Quantitative Measurements of Perfusion and Permeability of Oropharyngeal and Oral Cavity Cancer, Recurrent Disease, and Associated Lymph Nodes Using First-Pass Contrast-Enhanced Computed Tomography Studies

Abstract

Perfusion CT of oropharyngeal and oral cavity cancer in clinical routine is feasible and helps outlining the malignant tissue as well as differentiating recurrent disease from nonspecific post-therapeutic changes.

Perfusion CT in Squamous Cell Carcinoma of the Upper Aerodigestive Tract: Long-Term Predictive Value of Baseline Perfusion CT Measurements

“…In our work, T stage was marginally significant for predicting local outcome. Reinforcing this evidence, the weak predictive value (P Ͻ .05) of the T stage for local tumor control in the oropharynx for patients treated with curative surgery or radiation therapy 24,25 and the weak or nonsignificant correlation between the T stage and perfusion-associated parameters 4,11,13 make it hard to predict only on the basis of T. This difficulty highlights the role of perfusion measurements in patients with neoadjuvant chemoradiation. [26][27][28] Finally, the perfusion estimations in our study did not have any predictive value for OS.…”

“…[4][5][6][7][8] In particular, the necessity to detect early response to therapy and avoid any time delay in nonresponders has led to examining the predictive value of perfusion imaging, which might help in tailoring the therapy regimen on an individual basis. 9,10 Early proponents of perfusion studies have also demonstrated in a clinical setting that semi-or quantitatively estimated tumor perfusion might predict the outcome after definitive radiation therapy.…”

Optimization of Perfusion CT Protocol for Imaging of Extracranial Head and Neck Tumors

“…3, by assuming appropriate values for the model parameters F, v 1 , k 21 , and k 12 . The parameter values used in this study were obtained from a previous study 8 in our institution after institutional review board approval and informed consent from the patients as well as from similar studies in literature. [9][10] These parameter values are F = 70 ml/min/100 g, v 1 = 5 ml/100 g, k 21 = 3.4 min −1 , and k 12 =0.85 min −1 , giving PS= 17 ml/min/100 g.…”

“…On the basis of the selected optimal values for N ICS , Δt, and T, we then consider decreasing values of N in the attempt to identify the smallest value of N that do not compromise on the accuracy of the perfusion parameters. In this set of simulation experiments, the perfusion values assumed were again F=70 ml/min/100 g, v 1 =5 ml/100 g, and PS=17 ml/min/100 g. 8 After defining the optimal scan duration and number of scans, the acquisition protocol was applied in a patient with a head and neck tumor (left parotid gland) after informed consent was obtained. A single 12-mm-thick tumor slab was examined using a 16-row multislice CT scanner (Somatom 16, Siemens Medical Systems, Erlangen, Germany).…”

“…The deconvolution method used also for the calculation of permeability changes has been the method of choice in several reports in recent literature. [8][9][10] Although the acquisition time of DCE-CT data in these studies varies from 50-55 s, other variations in imaging protocols among these studies are apparent. The delay before the initiation of the contrast-enhanced scans can be up to about 6 s after contrast injection, and the injection rate is not standardized, which results in different durations of the contrast agent passage in the tissue microvasculature.…”