The purpose of this study was to evaluate the accuracy of diffusion-weighted imaging (DWI) for predicting locoregional failure of chemoradiotherapy in patients with head and neck squamous cell carcinoma (HNSCC). A comprehensive search was conducted through the EMBASE, PubMed and Cochrane Library databases for relevant publications. Stata software was used to calculate the pooled sensitivity, specificity, likelihood ratios and diagnostic odds ratios, and to construct a summary receiver operating characteristics (sROC) curve for DWI. A total of 9 studies comprising 421 patients were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 0.82 [95% confidence interval (CI): 0.72-0.88], 0.70 (95% CI: 0.62-0.77), 2.7 (95% CI: 2.1-3.6), 0.26 (95% CI: 0.17-0.41), and 10.48 (95% CI: 5.35-20.53), respectively. The area under the sROC curve was 0.84 (95% CI: 0.81-0.87). Therefore, DWI appears to be a promising imaging modality for predicting local failure of chemoradiotherapy in patients with HNSCC.
Keywords: chemoradiotherapy; diffusion-weighted imaging; head and neck squamous cell carcinoma; locoregional failure.