma, 11 with TDLs, five with metastases, and one with encephalitis who had undergone conventional and advanced MR imaging. However, only 40 patients (25 women, 15 men; mean age, 45 years) had undergone all studies and had data to allow completion of the entire strategy. Accuracy, sensitivity, and specificity of the strategy, respectively, were 90%, 97%, and 67% for discrimination of neoplastic from nonneoplastic diseases, 90%, 88%, and 100% for discrimination of high-grade from low-grade neoplasms, and 85%, 84%, and 87% for discrimination of high-grade neoplasms and lymphoma from low-grade neoplasms and nonneoplastic diseases. An integrated MR imaging-based strategy, which is accurate in differentiation of several intraaxial brain masses, was proposed.