Prediction of Locoregional Control in Head and Neck Squamous Cell Carcinoma with Serial CT Perfusion during Radiotherapy

• Published in: American journal of neuroradiology : AJNR 2011-08, Vol.32 (7), p.1195-1201
• Main Authors: TRUONG, M. T, SAITO, N, OZONOFF, A, WANG, J, LEE, R, QURESHI, M. M, JALISI, S, SAKAI, O
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Carcinoma, Squamous Cell - blood supply; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - radiotherapy; Electrodiagnosis. Electric activity recording; Female; Follow-Up Studies; Head and Neck; Head and Neck Neoplasms - blood supply; Head and Neck Neoplasms - diagnostic imaging; Head and Neck Neoplasms - radiotherapy; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Miscellaneous. Technology; Nervous system; Perfusion Imaging - methods; Predictive Value of Tests; Prospective Studies; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiotherapy - methods; Survival Rate; Tomography, X-Ray Computed - methods; Treatment Outcome
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A2501

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. 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. 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. 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.