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Research ArticleHead and NeckF

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

K. Šurlan-Popovič, S. Bisdas, Z. Rumboldt, T.S. Koh and P. Strojan
American Journal of Neuroradiology March 2010, 31 (3) 570-575; DOI: https://doi.org/10.3174/ajnr.A1859
K. Šurlan-Popovič
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S. Bisdas
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Z. Rumboldt
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T.S. Koh
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P. Strojan
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Abstract

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
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American Journal of Neuroradiology: 31 (3)
American Journal of Neuroradiology
Vol. 31, Issue 3
1 Mar 2010
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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
K. Šurlan-Popovič, S. Bisdas, Z. Rumboldt, T.S. Koh, P. Strojan
American Journal of Neuroradiology Mar 2010, 31 (3) 570-575; DOI: 10.3174/ajnr.A1859

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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
K. Šurlan-Popovič, S. Bisdas, Z. Rumboldt, T.S. Koh, P. Strojan
American Journal of Neuroradiology Mar 2010, 31 (3) 570-575; DOI: 10.3174/ajnr.A1859
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  • Usefulness of Pseudocontinuous Arterial Spin-Labeling for the Assessment of Patients with Head and Neck Squamous Cell Carcinoma by Measuring Tumor Blood Flow in the Pretreatment and Early Treatment Period
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  • CT Perfusion of Head and Neck Cancer: Why We Should Care versus Why Should We Care!
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