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Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during the Course of Concomitant Chemoradiotherapy

Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during... This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1859v1 31/3/570 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Google Scholar Articles by Surlan-Popovic, K. Articles by Strojan, P. PubMed PubMed Citation Articles by Surlan-Popovic, K. Articles by Strojan, P. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 31:570-575, March 2010 © 2010 American Society of Neuroradiology HEAD AND NECK Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during the Course of Concomitant Chemoradiotherapy K. urlan-Popovi a , S. Bisdas e , Z. Rumboldt b , T.S. Koh c and P. Strojan d a From the Department of Radiology (K.S.-P.), University Clinical Centre, Ljubljana, Slovenia b Department of Neuroradiology (Z.R.), Medical University of South Carolina, Charleston, South Carolina c Center for Modeling and Control of Complex Systems (T.S.K.), Nanyang University, Singapore d Department of Radiation Oncology (P.S.), Department of Oncology, Ljubljana, Slovenia e Department of Neuroradiology (S.B.), Eberhard Karls University, Tübingen, Germany. Please address correspondence to Sotirios Bisdas, MD, Department of Neuroradiology, Eberhard Karls University, Hoppe-Seyler-Str 3, D-72076 Tübingen, Germany; e-mail: Sotirios.Bisdas@med.uni-tuebingen.de BACKGROUND AND PURPOSE: Concomitant chemoradiation is a promising therapy for the treatment of locoregionally advanced head and neck carcinoma. The purpose of this study was to prospectively evaluate early changes in primary tumor perfusion parameters during concomitant cisplatin-based chemoradiotherapy of locoregionally advanced SCCHN and to evaluate their predictive value for response of the primary tumor to therapy. MATERIALS AND METHODS: Twenty patients with locoregionally advanced SCCHN underwent perfusion CT scans before therapy and after completion of 40 Gy and 70 Gy of chemoradiotherapy. BF, BV, MTT, and PS of primary tumors were quantified. Differences in perfusion and tumor volume values during the therapy as well as between responders and nonresponders were analyzed, and ROC curves were used to assess predictive value of the baseline and follow-up functional parameters. RESULTS: The tumor volumes at 40 Gy and at 70 Gy were significantly lower compared with baseline values ( P = .014 and P = .007). In the 6 nonresponders, measurements after 40 Gy showed a nonsignificant trend of increased BF, BV, and PS values compared with the baseline values ( P = .06). In 14 responders, a significant reduction of BF values was recorded after 40 Gy ( P = .04) and after 70 Gy ( P = .01). In responders, BV values showed a reduction after 40 Gy followed by a plateau after 70 Gy ( P = .04), whereas in nonresponders there was a nonsignificant elevation of the BV. Baseline BV predicted short-term tumor response with a sensitivity of 60% and specificity of 100% ( P = .01). After completion of 40 Gy of concomitant chemoradiation BV was a more significant predictor than were BF and MTT. CONCLUSIONS: The results suggest that in advanced SCCHN the perfusion CT monitoring might be of predictive value for identifying tumors that may respond to cisplatin-based chemoradiotherapy. Abbreviations: AUC, area under the curve • BF, blood flow • BV, blood volume • CECT, contrast-enhanced CT • LR, likelihood ratio • MTT, mean transit time • PCT, perfusion CT • PET, positron-emission tomography • PS, permeability surface area product • ROC, receiver operating characteristic • ROI, region of interest • SCCHN, squamous cell carcinoma of the head and neck • VEGF, vascular endothelial growth factor This article has been cited by other articles: S.K. Mukherji and J.A. Castelijns CT Perfusion of Head and Neck Cancer: Why We Should Care versus Why Should We Care! AJNR Am. J. Neuroradiol., March 1, 2010; 31(3): 391 - 393. Full Text PDF Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during the Course of Concomitant Chemoradiotherapy

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2010 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A1859
Publisher site
See Article on Publisher Site

Abstract

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1859v1 31/3/570 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Google Scholar Articles by Surlan-Popovic, K. Articles by Strojan, P. PubMed PubMed Citation Articles by Surlan-Popovic, K. Articles by Strojan, P. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 31:570-575, March 2010 © 2010 American Society of Neuroradiology HEAD AND NECK Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during the Course of Concomitant Chemoradiotherapy K. urlan-Popovi a , S. Bisdas e , Z. Rumboldt b , T.S. Koh c and P. Strojan d a From the Department of Radiology (K.S.-P.), University Clinical Centre, Ljubljana, Slovenia b Department of Neuroradiology (Z.R.), Medical University of South Carolina, Charleston, South Carolina c Center for Modeling and Control of Complex Systems (T.S.K.), Nanyang University, Singapore d Department of Radiation Oncology (P.S.), Department of Oncology, Ljubljana, Slovenia e Department of Neuroradiology (S.B.), Eberhard Karls University, Tübingen, Germany. Please address correspondence to Sotirios Bisdas, MD, Department of Neuroradiology, Eberhard Karls University, Hoppe-Seyler-Str 3, D-72076 Tübingen, Germany; e-mail: Sotirios.Bisdas@med.uni-tuebingen.de BACKGROUND AND PURPOSE: Concomitant chemoradiation is a promising therapy for the treatment of locoregionally advanced head and neck carcinoma. The purpose of this study was to prospectively evaluate early changes in primary tumor perfusion parameters during concomitant cisplatin-based chemoradiotherapy of locoregionally advanced SCCHN and to evaluate their predictive value for response of the primary tumor to therapy. MATERIALS AND METHODS: Twenty patients with locoregionally advanced SCCHN underwent perfusion CT scans before therapy and after completion of 40 Gy and 70 Gy of chemoradiotherapy. BF, BV, MTT, and PS of primary tumors were quantified. Differences in perfusion and tumor volume values during the therapy as well as between responders and nonresponders were analyzed, and ROC curves were used to assess predictive value of the baseline and follow-up functional parameters. RESULTS: The tumor volumes at 40 Gy and at 70 Gy were significantly lower compared with baseline values ( P = .014 and P = .007). In the 6 nonresponders, measurements after 40 Gy showed a nonsignificant trend of increased BF, BV, and PS values compared with the baseline values ( P = .06). In 14 responders, a significant reduction of BF values was recorded after 40 Gy ( P = .04) and after 70 Gy ( P = .01). In responders, BV values showed a reduction after 40 Gy followed by a plateau after 70 Gy ( P = .04), whereas in nonresponders there was a nonsignificant elevation of the BV. Baseline BV predicted short-term tumor response with a sensitivity of 60% and specificity of 100% ( P = .01). After completion of 40 Gy of concomitant chemoradiation BV was a more significant predictor than were BF and MTT. CONCLUSIONS: The results suggest that in advanced SCCHN the perfusion CT monitoring might be of predictive value for identifying tumors that may respond to cisplatin-based chemoradiotherapy. Abbreviations: AUC, area under the curve • BF, blood flow • BV, blood volume • CECT, contrast-enhanced CT • LR, likelihood ratio • MTT, mean transit time • PCT, perfusion CT • PET, positron-emission tomography • PS, permeability surface area product • ROC, receiver operating characteristic • ROI, region of interest • SCCHN, squamous cell carcinoma of the head and neck • VEGF, vascular endothelial growth factor This article has been cited by other articles: S.K. Mukherji and J.A. Castelijns CT Perfusion of Head and Neck Cancer: Why We Should Care versus Why Should We Care! AJNR Am. J. Neuroradiol., March 1, 2010; 31(3): 391 - 393. Full Text PDF Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Mar 1, 2010

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