Head and neck cancer: Value of perfusion CT in depicting primary tumor spread

Abstract

SummaryBackgroundThe aim of this study was to assess head and neck squamous cell cancer and surrounding tissue in computed tomography contrast enhanced and perfusion studies, and to examine the role of perfusion imaging in depiction of tissue infiltration.Material/MethodsWe prospectively evaluated 43 primary malignant head and neck tumors, using standard CT followed by perfusion. Blood flow, blood volume, mean transit time, and permeability values were obtained using regions of interest (ROIs) over lesions and surrounding tissue. Results were compared with histological analysis of resected tissue. Sensitivity, specificity, accuracy, positive and negative predictive values were calculated for both methods.ResultsWe found significant differences between infiltrated and non-infiltrated tissue, especially with regard to muscles. In case of bone and salivary gland infiltration, change in perfusion parameters did not allow proper diagnosis.ConclusionsCTP shows promise in depicting malignant infiltration. The combined use of CECT plus CTP results in correct staging of the majority of head and neck tumors.

Pleomorphic Adenoma Versus Warthin Tumor of the Parotid Gland: Diagnostic Value of CT Perfusion Imaging and Its Pathologic Explanation

“…When compared with dualphased enhanced CT, we assumed that Type I TDC was similar to early increase and fast decrease, and type III TDC were similar to delayed enhancement. The TDC findings features for WTs and PAs in this study strongly supported the previous opinions [9][10][11][12][13]15] , but some differences were also depicted. Type II TDC for 2 WTs cases observed in present work, showed fast enhancement and gradual washout, which was similar to type C TDC described by Y Dong et al [10] .…”

“…The measured signal density is the increased CT value after injection of contrast agent, so the change in contrast agent concentration in the tissue can be reflected. Therefore, CTP can reflect the blood flow within tissue directly, truly and reliably [9,12,13] . Previous studies [9][10][11][12][13] demonstrated that CTP imaging was usefulness to evaluate the vasclarituy and to differential the tumors in the head and neck, including those of the salivary glands.…”

“…Compared with two-phases and three-phases enhancement, TDC reveals the lesion attenuation changes in multiple time points, and the perfusion parameters can be evaluated at the same time. There is evidence that TDC curves, BF, BV, TTP and PEI parameters can help objectively evaluate the microcirculation and tumor vessel formation and reflect the pathohistological characteristics of foci, and BF, BV and PEI can be used to effectively evaluate micro-vessel density and tumor angiogenesis [9,12,13] . Y Dong et al [10] and Bisdas S. et al [15] studies demonstrated that TDC pattern was very helpful for parotid tumor differential diagnosis.…”

“…Compared with dual phases enhanced CT, CTP is not only can provide time density curves (TDCs) that show the dynamic change of blood supply, but also can multiple perfusion parameter values. Previous CTP pilot studies have reported the feasibility of the study in head and neck imaging and provided normal as well as pathologic perfusion values [7,12] . The aim of this study is to examine the feasibility of CTP imaging in differentiating between PAs and WTs by using TDCs features and perfusion values analysis, and to explain its pathological basis.…”

Role of perfusion CT in the evaluation of functional primary tumour response after radiochemotherapy in head and neck cancer: preliminary findings

“…8 More recently, obtaining quantitative perfusion CT (PCT) information on the status of tumour microcirculation that might reflect early treatment response or predict outcome has been proposed as a potential additional tool for the non-invasive functional assessment of treatment response. [9][10][11][12][13][14] Although no consensus has been reached so far about the optimal timing of PCT imaging for the assessment of early treatment response, several experimental studies on both humans and animal models have shown the ability of PCT to detect changes of PCT parameters less than 1 month after or even within days of beginning of therapy (i.e. well before a reduction in tumour size can be demonstrated on conventional morphological CT imaging).…”