Tumor perfusion rate determined noninvasively by dynamic computed tomography predicts outcome in head-and-neck cancer after radiotherapy

Hermans, Robert; Meijerink, Martijn R.; Bogaert, Walter Van den; Rijnders, A.; Weltens, Caroline; Lambin, Philippe

doi:10.1016/s0360-3016(03)00764-8

Cited by 162 publications

(141 citation statements)

References 27 publications

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“…The proposed threshold of 73 mL/min/100 mL of tissue was based on the best combination of sensitivity and specificity, whereas the choice of PCT studies as a screening technique (which implies higher sensitivity rates) may elevate the cutoff value (ie, a threshold of 100 mL/min/100 mL of tissue offers sensitivity/specificity rates of 85%/25%). Our results are in agreement with those of Hermans et al, 11 who also highlighted the predictive value of PCT studies in patients treated with definitive radiation therapy (15 of them also received concomitant chemotherapy) and stratified them with a cutoff value of 83.5 mL/min/100 mL of tissue on the basis of the maximumslope model.…”

Section: Resultssupporting

confidence: 92%

“…An example of BF-BV mismatch is shown in Fig 3. Discussion PCT appears as a robust, reproducible, widely accessible, and promising method for the assessment of functional parameters on the tissue level. 7,11,14 Because of clinical study results showing that long-term follow-up (2-3 years) is necessary for determining the local control rate of SCCA in the head and neck, 15 the present work focused on a long follow-up in a large patient population receiving neoadjuvant chemoradiation.…”

Section: Resultsmentioning

confidence: 99%

“…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. 11,12 A recent study also reported the significant predictive value of PCT studies in a small patient population treated with surgery and adjuvant chemoradiation. 13 However, to the best of our knowledge, there is no large-scale study examining the longterm predictive value of baseline PCT studies in patients treated with neoadjuvant chemoradiation or chemoradiation with curative intent.…”

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confidence: 92%

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

Bisdas¹,

Rumboldt²,

Surlan-Popovic³

et al. 2009

AJNR Am J Neuroradiol

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Section: Resultssupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 92%

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

Bisdas¹,

Rumboldt²,

Surlan-Popovic³

et al. 2009

AJNR Am J Neuroradiol

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“…Our results appear at odds with an earlier study using perfusion CT in a similar setting. Hermans et al stratified 105 HNSCC patients according to the median perfusion value and found that patients with lower perfusion had a significantly higher local failure rate after radiotherapy (40).…”

Section: Discussionmentioning

confidence: 99%

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Dirix¹,

Vandecaveye²,

Keyzer³

et al. 2009

J Nucl Med

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The purpose of this work was to evaluate the potential of functional imaging with 18 F-FDG PET, 18 F-fluoromisonidazole PET, diffusion-weighted MRI, and dynamic contrast-enhanced MRI to provide an appropriate and reliable biologic target for dose painting in radiotherapy for head and neck squamous cell carcinoma (HNSCC). Methods: Fifteen patients with locally advanced HNSCC, treated with concomitant chemoradiotherapy, were prospectively enrolled in a bioimaging protocol. Sequential PET ( 18 F-FDG and 18 F-fluoromisonidazole) and MRI (T1, T2, dynamic enhanced, and diffusion-weighted sequences) were performed before, during, and after radiotherapy. Results: Median follow-up was 30.7 mo (range, 6.3-56.3 mo); in 7 patients, disease recurred. Disease-free survival correlated negatively with the maximum tissue-to-blood 18 F-fluoromisonidazole ratio (T/B max ) on the baseline 18 F-fluoromisonidazole scan (P 5 0.04), with the size of the initial hypoxic volume (P 5 0.04), and with T/B max on the 18 F-fluoromisonidazole scan during treatment (P 5 0.02). All locoregional recurrences were within the 18 F-FDGavid regions on baseline 18 F-FDG PET; 3 recurrences mapped outside the hypoxic volume on baseline 18 F-fluoromisonidazole PET. Lesions (primary tumor and lymph nodes) where a locoregional recurrence developed during follow-up had significantly lower apparent diffusion coefficients on diffusion-weighted MRI during week 4 of radiotherapy (0.0013 vs. 0.0018 mm 2 /s, P 5 0.01) and at 3 wk after treatment (0.0014 vs. 0.0018 mm 2 /s, P 5 0.01) and a significantly higher initial slope on baseline dynamic enhanced MRI (26.2 vs. 17.5/s, P 5 0.03) than did lesions that remained controlled. Conclusion: These results confirm the added value of 18 F-FDG PET and 18 F-fluoromisonidazole PET for radiotherapy planning of HNSCC and suggest the potential of diffusion-weighted and dynamic enhanced MRI for dose painting and early response assessment.

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“…The more abundant the blood supply, the more sensitive the tumour is to radiotherapy, leading to a more obvious therapeutic effect. Hermans et al (2003) performed a CT perfusion study on 18 head and neck squamous cell carcinoma patients and found that tumours with poor perfusion are not sensitive to radiotherapy, while high perfusion tumours are radiation-sensitive. Clinically, it is generally accepted that the treatment effect of γ knife on bloodsupplied brain metastases is best.…”

Section: Introductionmentioning

confidence: 99%

Correlation of CT Perfusion Images with VEGF Expression in Solitary Brain Metastases

Zhang¹,

Wang²,

Pan³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Objectives: To obtain permeability surface (PS) values using multi-slice helical CT perfusion imaging and to evaluate the spatial distribution correlation between PS values and vascular endothelial growth factor (VEGF) expression in solitary brain metastases. Methods: Imaging was performed on 21 patients, PS values being calculated from the central, border and peripheral parts of tumours. VEGF expression was determined by immunohistochemical staining. Results: Rim enhancement was found in 16 cases, the border of the tumour featuring PS elevation with high VEGF expression in 13 cases. In the 5 cases with nodular enhancement, the border and the central part had high permeability and VEGF expression was high in all cases, the correlation being significant (P<0.01) . Conclusion: VEGF expression in brain metastases positively correlates with PS values from CT perfusion imaging, so that the latter can be used in the surveillance of angiogenic activity in brain metastases.

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Tumor perfusion rate determined noninvasively by dynamic computed tomography predicts outcome in head-and-neck cancer after radiotherapy

Cited by 162 publications

References 27 publications

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

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

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Correlation of CT Perfusion Images with VEGF Expression in Solitary Brain Metastases

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Tumor perfusion rate determined noninvasively by dynamic computed tomography predicts outcome in head-and-neck cancer after radiotherapy

Cited by 162 publications

References 27 publications

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

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

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with18F-FDG PET,18F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Correlation of CT Perfusion Images with VEGF Expression in Solitary Brain Metastases

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Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI