Exploratory study reveals spatially heterogeneous treatment responses in head and neck cancer using daily quantitative MRI, highlighting potential utility for biologically adaptive radiotherapy.
Background and Purpose: Quantitative MRI (qMRI) is an emerging technique for characterizing tissue microenvironments. Prior work has shown that daily qMRI during MR-guided radiotherapy (MRgRT) detects differential responses to hypofractionated radiotherapy (RT) in head and neck squamous cell carcinoma (HNSCC) within the primary gross tumor volume (GTVp). This exploratory study investigates whether subregions of HNSCC tumors show distinct qMRI responses to hypofractionated RT using contoured GTVp subregions and voxelwise data. Materials and Methods: were calculated for concentric GTVp subregions and an intra-subject control contour in paraspinal muscle. Mixed effect models were fit for each parameter. Voxelwise analysis included quantile tracking, histograms, and paired tests over the length of RT. Results: changes were quantile dependent. These trends may reflect biological processes such as declining cellularity, reperfusion, or edema. Conclusions: In this exploratory study, qMRI detected spatial heterogeneity in HNSCC. These findings support its potential role in guiding biologically adaptive RT strategies.
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Bonate et al. (2025) studied this question.
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