Correlation between Initial and Early Follow-Up CT Perfusion Parameters with Endoscopic Tumor Response in Patients with Advanced Squamous Cell Carcinomas of the Oropharynx Treated with Organ-Preservation Therapy
D. Gandhia,
D.B. Chepehab,
T. Millerb,
R.C. Carlosa,
C.R. Bradfordb,
R. Karamchandanib,
F. Wordenc,
A. Eisbruchd,
T.N. Teknosb,
G.T. Wolfb and
S.K. Mukherjia
a Department of Radiology, University of Michigan Health System, Ann Arbor, Mich
b Department of Otolaryngology, University of Michigan Health System, Ann Arbor, Mich
c Department of Head Neck Surgery, Hematology-Oncology, University of Michigan Health System, Ann Arbor, Mich
d Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, Mich
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Fig 1. CTP in a patient with T2N2a carcinoma of the left valeculla before and after one cycle of neoadjuvant chemotherapy.
Axial CT image (A) through the level of the tumor, color maps of BF (B), and BV (C) were acquired before the start of therapy (baseline). Note a large tumor in the valeculla (arrows) before the start of therapy and a metastatic left cervical node (arrowhead). This tumor showed a high level of BF (131.5 mL/100 g/min) and BV (5.12 mL/100 g). Postinduction chemotherapy CT image through the level of the tumor (D), color maps of BF (E) and BV (F) at approximately similar anatomical level are also shown. A marked reduction in tumor size was noted after the chemotherapy (arrows). Also the perfusion maps demonstrate decrease in BF and BV. Quantitatively, there was 96% reduction in BF and 63% reduction in BV. Direct laryngoscopy showed nearly complete resolution of the tumor (patient 2).
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Fig 2. Graph showing the distribution of percent tumor response as a function of pretreatment BV. The pretherapy BVs ranged between 2.23 and 8.16 mL/100 g and endoscopic tumor response ranged between 0% and 100%.
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