Optimization of MR diffusion image quality and the use of low-b-values at intravoxel incoherent motion in head and neck

Nowadays more imaging techniques are used for diagnostic purposes,
treatmentplanning, non-invasive treatment monitoring of (chemo)radiotherapy or
for outcome prediction. Continuous optimization of this imaging is necessary to
optimize the sensitivity and specificity for both diagnosis and prognosis.

On one hand, conventional MRI images are specifically directed to the anatomy
of (tumor) tissue. On the other hand, perfusion MRI (contrast enhancement) and
diffusion MRI can map physiology in tissue, which can be of value in
determining precise staging and predictive response response rate. In addition,
there are indications that changes in functional parameters occur faster than
the classic response parameters based on size (diameter or volume change).
Intravoxel incoherent motion (IVIM) is a technique within the
diffusion-weighted MRI that has recently emerged strongly. This image technique
contribute to the characterization of a tumor, for example to what extent
microperfusion and diffusion is present in tissue or tumor. This study will be
investigated becaus IVIM parameters vary between tissues in head and neck and
this is not previously described in literature, especially for low B values*.
The main problem of imaging in the head-neck area is the inhomogeneity of the
magnetic field. This is expected to be greatly improved by draining a
fluid-filled pillow around the neck, so that there are fewer air-tissue
transitions near the neck region. This fluid contains manganese (pineapple)
juice to reduce T2 time, so that the liquid does not give an excessively strong
signal that can complicate the assessment of the MRI images of the neck.

Primary objective:
- Optimization of MR diffusion quality in head and neck squamous cell carcinoma
by an extension of the scan protocol and a pillow filled with pineapple juice.

Secundary objective:
- To determine the most optimal amount and distribution of b-values to obtain a
good bi-exponential fit with IVIM.
- To determine IVIM-parameters of normal tissue of different
areas/structures in head and neck
- To test the reproducibility of IVIM parameters in healty heak and neck
tissue.

Observational

Patients has to lie still for about 6 minutes after the normal MRI, without
risks or benifits.