Prediction of Response to Chemoradiation Therapy in Squamous Cell Carcinomas of the Head and Neck Using Dynamic Contrast-Enhanced MR Imaging

Abstract

BACKGROUND AND PURPOSE: Tumor microenvironment, including blood flow and permeability, may provide crucial information regarding response to chemoradiation therapy. Thus, the objective of this study was to investigate the efficacy of pretreatment DCE-MR imaging for prediction of response to chemoradiation therapy in HNSCC.

Prediction of Disease-Free Survival in Patients with Squamous Cell Carcinomas of the Head and Neck Using Dynamic Contrast-Enhanced MR Imaging

“…Pharmacokinetic analysis of the DCE-MRI data was performed for each voxel in the selected region of interest by using the shutter-speed model reported earlier. 10,15 These regions of interest were also used for the volumetric analysis. Median pretreatment K trans values were computed from the larg- …”

“…The DCE-MRI protocol used in this study was described previously. 10,15 Briefly, DCE-MRI was performed by using a fast 3D spoiled gradient-echo sequence, which was modified to acquire 8 angle-interleaved subaperture images from the full-echo radial data. seconds with fat and spatial saturations.…”

“…The pretreatment K trans , which reflects tumor perfusion/permeability, has been shown to predict nodal treatment response to chemoradiation therapy in patients with HNSCC. 10 These studies imply that tumor vascularity may be an important predictor of local treatment response and disease control in HNSCC because elevated blood flow may permit improved delivery of therapeutic agents to the tumor. While other imaging modalities such as CT and PET have also been proposed for predicting prognosis and survival in patients with HNSCC, 6,[11][12][13] lower soft tissue contrast and exposure to radiation associated with these modalities 14 call for an alternate imaging technique.…”

Texture analysis on parametric maps derived from dynamic contrast-enhanced magnetic resonance imaging in head and neck cancer

“…For patients with advanced head and neck squamous cell carcinoma (HNSCC), DCE-MRI has shown potential for assessment of treatment response and outcome [4][5][6] . More specifically, measures derived from DCE-MRI, such as K trans and ve, were demonstrated to provide helpful additional information regarding characterization and prognosis of HNSCC with neck nodal metastases [7,8] . HNSCC has been shown to be heterogeneous, due to a chaotic and poorly organized tumor vasculature.…”

MRI Sequences in Head & Neck Radiology – State of the Art

“…The output may vary between and within institutions, because of differences in T1 analysis, methods to measure arterial input function (AIF), choice of ROI, scanner model, pharmacokinetic model and time point chosen during treatment [33]. However, K trans emerged as a marker for tumor hypoxia indicating poorer survival or poorer treatment response and has the potential to be a useful biomarker to guide treatment in head & neck squamous cell cancer [32,34,35]. It may also have the potential to identify early locoregional recurrence and differentiate metastatic lymph nodes from normal nodes [36].…”