Correction of Gradient Nonlinearity Bias in Apparent Diffusion Coefficient Measurement for Head and Neck Cancers Using Single- and Multi-Shot Echo Planar Diffusion Imaging.

This work prospectively evaluates the vendor-provided Low Variance (LOVA) apparent diffusion coefficient (ADC) gradient nonlinearity correction (GNC) technique for primary tumors, neck nodal metastases, and normal masseter muscles in patients with head and neck cancers (HNCs). : Multiple b-value diffusion-weighted (DW)-MR images were acquired on a 3.0 T scanner using a single-shot echo planar imaging (SS-EPI) and multi-shot (MS)-EPI for diffusion phantom materials (20% and 40% polyvinylpyrrolidone (PVP) in water). Pretreatment DW-MRI acquisitions were performed for sixty HNC patients (n = 60) who underwent chemoradiation therapy. ADC values with and without GNC were calculated offline using a monoexponential diffusion model over all b-values, relative percentage (r%) changes (Δ) in ADC values with and without GNC were calculated, and the ADC histograms were analyzed. : Mean ADC values calculated using SS-EPI DW data with and without GNC differed by ≤1% for both PVP20% and PVP40% at the isocenter, whereas off-center differences were ≤19.6% for both concentrations. A similar trend was observed for these materials with MS-EPI. In patients, the mean rΔADC (%) values measured with SS-EPI differed by 4.77%, 3.98%, and 5.68% for primary tumors, metastatic nodes, and masseter muscle. MS-EPI exhibited a similar result with 5.56%, 3.95%, and 4.85%, respectively. : This study showed that the GNC method improves the robustness of the ADC measurement, enhancing its value as a quantitative imaging biomarker used in HNC clinical trials.