|
1
|
Guo Y, Zhang S, Sun S, Zhang Q, Zhai Y, Wang X, Ge P, Zhang D. Analysis of the role of perfusion parameters in predicting rupture of brain arteriovenous malformations: a multi-center study. Sci Rep 2024; 14:25566. [PMID: 39462139 PMCID: PMC11513006 DOI: 10.1038/s41598-024-77316-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 10/21/2024] [Indexed: 10/28/2024] Open
Abstract
This study aimed to investigate the potential correlation between the perfusion parameters of brain arteriovenous malformations (bAVMs) as determined by multiphase CT angiography and bAVM rupture. Based on the occurrence of bAVM-related hemorrhage, 480 diagnosed bAVM patients were divided into hemorrhage (n = 220) and non-hemorrhage (n = 260) groups in this retrospective multi-center study spanning 2010 to 2020. On initial rupture CT images, the bAVM nidus and major draining vein were segmented, and time-density curves were extracted to compute perfusion parameters including mean transit time (MTT), time to peak (TTP), blood volume (BV), and blood flow (BF). To examine the potential correlation between these parameters and bAVM rupture, logistic regression was utilized to analyze multifactorial data and compare differences between the two groups. The ruptured group demonstrated a bAVM nidus characterized by an increased BF, a shorter TTP and MTT, and a higher peak density. The veins that were draining exhibited a reduced TTP, MTT, and peak density. A nidus TTP of less than 4s was identified by the multifactorial analysis as a critical risk factor for bAVM rupture. The statistical results highlight the noteworthy correlation between nidus TTP and bAVM rupture, presenting an original framework for assessing the risk of rupture.
Collapse
Affiliation(s)
- Yue Guo
- Department of Radiology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China.
- Department of Radiology, Beijing Rehabilitation Hospital, Capital Medical University, South Xixiazhuang, Shijingshan district, Beijing, China.
| | - Shaosen Zhang
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Shengjun Sun
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qian Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuanren Zhai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaochen Wang
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peicong Ge
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dong Zhang
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
|
2
|
Schawkat K, Sah BR, Ter Voert EE, Delso G, Wurnig M, Becker AS, Leibl S, Schneider PM, Reiner CS, Huellner MW, Veit-Haibach P. Role of intravoxel incoherent motion parameters in gastroesophageal cancer: relationship with 18F-FDG-positron emission tomography, computed tomography perfusion and magnetic resonance perfusion imaging parameters. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2019; 65:178-186. [PMID: 31496202 DOI: 10.23736/s1824-4785.19.03153-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Identification of pretherapeutic predictive markers in gastro-esophageal cancer is essential for individual-oriented treatment. This study evaluated the relationship of multimodality parameters derived from intravoxel incoherent motion method (IVIM), 18F-FDG-positron emission tomography (PET), computed tomography (CT) perfusion and dynamic contrast enhanced magnetic resonance imaging (MRI) in patients with gastro-esophageal cancer and investigated their histopathological correlation. METHODS Thirty-one consecutive patients (28 males; median age 63.9 years; range 37-84 years) with gastro-esophageal adenocarcinoma (N.=22) and esophageal squamous cell carcinoma (N.=9) were analyzed. IVIM parameters: pseudodiffusion (D*), perfusion fraction (fp), true diffusion (D) and the threshold b-value (bval); PET-parameters: SUV<inf>max</inf>, metabolic tumor volume (MTV) and total lesion glycolysis (TLG); CT perfusion parameters: blood flow (BF), blood volume (BV) and mean transit time (MTT); and MR perfusion parameters: time to enhance, positive enhancement integral, time-to-peak (TTP), maximum-slope-of-increase, and maximum-slope-of-decrease were determined, and correlated to each other and to histopathology. RESULTS IVIM and PET parameters showed significant negative correlations: MTV and bval (r<inf>s</inf> =-0.643, P=0.002), TLG and bval (r<inf>s</inf>=-0.699, P<0.01) and TLG and fp (r<inf>s</inf>=-0.577, P=0.006). Positive correlation was found for TLG and D (r<inf>s</inf>=0.705, P=0.000). Negative correlation was found for bval and staging (r<inf>s</inf>=0.590, P=0.005). Positive correlation was found for positive enhancement interval and BV (r<inf>s</inf>=0.547, P=0.007), BF and regression index (r<inf>s</inf>=0.753, P=0.005) and for time-to-peak and staging (r<inf>s</inf>=0.557, P=0.005). CONCLUSIONS IVIM parameters (bval, fp, D) provide quantitative information and correlate with PET parameters (MTV, TLG) and staging. IVIM might be a useful tool for additional characterization of gastro-esophageal cancer.
Collapse
Affiliation(s)
- Khoschy Schawkat
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland - .,University of Zurich, Zurich, Switzerland -
| | - Bert-Ram Sah
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Edwin E Ter Voert
- University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Gaspar Delso
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Moritz Wurnig
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Anton S Becker
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Sebastian Leibl
- Department of Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Paul M Schneider
- Center for Visceral, Thoracic and Specialized Tumor Surgery, Hirslanden Medical Center, Zurich, Switzerland
| | - Cäcilia S Reiner
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martin W Huellner
- University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Patrick Veit-Haibach
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Toronto, Toronto, ON, Canada.,Toronto Joint Department of Medical Imaging, University Hospital of Zurich, Toronto General Hospital, Zurich, Switzerland
| |
Collapse
|
|
3
|
Garbajs M, Strojan P, Surlan-Popovic K. Prognostic role of diffusion weighted and dynamic contrast-enhanced MRI in loco-regionally advanced head and neck cancer treated with concomitant chemoradiotherapy. Radiol Oncol 2019; 53:39-48. [PMID: 30840595 PMCID: PMC6411028 DOI: 10.2478/raon-2019-0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/04/2019] [Indexed: 02/08/2023] Open
Abstract
Background In the study, the value of pre-treatment dynamic contrast-enhanced (DCE) and diffusion weighted (DW) MRI-derived parameters as well as their changes early during treatment was evaluated for predicting disease-free survival (DFS) and overall survival (OS) in patients with locoregionally advanced head and neck squamous carcinoma (HNSCC) treated with concomitant chemoradiotherapy (cCRT) with cisplatin. Patients and methods MRI scans were performed in 20 patients with locoregionally advanced HNSCC at baseline and after 10 Grays (Gy) of cCRT. Tumour apparent diffusion coefficient (ADC) and DCE parameters (volume transfer constant [Ktrans], extracellular extravascular volume fraction [ve], and plasma volume fraction [Vp]) were measured. Relative changes in parameters from baseline to 10 Gy were calculated. Univariate and multivariate Cox regression analysis were conducted. Receiver operating characteristic (ROC) curve analysis was employed to identify parameters with the best diagnostic performance. Results None of the parameters was identified to predict for DFS. On univariate analysis of OS, lower pre-treatment ADC (p = 0.012), higher pre-treatment Ktrans (p = 0.026), and higher reduction in Ktrans (p = 0.014) from baseline to 10 Gy were identified as significant predictors. Multivariate analysis identified only higher pre-treatment Ktrans (p = 0.026; 95% CI: 0.000-0.132) as an independent predictor of OS. At ROC curve analysis, pre-treatment Ktrans yielded an excellent diagnostic accuracy (area under curve [AUC] = 0.95, sensitivity 93.3%; specificity 80 %). Conclusions In our group of HNSCC patients treated with cisplatin-based cCRT, pre-treatment Ktrans was found to be a good predictor of OS.
Collapse
Affiliation(s)
- Manca Garbajs
- Institute of Clinical Radiology, University Medical CentreLjubljana, Slovenia
- Manca Garbajs, M.D., Institute of Clinical Radiology, University Medical Centre, Zaloška c. 7, SI-1000 Ljubljana, Slovenia.
Phone: + 386 40 212 226
| | - Primoz Strojan
- Division of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | | |
Collapse
|
|
4
|
Emerging Functional Imaging Biomarkers of Tumour Responses to Radiotherapy. Cancers (Basel) 2019; 11:cancers11020131. [PMID: 30678055 PMCID: PMC6407112 DOI: 10.3390/cancers11020131] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/11/2019] [Accepted: 01/13/2019] [Indexed: 12/11/2022] Open
Abstract
Tumour responses to radiotherapy are currently primarily assessed by changes in size. Imaging permits non-invasive, whole-body assessment of tumour burden and guides treatment options for most tumours. However, in most tumours, changes in size are slow to manifest and can sometimes be difficult to interpret or misleading, potentially leading to prolonged durations of ineffective treatment and delays in changing therapy. Functional imaging techniques that monitor biological processes have the potential to detect tumour responses to treatment earlier and refine treatment options based on tumour biology rather than solely on size and staging. By considering the biological effects of radiotherapy, this review focusses on emerging functional imaging techniques with the potential to augment morphological imaging and serve as biomarkers of early response to radiotherapy.
Collapse
|
|
5
|
Martens RM, Noij DP, Ali M, Koopman T, Marcus JT, Vergeer MR, de Vet H, de Jong MC, Leemans CR, Hoekstra OS, de Bree R, de Graaf P, Boellaard R, Castelijns JA. Functional imaging early during (chemo)radiotherapy for response prediction in head and neck squamous cell carcinoma; a systematic review. Oral Oncol 2018; 88:75-83. [PMID: 30616800 DOI: 10.1016/j.oraloncology.2018.11.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/02/2018] [Accepted: 11/05/2018] [Indexed: 10/27/2022]
Abstract
This systematic review gives an extensive overview of the current state of functional imaging during (chemo)radiotherapy to predict locoregional control (LRC) and overall survival (OS) for head and neck squamous cell carcinoma. MEDLINE and EMBASE were searched for literature until April 2018 assessing the predictive performance of functional imaging (computed tomography perfusion (CTp), MRI and positron-emission tomography (PET)) within 4 weeks after (chemo)radiotherapy initiation. Fifty-two studies (CTp: n = 4, MRI: n = 19, PET: n = 26, MRI/PET: n = 3) were included involving 1623 patients. Prognostic information was extracted according the PRISMA protocol. Pooled estimation and subgroup analyses were performed for comparable parameters and outcome. However, the heterogeneity of included studies limited the possibility for comparison. Early tumoral changes from (chemo)radiotherapy can be captured by functional MRI and 18F-FDG-PET and could allow for personalized treatment adaptation. Lesions showed potentially prognostic intratreatment changes in perfusion, diffusion and metabolic activity. Intratreatment ADCmean increase (decrease of diffusion restriction) and low SUVmax (persistent low or decrease of 18F-FDG uptake) were most predictive of LRC. Intratreatment persistent high or increase of perfusion on CT/MRI (i.e. blood flow, volume, permeability) also predicted LRC. Low SUVmax and total lesion glycolysis (TLG) predicted favorable OS. The optimal timing to perform functional imaging to predict LRC or OS was 2-3 weeks after treatment initiation.
Collapse
Affiliation(s)
- Roland M Martens
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands.
| | - Daniel P Noij
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Meedie Ali
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Thomas Koopman
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - J Tim Marcus
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Marije R Vergeer
- Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - Henrica de Vet
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Marcus C de Jong
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - C René Leemans
- Department of Otolaryngology - Head and Neck Surgery, VU University Medical Center, Amsterdam, the Netherlands
| | - Otto S Hoekstra
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Pim de Graaf
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Jonas A Castelijns
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| |
Collapse
|
|
6
|
|
|
7
|
Popovic P, Leban A, Kregar K, Garbajs M, Dezman R, Bunc M. Computed Tomographic Perfusion Imaging for the Prediction of Response and Survival to Transarterial Chemoembolization of Hepatocellular Carcinoma. Radiol Oncol 2017. [PMID: 29520201 PMCID: PMC5839077 DOI: 10.1515/raon-2017-0052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background The purpose of this retrospective cohort study was to evaluate the clinical value of computed tomographic perfusion imaging (CTPI) parameters in predicting the response to treatment and overall survival in patients with hepatocellular carcinoma (HCC) treated with drug-eluting beads transarterial chemoembolization (DEBTACE). Patients and methods Between December 2010 and January 2013 eighteen patients (17 men, 1 woman; mean age 69 ± 5.8 years) with intermediate stage HCC underwent CTPI of the liver prior to treatment with DEBTACE. Treatment response was evaluated on follow-up imaging according to modified Response Evaluation Criteria in Solid Tumors. Pre-treatment CTPI parameters were compared between patients with complete response and partial response with a Student t-test. We compared survival times with Kaplan-Meier method. Results CTPI parameters of patients with complete response and others did not show statistical significant difference. The mean survival time was 25.4 ± 3.2 months (95%; CI: 18.7-32.1). Survival was statistically significantly longer in patients with hepatic blood flow (BF) lower than 50.44 ml/100 ml/min (p = 0.033), hepatic blood volume (BV) lower than 13.32 ml/100 ml (p = 0.028) and time to peak (TTP) longer than 19.035 s (p = 0.015). Conclusions CTPI enables prediction of survival in patients with intermediate stage HCC, treated with DEBTACE based on the pre-treatment values of BF, BV and TTP perfusion parameters. CT perfusion imaging can’t be used to predict treatment response to DEBTACE.
Collapse
Affiliation(s)
- Peter Popovic
- Clinical Institute of Radiology, University Medical Centre, Ljubljana, Slovenia
| | - Ana Leban
- General Hospital Dr. Franca Derganca, Šempeter pri Gorici, Slovenia
| | | | - Manca Garbajs
- Clinical Institute of Radiology, University Medical Centre, Ljubljana, Slovenia
| | - Rok Dezman
- Clinical Institute of Radiology, University Medical Centre, Ljubljana, Slovenia
| | - Matjaz Bunc
- Department of Cardiology, University Medical Centre, Ljubljana, Slovenia
| |
Collapse
|
|
8
|
Marzi S, Piludu F, Forina C, Sanguineti G, Covello R, Spriano G, Vidiri A. Correlation study between intravoxel incoherent motion MRI and dynamic contrast-enhanced MRI in head and neck squamous cell carcinoma: Evaluation in primary tumors and metastatic nodes. Magn Reson Imaging 2017; 37:1-8. [DOI: 10.1016/j.mri.2016.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/07/2016] [Accepted: 10/05/2016] [Indexed: 12/12/2022]
|
|
9
|
Dickerson E, Srinivasan A. Advanced Imaging Techniques of the Skull Base. Radiol Clin North Am 2017; 55:189-200. [DOI: 10.1016/j.rcl.2016.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
|
10
|
Franklin JM, Sharma RA, Harris AL, Gleeson FV. Imaging oligometastatic cancer before local treatment. Lancet Oncol 2016; 17:e406-14. [PMID: 27599145 DOI: 10.1016/s1470-2045(16)30277-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 06/21/2016] [Accepted: 06/23/2016] [Indexed: 12/21/2022]
Abstract
With the advent of novel treatment strategies to help widen the therapeutic window for patients with oligometastatic cancer, improved biomarkers are needed to reliably define patients who can benefit from these treatments. Multimodal imaging is one such option and should be optimised to comprehensively assess metastatic sites, disease burden, and response to neoadjuvant treatment in each disease setting. These features will probably remain important prognostic biomarkers, and are crucial in planning multidisciplinary treatment. There are opportunities to extract additional phenotypic information from conventional imaging, while novel imaging techniques can also reveal specific aspects of tumour biology. Imaging can both characterise and localise the phenotypic heterogeneity of multiple tumour sites. Novel approaches to existing imaging datasets and correlation with tumour biology will be important in realising the potential of imaging to guide treatment in the oligometastatic setting. In this Personal View, we discuss the current status and future directions of imaging before treatment in patients with extracranial oligometastases.
Collapse
Affiliation(s)
- James M Franklin
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Department of Oncology, University of Oxford, UK.
| | | | - Adrian L Harris
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Department of Oncology, University of Oxford, UK
| | - Fergus V Gleeson
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Department of Oncology, University of Oxford, UK
| |
Collapse
|
|
11
|
Dong L, Kudrimoti M, Irwin D, Chen L, Kumar S, Shang Y, Huang C, Johnson EL, Stevens SD, Shelton BJ, Yu G. Diffuse optical measurements of head and neck tumor hemodynamics for early prediction of chemoradiation therapy outcomes. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:85004. [PMID: 27564315 PMCID: PMC4999482 DOI: 10.1117/1.jbo.21.8.085004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 08/08/2016] [Indexed: 05/03/2023]
Abstract
This study used a hybrid near-infrared diffuse optical instrument to monitor tumor hemodynamic responses to chemoradiation therapy for early prediction of treatment outcomes in patients with head and neck cancer. Forty-seven patients were measured once per week to evaluate the hemodynamic status of clinically involved cervical lymph nodes as surrogates for the primary tumor response. Patients were classified into two groups: complete response (CR) (n=29) and incomplete response (IR) (n=18). Tumor hemodynamic responses were found to be associated with clinical outcomes (CR/IR), wherein the associations differed depending on human papillomavirus (HPV-16) status. In HPV-16 positive patients, significantly lower levels in tumor oxygenated hemoglobin concentration ([HbO2]) at weeks 1 to 3, total hemoglobin concentration at week 3, and blood oxygen saturation (StO2) at week 3 were found in the IR group. In HPV-16 negative patients, significantly higher levels in tumor blood flow index and reduced scattering coefficient (μs′) at week 3 were observed in the IR group. These hemodynamic parameters exhibited significantly high accuracy for early prediction of clinical outcomes, within the first three weeks of therapy, with the areas under the receiver operating characteristic curves (AUCs) ranging from 0.83 to 0.96.
Collapse
Affiliation(s)
- Lixin Dong
- University of Kentucky College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
| | - Mahesh Kudrimoti
- University of Kentucky College of Medicine, Department of Radiation Medicine, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Daniel Irwin
- University of Kentucky College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
| | - Li Chen
- University of Kentucky, Biostatistics and Bioinformatics Shared Resource Facility, Markey Cancer Center, Lexington, 800 Rose Street, Kentucky 40536, United States
- University of Kentucky College of Public Health, Department of Biostatistics, Lexington, 111 Washington Avenue, Kentucky 40536, United States
| | - Sameera Kumar
- University of Kentucky College of Medicine, Department of Radiation Medicine, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Yu Shang
- University of Kentucky College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
| | - Chong Huang
- University of Kentucky College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
| | - Ellis L. Johnson
- University of Kentucky College of Medicine, Department of Radiation Medicine, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Scott D. Stevens
- University of Kentucky College of Medicine, Department of Radiology, 800 Rose Street, Lexington, Kentucky 40536, United States
| | - Brent J. Shelton
- University of Kentucky, Biostatistics and Bioinformatics Shared Resource Facility, Markey Cancer Center, Lexington, 800 Rose Street, Kentucky 40536, United States
- University of Kentucky College of Public Health, Department of Biostatistics, Lexington, 111 Washington Avenue, Kentucky 40536, United States
| | - Guoqiang Yu
- University of Kentucky College of Engineering, Department of Biomedical Engineering, 143 Graham Avenue, Lexington, Kentucky 40506, United States
- Address all correspondence to: Guoqiang Yu, E-mail:
| |
Collapse
|
|
12
|
Min M, Lin P, Liney G, Lee M, Forstner D, Fowler A, Holloway L. A review of the predictive role of functional imaging in patients with mucosal primary head and neck cancer treated with radiation therapy. J Med Imaging Radiat Oncol 2016; 61:99-123. [DOI: 10.1111/1754-9485.12496] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 06/11/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Myo Min
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
- Ingham Institute of Applied Medical Research; Liverpool New South Wales Australia
| | - Peter Lin
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
- Department of Nuclear Medicine and Positron Emission Tomography; Liverpool Hospital; Liverpool New South Wales Australia
- University of Western Sydney; Sydney New South Wales Australia
| | - Gary Liney
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
- Ingham Institute of Applied Medical Research; Liverpool New South Wales Australia
- Centre for Medical Radiation Physics; University of Wollongong; Wollongong New South Wales Australia
| | - Mark Lee
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
| | - Dion Forstner
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
- Ingham Institute of Applied Medical Research; Liverpool New South Wales Australia
| | - Allan Fowler
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
| | - Lois Holloway
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
- Ingham Institute of Applied Medical Research; Liverpool New South Wales Australia
- Centre for Medical Radiation Physics; University of Wollongong; Wollongong New South Wales Australia
- Institute of Medical Physics; School of Physics; University of Sydney; Sydney New South Wales Australia
| |
Collapse
|
|
13
|
Ursino S, Faggioni L, Guidoccio F, Ferrazza P, Seccia V, Neri E, Cernusco LN, Delishaj D, Morganti R, Volterrani D, Paiar F, Caramella D. Role of perfusion CT in the evaluation of functional primary tumour response after radiochemotherapy in head and neck cancer: preliminary findings. Br J Radiol 2016; 89:20151070. [PMID: 27377172 DOI: 10.1259/bjr.20151070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To report the initial results of a prospective study aimed at evaluating the CT perfusion parameter changes (∆PCTp) of the primary tumour after radiochemotherapy (RCT) in head and neck cancer (HNC) and to correlate with positron emission tomography (PET)/CT response. METHODS Eligibility criteria included HNC (Stage III-IV) candidates for RCT. Patients underwent perfusion CT (PCT) at baseline and at 3 weeks and 3 months after treatment. Blood volume, blood flow, mean transit time (MTT) and permeability surface (PS) product were computed. Moreover, PET/CT was performed at baseline and 3 months after treatment. The ∆PCTp were evaluated between baseline and 3-week/3-month evaluations, whereas PET/CT response was based on the maximum standardized uptake value changes according to the European Organization for Research and Treatment of Cancer criteria. RESULTS Between July 2012 and July 2015, 25 patients were enrolled. A significant reduction of all CT tumour perfusion parameters (PCTp) was observed from the baseline to after RCT (p < 0.001). Specifically, a significant reduction was shown at 3 weeks for all PCTp except MTT (from 6.18 to 5.14 s; p = 0.722). Differently, a significant reduction of all PCTp (p < 0.001) including MTT (from 6.18 to 2.24 s; p = 0.001) was shown at 3 months. Moreover, the reduction of PS resulted in a significant prediction of PET/CT response at 3 months (p = 0.037) with the trend also at 3 weeks (p = 0.099) at the multivariate analysis. CONCLUSION Our preliminary findings seem to show that almost all PCTp are significantly reduced after RCT, whereas PS seems to come out as the strongest factor in predicting the PET/CT response. ADVANCES IN KNOWLEDGE This article provides information on the potential useful role of PCT in evaluating tumour response after both early and late RCT.
Collapse
Affiliation(s)
- Stefano Ursino
- 1 Department of Radiation Oncology, University Hospital S. Chiara, Pisa, Italy
| | - Lorenzo Faggioni
- 2 Department of Radiology, University Hospital Cisanello, Pisa, Italy
| | - Federica Guidoccio
- 3 Department of Nuclear Medicine, University Hospital S.Chiara, Pisa, Italy
| | - Patrizia Ferrazza
- 1 Department of Radiation Oncology, University Hospital S. Chiara, Pisa, Italy
| | - Veronica Seccia
- 4 First Otorhinolaryngology Unit, University Hospital Cisanello, Pisa, Italy
| | - Emanuele Neri
- 2 Department of Radiology, University Hospital Cisanello, Pisa, Italy
| | - Luna N Cernusco
- 1 Department of Radiation Oncology, University Hospital S. Chiara, Pisa, Italy
| | - Durim Delishaj
- 1 Department of Radiation Oncology, University Hospital S. Chiara, Pisa, Italy
| | - Riccardo Morganti
- 5 Biostatistical Consulting, Department of Oncology, University Hospital S.Chiara, Pisa, Italy
| | - Duccio Volterrani
- 3 Department of Nuclear Medicine, University Hospital S.Chiara, Pisa, Italy
| | - Fabiola Paiar
- 1 Department of Radiation Oncology, University Hospital S. Chiara, Pisa, Italy
| | - Davide Caramella
- 2 Department of Radiology, University Hospital Cisanello, Pisa, Italy
| |
Collapse
|
|
14
|
Peripharyngeal space tumors: Can magnetic resonance and multidetector-row computed tomography help predict location, malignancy and tumor type? Diagn Interv Imaging 2016; 97:617-25. [DOI: 10.1016/j.diii.2015.09.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 09/13/2015] [Accepted: 09/14/2015] [Indexed: 11/20/2022]
|
|
15
|
|
|
16
|
Fujima N, Yoshida D, Sakashita T, Homma A, Tsukahara A, Tha KK, Kudo K, Shirato H. Usefulness of Pseudocontinuous Arterial Spin-Labeling for the Assessment of Patients with Head and Neck Squamous Cell Carcinoma by Measuring Tumor Blood Flow in the Pretreatment and Early Treatment Period. AJNR Am J Neuroradiol 2016; 37:342-8. [PMID: 26427828 PMCID: PMC7959962 DOI: 10.3174/ajnr.a4513] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 07/06/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE For the assessment of the treatment response in non-surgical treatment, tumor blood flow provides the functional information of the tumor which is different from the morphological information such as tumor volume. The purpose of this study was to evaluate the diagnostic value of tumor blood flow values obtained by pseudocontinuous arterial spin-labeling in patients with head and neck squamous cell carcinoma. MATERIALS AND METHODS Forty-one patients with head and neck squamous cell carcinoma were evaluated by using pseudocontinuous arterial spin-labeling. Quantitative tumor blood flow was calculated at the pretreatment and the early treatment periods in all the patients, and the percentage change of tumor blood flow between the two was calculated. At the early treatment period, based on their tumor volume reduction rate, we divided the patients into stable disease and partial response groups for a subgroup analysis. The local control or failure was confirmed either by histopathology or by radiologic evaluation within the follow-up. RESULTS Pretreatment tumor blood flow in patients in the failure group was significantly lower than that in patients in the local control group. In the subgroup analysis of patients with stable disease, the percentage change of tumor blood flow was significantly larger (due to the tumor blood flow increase from pretreatment value) in the local control group than in the failure group. In addition, in patients with a partial response, the percentage change of tumor blood flow was significantly smaller (due to the tumor blood flow decrease from the pretreatment value) in the local control group than in the failure group. The accuracy for determination of the local control group or the failure group in pretreatment tumor blood flow was 0.83 and that in the combination use of the percentage change of tumor blood flow and tumor volume in the early treatment period was 0.93. CONCLUSIONS Tumor blood flow obtained by pseudocontinuous arterial spin-labeling can be useful for the determination of local control. The combined use of the percentage change of tumor blood flow and tumor volume had particularly high diagnostic accuracy.
Collapse
Affiliation(s)
- N Fujima
- From the Department of Diagnostic and Interventional Radiology (N.F., D.Y., A.T., K.K.), Hokkaido University Hospital, Sapporo, Japan
| | - D Yoshida
- From the Department of Diagnostic and Interventional Radiology (N.F., D.Y., A.T., K.K.), Hokkaido University Hospital, Sapporo, Japan
| | - T Sakashita
- Departments of Otolaryngology-Head and Neck Surgery (T.S., A.H.)
| | - A Homma
- Departments of Otolaryngology-Head and Neck Surgery (T.S., A.H.)
| | - A Tsukahara
- From the Department of Diagnostic and Interventional Radiology (N.F., D.Y., A.T., K.K.), Hokkaido University Hospital, Sapporo, Japan
| | - K K Tha
- Radiation Medicine (K.K.T., H.S.), Hokkaido University Graduate School of Medicine, Sapporo, Japan Global Station for Quantum Medical Science and Engineering (K.K.T., H.S.), Global Institution for Collaborative Research and Education, Sapporo, Japan
| | - K Kudo
- From the Department of Diagnostic and Interventional Radiology (N.F., D.Y., A.T., K.K.), Hokkaido University Hospital, Sapporo, Japan
| | - H Shirato
- Radiation Medicine (K.K.T., H.S.), Hokkaido University Graduate School of Medicine, Sapporo, Japan Global Station for Quantum Medical Science and Engineering (K.K.T., H.S.), Global Institution for Collaborative Research and Education, Sapporo, Japan
| |
Collapse
|
|
17
|
Djuric-Stefanovic A, Micev M, Stojanovic-Rundic S, Pesko P, Saranovic D. Absolute CT perfusion parameter values after the neoadjuvant chemoradiotherapy of the squamous cell esophageal carcinoma correlate with the histopathologic tumor regression grade. Eur J Radiol 2015; 84:2477-84. [PMID: 26467704 DOI: 10.1016/j.ejrad.2015.09.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/21/2015] [Accepted: 09/27/2015] [Indexed: 12/19/2022]
Abstract
PURPOSE To analyze value of the computed tomography (CT) perfusion imaging in response evaluation of the esophageal carcinoma to neoadjuvant chemoradiotherapy (nCRT) using the histopathology as reference standard. METHODS Forty patients with the squamous cell esophageal carcinoma were re-evaluated after the nCRT by CT examination, which included low-dose CT perfusion study that was analyzed using the deconvolution-based CT perfusion software (Perfusion 3.0, GE). Histopathologic assessment of tumor regression grade (TRG) according to Mandard's criteria served as reference standard of response evaluation. Statistical analysis was performed using Spearman's rank correlation coefficient (r(S)) and Kruskal-Wallis's test. RESULTS The perfusion CT parameter values, measured after the nCRT in the segment of the esophagus that had been affected by neoplasm prior to therapy, significantly correlated with the TRG: blood flow (BF) (r(S)=0.851; p<0.001), blood volume (BV) (r(S)=0.732; p<0.001) and mean transit time (MTT) (r(S)=-0.386; p=0.014). Median values of BF and BV significantly differed among TRG 1-4 groups (p<0.001), while maximal esophageal wall thickness did not (p=0.102). Median BF and BV were gradually rose and MTT decreased as TRG increased, from 21.4 ml/min/100 g (BF), 1.6 ml/100 g (BV) and 8.6 s (MTT) in TRG 1 group, to 37.3 ml/min/100 g, 3.5 ml/100 g and 7.5 s in TRG 2 group, 81.4 ml/min/100 g, 4.1 ml/100 g and 3.8 s in TRG 3 group, and 121.1 ml/min/100 g, 4.9 ml/100 g and 3.7 s in TRG 4 group. In all 15 patients who achieved complete histopathologic regression (TRG 1), BF was <30.0 ml/min/100 g. CONCLUSIONS CT perfusion could improve the accuracy in response evaluation of the esophageal carcinoma to nCRT.
Collapse
Affiliation(s)
- A Djuric-Stefanovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Digestive Radiology (First Surgery University Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade, Serbia.
| | - M Micev
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Pathology, First Surgery University Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - S Stojanovic-Rundic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Radiation Oncology and Diagnostics, Department of Radiation Oncology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - P Pesko
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; First Surgery University Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - Dj Saranovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Digestive Radiology (First Surgery University Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade, Serbia
| |
Collapse
|
|
18
|
Fujima N, Kudo K, Yoshida D, Homma A, Sakashita T, Tsukahara A. Arterial spin labeling to determine tumor viability in head and neck cancer before and after treatment. J Magn Reson Imaging 2015; 40:920-8. [PMID: 25356468 DOI: 10.1002/jmri.24421] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate the feasibility of arterial spin-labeling (ASL) in head and neck cancer for noninvasive measurement of tumor blood flow (TBF), by comparing 1) the TBF change before and after the treatment, and 2) posttreatment TBF and its reduction rate between residual and nonresidual tumors after treatment. MATERIALS AND METHODS Twenty-two patients with head and neck cancer were evaluated using ASL on 3.0-T magnetic resonance imaging (MRI) before and after nonsurgical treatment. A pulsed ASL sequence with Look–Locker readout was used to calculate quantitative TBF. TBF reduction rates between pre- and posttreatment values were also calculated. Residual tumors were confirmed when present with either histopathologically or clinical follow-up. RESULTS Pre- and posttreatment mean TBF values were 121.4 ± 27.8 (standard deviation) and 24.9 ± 14.9 mL/100g/min, respectively. Pre- and posttreatment TBF differed significantly. Posttreatment TBF was significantly higher in patients with residual tumors (five patients, 46.9 ± 7.1 mL/100g/min) than in those without (17 patients, 18.4 ± 9.2 mL/100g/min). The TBF reduction rate was significantly lower in patients with residual tumors (0.540.55 ± 0.120.12) than in those without (0.85 ± 0.06). CONCLUSION ASL allows quantitative assessment of TBF in head and neck cancer. ASL may be useful for noninvasive assessment of tumor viability in head and neck cancer.
Collapse
|
|
19
|
Abramyuk A, Hietschold V, Appold S, von Kummer R, Abolmaali N. Radiochemotherapy-induced changes of tumour vascularity and blood supply estimated by dynamic contrast-enhanced CT and fractal analysis in malignant head and neck tumours. Br J Radiol 2015; 88:20140412. [PMID: 25412001 DOI: 10.1259/bjr.20140412] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate radiochemotherapy (RChT)-induced changes of transfer coefficient (K(trans)) and relative tumour blood volume (rTBV) estimated by dynamic contrast-enhanced CT (DCE-CT) and fractal analysis in head and neck tumours (HNTs). METHODS DCE-CT was performed in 15 patients with inoperable HNTs before RChT, and after 2 and 5 weeks. The dynamics of K(trans) and rTBV as well as lacunarity, slope of log(lacunarity) vs log(box size), and fractal dimension were compared with tumour behaviour during RChT and in the 24-month follow-up. RESULTS In 11 patients, an increase of K(trans) and/or rTBV after 20 Gy followed by a decrease of both parameters after 50 Gy was noted. Except for one local recurrence, no tumour residue was found during the follow-up. In three patients with partial tumour reduction during RChT, a decrease of K(trans) accompanied by an increase in rTBV between 20 and 50 Gy was detected. In one patient with continuous elevation of both parameters, tumour progressed after RChT. Pre-treatment difference in intratumoral heterogeneity with its decline under RChT for the responders vs non-responders was observed. CONCLUSION Initial growth of K(trans) and/or rTBV followed by further reduction of both parameters along with the decline of the slope of log(lacunarity) vs log(box size) was associated with positive radiochemotherapeutic response. Increase of K(trans) and/or rTBV under RChT indicated a poor outcome. ADVANCES IN KNOWLEDGE The modification of K(trans) and rTBV as measured by DCE-CT may be applied for the assessment of tumour sensitivity to chose RChT regimen and, consequently, to reveal clinical impact allowing individualization of RChT strategy in patients with HNT.
Collapse
Affiliation(s)
- A Abramyuk
- 1 Department of Neuroradiology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | | | | | | | | |
Collapse
|
|
20
|
Dynamic contrast-enhanced computed tomography to assess early activity of cetuximab in squamous cell carcinoma of the head and neck. Radiol Oncol 2015; 49:17-25. [PMID: 25810697 PMCID: PMC4362602 DOI: 10.2478/raon-2014-0030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Accepted: 05/23/2013] [Indexed: 01/15/2023] Open
Abstract
Background Cetuximab, a monoclonal antibody targeting the Epidermal Growth Factor Receptor (EGFR), has demonstrated activity in various tumor types. Using dynamic contrast-enhanced computed tomography (DCE-CT), we investigated the early activity of cetuximab monotherapy in previously untreated patients with squamous cell carcinoma of the head and neck (SCCHN). Methods Treatment-naïve patients with SCCHN received cetuximab for 2 weeks before curative surgery. Treatment activity was evaluated by DCE-CT at baseline and before surgery. Tumor vascular and interstitial characteristics were evaluated using the Brix two-compartment kinetic model. Modifications of the perfusion parameters (blood flow Fp, extravascular space ve, vascular space vp, and transfer constant PS) were assessed between both time points. DCE data were compared to FDG-PET and histopathological examination obtained simultaneously. Plasmatic vascular markers were investigated at different time points. Results Fourteen patients had evaluable DCE-CT parameters at both time points. A significant increase in the extravascular extracellular space ve accessible to the tracer was observed but no significant differences were found for the other kinetic parameters (Fp, vp or PS). Significant correlations were found between DCE parameters and the other two modalities. Plasmatic VEGF, PDGF-BB and IL-8 decreased as early as 2 hours after cetuximab infusion. Conclusions Early activity of cetuximab on tumor interstitial characteristics was detected by DCE-CT. Modifications of plasmatic vascular markers are not sufficient to confirm anti-angiogenic cetuximab activity in vivo. Further investigation is warranted to determine to what extent DCE-CT parameters are modified and to evaluate whether they are able to predict treatment outcome.
Collapse
|
|
21
|
La Fontaine MD, McDaniel LS, Kubicek LN, Chappell RJ, Forrest LJ, Jeraj R. Patient characteristics influencing the variability of distributed parameter-based models in DCE-CT kinetic analysis. Vet Comp Oncol 2015; 15:105-117. [PMID: 25702795 DOI: 10.1111/vco.12143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 01/07/2015] [Accepted: 01/13/2015] [Indexed: 12/17/2022]
Abstract
Kinetic parameter variability may be sensitive to kinetic model choice, kinetic model implementation or patient-specific effects. The purpose of this study was to assess their impact on the variability of dynamic contrast-enhanced computed tomography (DCE-CT) kinetic parameters. A total of 11 canine patients with sinonasal tumours received high signal-to-noise ratio, test-double retest DCE-CT scans. The variability for three distributed parameter (DP)-based models was assessed by analysis of variance. Mixed-effects modelling evaluated patient-specific effects. Inter-model variability (CVinter ) was comparable to or lower than intra-model variability (CVintra ) for blood flow (CVinter :[4-28%], CVintra :[28-31%]), fractional vascular volume (CVinter :[3-17%], CVintra :[16-19%]) and permeability-surface area product (CVinter :[5-12%], CVintra :[14-15%]). The kinetic models were significantly (P<0.05) impacted by patient characteristics for patient size, area underneath the curve of the artery and of the tumour. In conclusion, DP-based models demonstrated good agreement with similar differences between models and scans. However, high variability in the kinetic parameters and their sensitivity to patient size may limit certain quantitative applications.
Collapse
Affiliation(s)
- M D La Fontaine
- Department of Medical Physics, University of Wisconsin, Madison, WI, USA
| | - L S McDaniel
- Department of Statistics, University of Wisconsin, Madison, WI, USA
| | - L N Kubicek
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, USA
| | - R J Chappell
- Department of Statistics, University of Wisconsin, Madison, WI, USA
| | - L J Forrest
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, USA
| | - R Jeraj
- Department of Medical Physics, University of Wisconsin, Madison, WI, USA
| |
Collapse
|
|
22
|
Hayano K, Fujishiro T, Sahani DV, Satoh A, Aoyagi T, Ohira G, Tochigi T, Matsubara H, Shuto K. Computed tomography perfusion imaging as a potential imaging biomarker of colorectal cancer. World J Gastroenterol 2014; 20:17345-17351. [PMID: 25516645 PMCID: PMC4265592 DOI: 10.3748/wjg.v20.i46.17345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 04/01/2014] [Accepted: 07/22/2014] [Indexed: 02/06/2023] Open
Abstract
Neovascularization was reported to arise early in the adenoma-carcinoma sequence in colorectal cancer (CRC), and the importance of angiogenesis in cancer progression has been established. Computed tomography (CT) perfusion (CTP) based on high temporal resolution CT images enables evaluation of hemodynamics of tissue in vivo by modeling tracer kinetics. CTP has been reported to characterize tumor angiogenesis, and to be a sensitive marker for predicting recurrence or survival in CRC. In this review, we will discuss the biomarker value of CTP in the management of CRC patients.
Collapse
|
|
23
|
Value of Whole-Tumor Dual-Input Perfusion CT in Predicting the Effect of Multiarterial Infusion Chemotherapy on Advanced Non–Small Cell Lung Cancer. AJR Am J Roentgenol 2014; 203:W497-505. [PMID: 25341164 DOI: 10.2214/ajr.13.11621] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
|
24
|
Luczynska E, Blecharz P, Dyczek S, Stelmach A, Petralia G, Bellomi M, Jereczek-Fossa BA, Jakubowicz J. Perfusion CT is a valuable diagnostic method for prostate cancer: a prospective study of 94 patients. Ecancermedicalscience 2014; 8:476. [PMID: 25435904 PMCID: PMC4239130 DOI: 10.3332/ecancer.2014.476] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Indexed: 12/04/2022] Open
Abstract
Purpose The aim of this study is to assess the usefulness of perfusion computer tomography (pCT) in prostate cancer (PCa) diagnostics. Materials and Methods 94 patients with biopsy-proven PCa were enrolled in the study. Dynamic pCT of the prostate gland was performed for 50 seconds after an intravenous injection of contrast medium. Blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS) were computed in the suspected PCa area and in normal prostatic tissue. Results PCa was visible in pCT in 90 of the 94 examined patients as a focal peripheral CT enhancement. When PCa was located in the peripheral zone (PZ), it was visible on perfusion maps, mostly showing an early peak followed by wash-out. The average values of all perfusion parameters were higher for tumour than for normal prostate tissue (p < 0.000). BV and BF were dependent on tumour grade expressed by the Gleason score (GS). All PCa cases were divided into groups, according to histological grade, as low (GS ≤ 6), medium (GS = 7), and high (GS > 7). In high-grade PCa, the mean BF value was significantly higher (p = 0.001) than the mean value of BF low- and medium-grade PCa (p = 0.011). Similar results were obtained regarding the mean values of BV; the more aggressive the cancer grade, the higher the mean BV value (p = 0.04). Conclusion CT quantitative perfusion imaging allows PCa to be distinguished from normal prostate tissue. The highest values for BF and BV were observed in the most aggressive PCa grade.
Collapse
Affiliation(s)
- Elzbieta Luczynska
- Radiology Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Pawel Blecharz
- Gynecologic Oncology Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Sonia Dyczek
- Radiology Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Andrzej Stelmach
- Radiotherapy Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | | | - Massimo Bellomi
- Radiology Department, European Institute of Oncology, Milan, Italy ; Radiology Department, European Institute of Oncology, Milan, Italy
| | | | - Jerzy Jakubowicz
- Surgery Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| |
Collapse
|
|
25
|
Arya S, Rane P, Deshmukh A. Oral cavity squamous cell carcinoma: Role of pretreatment imaging and its influence on management. Clin Radiol 2014; 69:916-30. [DOI: 10.1016/j.crad.2014.04.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 03/31/2014] [Accepted: 04/15/2014] [Indexed: 11/28/2022]
|
|
26
|
Popovic KS, Harej M, Furlan T, Popovič P, Strojan P. Role of perfusion computed tomography in assessing submandibular gland radiochemotherapy-induced injury. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:241-7. [PMID: 25047931 DOI: 10.1016/j.oooo.2014.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/20/2014] [Accepted: 04/29/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE We aimed to detect changes in the volume and perfusion parameters of the submandibular glands during and after radiochemotherapy. STUDY DESIGN Twelve patients underwent computed tomography (CT) and perfusion CT before radiochemotherapy, after 40 Gy, after 70 Gy, and 3 months after radiochemotherapy. Submandibular gland volume, blood volume, permeability surface area product, and blood flow were quantified. RESULTS Submandibular gland volumes during and after therapy were significantly lower compared with the baseline value (P < .001). Blood volume, blood flow, and permeability surface area product values showed statistically significant reduction during and 3 months after therapy. A significant linear correlation was found between changes in submandibular gland volume and of the perfusion parameter blood volume in the period between baseline and 3 months after therapy (P = .012; RP = -0.697). CONCLUSIONS Changes in submandibular gland volume and dynamics of perfusion parameters imply that radiation-induced injury of submandibular glands develops early during radiochemotherapy.
Collapse
Affiliation(s)
| | - Maja Harej
- Institute of Radiology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Tjaša Furlan
- Institute of Radiology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Peter Popovič
- Institute of Radiology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Primož Strojan
- Division of Radiation Oncology, Oncology Institute Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
|
27
|
Role of CT perfusion in monitoring and prediction of response to therapy of head and neck squamous cell carcinoma. BIOMED RESEARCH INTERNATIONAL 2014; 2014:917150. [PMID: 25140324 PMCID: PMC4129140 DOI: 10.1155/2014/917150] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/05/2014] [Indexed: 01/06/2023]
Abstract
This review aims to summarize the technique and clinical applications of CT perfusion (CTp) of head and neck cancer. The most common pathologic type (90%) of head and neck cancer is squamous cell carcinoma (HNSCC): its diagnostic workup relies on CT and MRI, as they provide an accurate staging for the disease by determining tumour volume, assessing its extension, and detecting of lymph node metastases. Compared with conventional CT and MRI, CTp allows for obtaining measures of tumour vascular physiology and functional behaviour, and it has been demonstrated to be a feasible and useful tool in predicting local outcomes in patients undergoing radiation therapy and chemotherapy and may help monitor both treatments.
Collapse
|
|
28
|
Martens MH, Lambregts DMJ, Kluza E, Beets-Tan RGH. Tumor Response to Treatment: Prediction and Assessment. CURRENT RADIOLOGY REPORTS 2014. [DOI: 10.1007/s40134-014-0062-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
|
29
|
Effect of increasing the sampling interval to 2 seconds on the radiation dose and accuracy of CT perfusion of the head and neck. J Comput Assist Tomogr 2014; 38:469-73. [PMID: 24651742 DOI: 10.1097/rct.0000000000000066] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the effect of increasing the sampling interval from 1 second (1 image per second) to 2 seconds (1 image every 2 seconds) on computed tomographic (CT) perfusion (CTP) of head and neck tumors. MATERIALS AND METHODS Twenty patients underwent CTP studies of head and neck tumors with images acquired in cine mode for 50 seconds using sampling interval of 1 second. Using deconvolution-based software, analysis of CTP was done with sampling interval of 1 second and then 2 seconds. Perfusion maps representing blood flow, blood volume, mean transit time, and permeability surface area product (PS) were obtained. Quantitative tumor CTP values were compared between the 2 sampling intervals. Two blinded radiologists compared the subjective quality of CTP maps using a 3-point scale between the 2 sampling intervals. Radiation dose parameters were recorded for the 2 sampling interval rates. RESULTS No significant differences were observed between the means of the 4 perfusion parameters generated using both sampling intervals; all P >0.05. The 95% limits of agreement between the 2 sampling intervals were -65.9 to 48.1) mL/min per 100 g for blood flow, -3.6 to 3.1 mL/100 g for blood volume, -2.9 to 3.8 seconds for mean transit time, and -10.0 to 12.5 mL/min per 100 g for PS. There was no significant difference between the subjective quality scores of CTP maps obtained using the 2 sampling intervals; all P > 0.05. Radiation dose was halved when sampling interval increased from 1 to 2 seconds. CONCLUSIONS Increasing the sampling interval rate to 1 image every 2 seconds does not compromise the image quality and has no significant effect on quantitative perfusion parameters of head and neck tumors. The radiation dose is halved.
Collapse
|
|
30
|
Hayano K, Shuto K, Satoh A, Aoyagi T, Narushima K, Gunji H, Kono T, Yanagawa N, Okazumi S, Matsubara H. Tumor blood flow change measured by CT perfusion during chemoradiation therapy (CRT) for monitoring response and predicting survival in patients with esophageal cancer. Esophagus 2014; 11:72-79. [DOI: 10.1007/s10388-013-0400-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
|
|
31
|
Razek AAKA, Tawfik AM, Elsorogy LGA, Soliman NY. Perfusion CT of head and neck cancer. Eur J Radiol 2013; 83:537-44. [PMID: 24387935 DOI: 10.1016/j.ejrad.2013.12.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 12/05/2013] [Accepted: 12/08/2013] [Indexed: 12/17/2022]
Abstract
We aim to review the technique and clinical applications of perfusion CT (PCT) of head and neck cancer. The clinical value of PCT in the head and neck includes detection of head and neck squamous cell carcinoma (HNSCC) as it allows differentiation of HNSCC from normal muscles, demarcation of tumor boundaries and tumor local extension, evaluation of metastatic cervical lymph nodes as well as determination of the viable tumor portions as target for imaging-guided biopsy. PCT has been used for prediction of treatment outcome, differentiation between post-therapeutic changes and tumor recurrence as well as monitoring patient after radiotherapy and/or chemotherapy. PCT has a role in cervical lymphoma as it may help in detection of response to chemotherapy and early diagnosis of relapsing tumors.
Collapse
Affiliation(s)
| | - Ahmed Mohamed Tawfik
- Diagnostic Radiology Department, Mansoura Faculty of Medicine, Mansoura 13551, Egypt.
| | | | - Nermin Yehia Soliman
- Diagnostic Radiology Department, Mansoura Faculty of Medicine, Mansoura 13551, Egypt.
| |
Collapse
|
|
32
|
|
|
33
|
Jo SY, Wang PI, Nör JE, Bellile EL, Zhang Z, Worden FP, Srinivasan A, Mukherji SK. CT perfusion can predict overexpression of CXCL8 (interleukin-8) in head and neck squamous cell carcinoma. AJNR Am J Neuroradiol 2013; 34:2338-42. [PMID: 23828112 DOI: 10.3174/ajnr.a3610] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE Increased angiogenesis in head and neck squamous cell carcinoma correlates to more aggressive tumors with increased morbidity. Because both elevated blood flow and high serum CXCL8 levels are correlated with increased angiogenesis, our objective was to see if elevated blood flow measured with CT perfusion correlated with CXCL8 levels, thereby helping to identify candidates for targeted therapies that inhibit the Bcl-2 proangiogenic pathway associated with CXCL8. MATERIALS AND METHODS Seven patients with locally recurrent or metastatic head and neck squamous cell carcinoma were enrolled in the trial. These patients underwent CT perfusion and the following parameters were measured: blood volume, blood flow, capillary permeability, and MTT; relative values were calculated by dividing by normal-appearing muscle. Serum was drawn for CXCL8 enzyme-linked immunosorbent assay analysis in these patients. RESULTS There was a significant positive correlation between the CXCL8 levels and relative blood flow (r = 0.94; P = .01). No correlation was found between CXCL8 and relative blood volume, relative capillary permeability, or relative MTT. CONCLUSIONS Relative blood flow may be useful as a surrogate marker for elevated CXCL8 in patients with head and neck squamous cell cancer. Patients with elevated relative blood flow may benefit from treatment targeting the Bcl-2 proangiogenic pathways.
Collapse
|
|
34
|
Djuric-Stefanovic A, Saranovic D, Masulovic D, Ivanovic A, Pesko P. Comparison between the deconvolution and maximum slope 64-MDCT perfusion analysis of the esophageal cancer: is conversion possible? Eur J Radiol 2013; 82:1716-23. [PMID: 23810188 DOI: 10.1016/j.ejrad.2013.05.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 05/04/2013] [Accepted: 05/28/2013] [Indexed: 01/08/2023]
Abstract
PURPOSE To estimate if CT perfusion parameter values of the esophageal cancer, which were obtained with the deconvolution-based software and maximum slope algorithm are in agreement, or at least interchangeable. METHODS 278 esophageal tumor ROIs, derived from 35 CT perfusion studies that were performed with a 64-MDCT, were analyzed. "Slice-by-slice" and average "whole-covered-tumor-volume" analysis was performed. Tumor blood flow and blood volume were manually calculated from the arterial tumor-time-density graphs, according to the maximum slope methodology (BF(ms) and BV(ms)), and compared with the corresponding perfusion values, which were automatically computed by commercial deconvolution-based software (BF(deconvolution) and BV(deconvolution)), for the same tumor ROIs. Statistical analysis was performed using Wilcoxon matched-pairs test, paired-samples t-test, Spearman and Pearson correlation coefficients, and Bland-Altman agreement plots. RESULTS BF(deconvolution) (median: 74.75 ml/min/100g, range, 18.00-230.5) significantly exceeded the BF(ms) (25.39 ml/min/100g, range, 7.13-96.41) (Z=-14.390, p<0.001), while BV(deconvolution) (median: 5.70 ml/100g, range: 2.10-15.90) descended the BV(ms) (9.37 ml/100g, range: 3.44-19.40) (Z=-13.868, p<0.001). Both pairs of perfusion measurements significantly correlated with each other: BF(deconvolution), versus BF(ms) (rS=0.585, p<0.001), and BV(deconvolution), versus BV(ms) (rS=0.602, p<0.001). Geometric mean BF(deconvolution)/BF(ms) ratio was 2.8 (range, 1.1-6.8), while geometric mean BV(deconvolution)/BV(ms) ratio was 0.6 (range, 0.3-1.1), within 95% limits of agreement. CONCLUSIONS Significantly different CT perfusion values of the esophageal cancer blood flow and blood volume were obtained by deconvolution-based and maximum slope-based algorithms, although they correlated significantly with each other. Two perfusion-measuring algorithms are not interchangeable because too wide ranges of the conversion factors were found.
Collapse
Affiliation(s)
- A Djuric-Stefanovic
- Unit of Digestive Radiology (First Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade, Serbia.
| | | | | | | | | |
Collapse
|
|
35
|
Hauser T, Essig M, Jensen A, Gerigk L, Laun FB, Münter M, Simon D, Stieltjes B. Characterization and therapy monitoring of head and neck carcinomas using diffusion-imaging-based intravoxel incoherent motion parameters-preliminary results. Neuroradiology 2013; 55:527-36. [PMID: 23417120 DOI: 10.1007/s00234-013-1154-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 01/31/2013] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Using the intravoxel incoherent motion (IVIM) model, diffusion-related coefficient (D) and perfusion-related parameter (f) can be measured. Here, we used IVIM imaging to characterize squamous cell carcinomas of head and neck (HNSCC) and evaluated its application in follow-up after nonsurgical organ preserving therapy. METHODS Twenty-two patients with locally advanced HNSCC (clinical stage III to IVb) were examined before treatment using eight different b values (b = 0, 50, 100, 150, 200, 250, 700, 800 s/mm(2)). All patients were followed for at least 7.5 months after conclusion of therapy. In 16 of these patients, follow-up MRI was available. Using the IVIM approach, f and D were extracted using a bi-exponential fit. For comparison, ADC maps were calculated. RESULTS The initial values of f before therapy were located between 5.9 % and 12.9 % (mean: 9.4 ± 2.4 %) except for two outliers (f = 17.9 % and 18.2 %). These two patients exclusively displayed poor initial treatment response. Overall, high initial f (13.1 ± 4.1 % vs. 9.1 ± 2.4 %) and ADC (1.17 ± 0.08 × 10(-3) mm(2)/s vs. 0.98 ± 0.19 × 10(-3) mm(2)/s) were associated with poor short term outcome (n = 6) after 7.5 months follow-up. D values before treatment were 0.98 × 10(-3) ± 0.18 mm(2)/s and ADC values were 1.03 × 10(-3) ± 0.18 mm(2)/s. At follow-up, in all primary responders, D (69 ± 52 %), f (65 ± 46 %), and ADC (68 ± 49%) increased. CONCLUSIONS Our preliminary evaluation indicates that an initial high f may predict poor prognosis in HNSCC. In responders, a significant increase of all IVIM parameters after therapy was demonstrated.
Collapse
Affiliation(s)
- Thomas Hauser
- Department of Radiology E010, German Cancer Research Center, Heidelberg, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
|
36
|
Hoefling NL, McHugh JB, Light E, Kumar B, Walline H, Prince M, Bradford C, Carey TE, Mukherji SK. Human papillomavirus, p16, and epidermal growth factor receptor biomarkers and CT perfusion values in head and neck squamous cell carcinoma. AJNR Am J Neuroradiol 2013; 34:1062-6, S1-2. [PMID: 23370473 DOI: 10.3174/ajnr.a3349] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Head and neck squamous cell carcinoma tumors positive for laboratory biomarkers hrHPV and p16 and negative for EGFR often respond better to nonsurgical organ-preservation therapy than hrHPV-negative, p16-negative, and EGFR overexpressing tumors. CTP has been shown to distinguish which locally advanced head and neck squamous cell carcinomas will respond to induction chemotherapy or chemoradiation. Our purpose was to determine whether a relationship exists between CTP measures and the expression of these laboratory biomarkers, because both appear to separate head and neck squamous cell carcinoma tumors into similar groups. MATERIALS AND METHODS We conducted an institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective review of head and neck CTP in 25 patients with locally advanced head and neck squamous cell carcinoma who had signed informed consent. Eight women and 17 men, 41-80 years of age, constituted a pretreatment group of 18 patients and a palliative group of 7 patients. Tumor biopsy samples were analyzed for overexpression of hrHPV, p16, and EGFR. The hrHPV, p16, and EGFR status of the tumors was correlated with CTP parameters (MTT, BV, BF, CP) by using the Wilcoxon evaluation and Fischer exact test. RESULTS There were significantly lower CP values in pretreatment tumors overexpressing EGFR (P = .04). CP values ≤17.23 were significantly correlated with EGFR overexpression (P = .015). A trend toward higher CP values was present in hrHPV-positive and p16-overexpressing pretreatment tumors (P = .14). CONCLUSIONS A significant correlation exists between CTP measures and EGFR overexpression in head and neck squamous cell carcinomas, suggesting an association between certain imaging findings and molecular biomarkers. These results may be related to a tumor cell survival mechanism linking perfusion and biomarker expression.
Collapse
Affiliation(s)
- N L Hoefling
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
|
37
|
Caranci F, Brunese L, Reginelli A, Napoli M, Fonio P, Briganti F. Neck neoplastic conditions in the emergency setting: role of multidetector computed tomography. Semin Ultrasound CT MR 2013; 33:443-8. [PMID: 22964410 DOI: 10.1053/j.sult.2012.06.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Emergent conditions resulting from head and neck neoplasms and their treatment include acute airway obstruction, hemorrhage, spinal cord compression, bilateral vocal cord paralysis, and septic thrombophlebitis. These conditions require accurate diagnosis and rapid intervention to avoid severe permanent damage or death. Successful treatment requires a coordinated response by emergency medicine physicians, otolaryngologists, vascular surgeons, and radiologists. We review these head and neck oncological conditions, which present emergently, with a focus on radiological evaluation and interpretation.
Collapse
Affiliation(s)
- Ferdinando Caranci
- Department of Diagnostic Radiology and Radiotherapy, Federico II University of Naples, Naples, Italy.
| | | | | | | | | | | |
Collapse
|
|
38
|
Tawfik AM, Nour-Eldin NEA, Naguib NN, Razek AA, Denewer AT, Bisdas S, Vogl TJ. CT perfusion measurements of head and neck carcinoma from single section with largest tumor dimensions or average of multiple sections: Agreement between the two methods and effect on intra- and inter-observer agreement. Eur J Radiol 2012; 81:2692-6. [DOI: 10.1016/j.ejrad.2011.11.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 10/28/2011] [Accepted: 11/03/2011] [Indexed: 10/14/2022]
|
|
39
|
Veit-Haibach P, Schmid D, Strobel K, Soyka JD, Schaefer NG, Haerle SK, Huber G, Studer G, Seifert B, Hany TF. Combined PET/CT-perfusion in patients with head and neck cancers. Eur Radiol 2012; 23:163-73. [DOI: 10.1007/s00330-012-2564-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 05/18/2012] [Accepted: 05/24/2012] [Indexed: 12/23/2022]
|
|
40
|
Bharatha A, Yu E, Symons SP, Bartlett ES. Pictorial Essay: Early- and Late-term Effects of Radiotherapy in Head and Neck Imaging. Can Assoc Radiol J 2012; 63:119-28. [DOI: 10.1016/j.carj.2010.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Revised: 06/19/2010] [Accepted: 09/02/2010] [Indexed: 10/18/2022] Open
Abstract
The purpose of this article is to illustrate the cross-sectional imaging appearance of postradiation changes and complications of radiotherapy in the head and neck. Radiotherapy is an important treatment modality for head and neck cancer, and is often used in conjunction with chemotherapy. Recognition of the varied effects of radiotherapy to the head and neck region is essential to correctly interpret posttreatment imaging and may help prevent further complication.
Collapse
Affiliation(s)
- Aditya Bharatha
- Division of Neuroradiology, Department of Medical Imaging, London Health Sciences Centre–Victoria Hospital, University of Western Ontario, London, Ontario, Canada
- Division of Neuroradiology, Department of Medical Imaging, Princess Margaret Hospital, Toronto, Ontario, Canada
| | - Eugene Yu
- Division of Neuroradiology, Department of Medical Imaging, Princess Margaret Hospital, Toronto, Ontario, Canada
| | - Sean P. Symons
- Division of Neuroradiology, Department of Medical Imaging, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
| | - Eric S. Bartlett
- Division of Neuroradiology, Department of Medical Imaging, Princess Margaret Hospital, Toronto, Ontario, Canada
| |
Collapse
|
|
41
|
Srinivasan A, Mohan S, Mukherji SK. Biologic imaging of head and neck cancer: the present and the future. AJNR Am J Neuroradiol 2011; 33:586-94. [PMID: 22194364 DOI: 10.3174/ajnr.a2535] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
While anatomic imaging (CT and MR imaging) of HNC is focused on diagnosing and/or characterizing the disease, defining its local extent, and evaluating distant spread, accurate assessment of the biologic status of the cancer (cellularity, growth rate, response to nonsurgical chemoradiation therapy, and so forth) can be invaluable for prognostication, planning therapy, and follow-up of lesions after therapy. The combination of anatomic and biologic imaging techniques can thus provide a more comprehensive evaluation of the patient. The purpose of this work was to review the present and future clinical applications of advanced biologic imaging techniques in HNC evaluation and management. As part of the biologic imaging array, we discuss MR spectroscopy, diffusion and perfusion MR imaging, CTP, and FDG-PET scanning and conclude with exciting developments that hold promise in assessment of tumor hypoxia and neoangiogenesis.
Collapse
Affiliation(s)
- A Srinivasan
- Department of Radiology, Division of Neuroradiology, University of Michigan Health System, Ann Arbor, Michigan 48109, USA.
| | | | | |
Collapse
|
|
42
|
Li XS, Fan HX, Zhu HX, Song YL, Zhou CW. The value of perfusion CT in predicting the short-term response to synchronous radiochemotherapy for cervical squamous cancer. Eur Radiol 2011; 22:617-24. [DOI: 10.1007/s00330-011-2280-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 08/31/2011] [Accepted: 09/05/2011] [Indexed: 12/27/2022]
|
|
43
|
Truong MT, Saito N, Ozonoff A, Wang J, Lee R, Qureshi MM, Jalisi S, Sakai O. Prediction of locoregional control in head and neck squamous cell carcinoma with serial CT perfusion during radiotherapy. AJNR Am J Neuroradiol 2011; 32:1195-201. [PMID: 21757530 DOI: 10.3174/ajnr.a2501] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Tumor hypoxia is a known factor of radioresistance in HNSCC. CTP is a noninvasive method of measuring tumor perfusion in vivo. The purpose of our study was to determine serial changes in tumor perfusion in HNSCC during a course of RT by using CTP and to correlate tumor perfusion measurements to LRC. MATERIALS AND METHODS A prospective study was performed in 15 patients with HNSCC receiving definitive RT who underwent serial CTP before RT; at weeks 2, 4, and 6 of RT; and 6 weeks after RT. The median follow-up was 28 months (range, 6-44 months). Thirteen patients achieved LRC, and 2 patients had LRF. Tumor perfusion parameters, including BF, BV, MTT, and CP, were obtained by using a deconvolution-based analysis. RESULTS Pretreatment tumor BF was significantly higher in patients who achieved LRC, 118.0 mL/100 g/min, compared with those with LRF, 53.4 mL/100 g/min (P = .004). Similarly, pretreatment CP was higher in patients with LRC, 16.6 mL/100 g/min, compared with those with LRF, 7.7 mL/100 g/min (P = .02). At week 2 of RT, tumor BF parameters showed a 27.5% increase versus an 18.1% decrease from pretreatment BF values (P = .046) in patients with LRC and LRF, respectively. A decrease in BF and BV was observed in both groups 6 weeks after RT compared with these values at baseline scanning. CONCLUSIONS An increase in tumor BF and CP by using CTP early during a course of RT predicts LRC in patients with HNSCC treated with RT.
Collapse
Affiliation(s)
- M T Truong
- Departments of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.
| | | | | | | | | | | | | | | |
Collapse
|
|
44
|
Trojanowska A. Squamous cell carcinoma of the head and neck-The role of diffusion and perfusion imaging in tumor recurrence and follow-up. Rep Pract Oncol Radiother 2011; 16:207-12. [PMID: 24376982 DOI: 10.1016/j.rpor.2011.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 05/31/2011] [Accepted: 06/22/2011] [Indexed: 11/30/2022] Open
Abstract
Computed tomography and magnetic resonance imaging-based techniques of functional imaging are proven to be sensitive and reliable tools for detection and staging of head and neck cancer. These new techniques enable to visualize and differentiate subtle pathologic changes before they become evident on standard cross-sectional images. However, it is their role in evaluating possible recurrence and estimation of treatment response that holds the biggest promise. This article describes the role and usefulness of diffusion and perfusion in detecting recurrence and follow-up in patients with head and neck squamous cell carcinoma.
Collapse
Affiliation(s)
- Agnieszka Trojanowska
- Department of Diagnostic Radiology, Medical University in Lublin, ul. Ogrodowa 15, 20-075 Lublin, Poland
| |
Collapse
|
|
45
|
Truong MT, Lee R, Saito N, Qureshi MM, Ozonoff A, Romesser PB, Wang J, Sakai O. Correlating computed tomography perfusion changes in the pharyngeal constrictor muscles during head-and-neck radiotherapy to dysphagia outcome. Int J Radiat Oncol Biol Phys 2011; 82:e119-27. [PMID: 21669502 DOI: 10.1016/j.ijrobp.2011.04.058] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 04/20/2011] [Accepted: 04/21/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE To measure changes in perfusion of the pharyngeal constrictor muscles (PCM) using CT perfusion (CTP) imaging during a course of definitive radiotherapy (RT) in head-and-neck cancer (HNC) patients and correlate with dysphagia outcome after RT. METHODS AND MATERIALS Fifteen HNC patients underwent CTP imaging of the PCM at baseline and Weeks 2, 4, and 6 during RT and 6 weeks after RT. Blood flow and blood volume were measured in the PCM, and percentage change from baseline scan was determined. A single physician-based assessment of dysphagia was performed every 3 months after RT using the Common Terminology Criteria for Adverse Events, version 3.0 grading system. RESULTS With a median follow-up of 28 months (range, 6-44 months), Grade 3 dysphagia was present in 7 of 15 patients, and 8 patients experienced Grade 0-2 dysphagia. The CTP parameters at Week 2 of RT demonstrated an increase in mean PCM blood flow of 161.9% vs. 12.3% (p = 0.007) and an increase in mean PCM blood volume of 96.6% vs. 8.7% (p = 0.039) in patients with 6-month post-RT Grade 3 dysphagia and Grade 0-2 dysphagia, respectively. On multivariate analysis, when adjusting for smoking history, tumor volume, and baseline dysphagia status, an increase in blood flow in the second week of RT was significant for 3- and 6-month Grade 3 dysphagia (p < 0.05). CONCLUSIONS Perfusion changes in the PCM during Week 2 of RT in the PCM may predict the severity of dysphagia after HNC RT.
Collapse
Affiliation(s)
- Minh Tam Truong
- Department of Radiation Oncology, Boston Medical Center and Boston University School of Medicine, Boston, MA 02118, USA.
| | | | | | | | | | | | | | | |
Collapse
|
|
46
|
Perfusion CT of Head and Neck Cancer: Effect of Arterial Input Selection. AJR Am J Roentgenol 2011; 196:1374-80. [DOI: 10.2214/ajr.10.5343] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
|
47
|
Bisdas S, Seitz O, Middendorp M, Chambron-Pinho N, Bisdas T, Vogl TJ, Hammerstingl R, Ernemann U, Mack MG. An exploratory pilot study into the association between microcirculatory parameters derived by MRI-based pharmacokinetic analysis and glucose utilization estimated by PET-CT imaging in head and neck cancer. Eur Radiol 2010; 20:2358-66. [PMID: 20443116 DOI: 10.1007/s00330-010-1803-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Accepted: 03/17/2010] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To examine the feasibility of deriving quantitative microcirculatory parameters and to investigate the relationship between vascular and metabolic characteristics of head and neck tumours in vivo, using dynamic contrast-enhanced (DCE) MRI and fluorodeoxyglucose (FDG) PET imaging. METHODS Twenty-seven patients with primary squamous cell carcinoma (SCCA) underwent DCE-MRI and combined PET/CT imaging. DCE-MRI data were post-processed by using commercially available software. Transfer constant (K (trans)), extravascular extracellular blood volume (v (e)), transfer constant from the extracellular extravascular space to plasma (k (ep)) and iAUC (initial area under the signal intensity-time curve) were calculated. 3D static PET data were acquired and standardised uptake values (SUV) calculated. RESULTS All microcirculatory parameters in tumours were higher than in normal muscle tissue (P ≤ 0.0019). Significant correlations were shown between k (ep) and K (trans) (ρ = 0.77), v (e) and k (ep) (ρ = -0.7), and iAUC and v (e) (ρ = 0.53). Significant correlations were observed for SUV(mean) and v (e) as well as iAUC (ρ = 0.42 and ρ = 0.66, respectively). SUV(max) was significantly correlated with iAUC (ρ = 0.69). CONCLUSIONS The demonstrated relationships between vascular and metabolic characteristics of primary SCCA imply a complex interaction between vascular delivery characteristics and tumour metabolism. The lack of correlation between SUV and K (trans)/k (ep) suggests that both diagnostic techniques may provide complementary information.
Collapse
Affiliation(s)
- Sotirios Bisdas
- Department of Neuroradiology, Eberhard Karls University Hospital, Hoppe Seyler Str. 3, 72076, Tübingen, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
|
48
|
Mukherji SK, Castelijns JA. CT perfusion of head and neck cancer: why we should care versus why should we care! AJNR Am J Neuroradiol 2009; 31:391-3. [PMID: 19926707 DOI: 10.3174/ajnr.a1964] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|