Pharmacokinetic analysis based on dynamic contrast-enhanced MRI for evaluating tumor response to preoperative therapy for oral cancer

J Magn Reson Imaging. 2012 Sep;36(3):589-97. doi: 10.1002/jmri.23704. Epub 2012 May 30.

Abstract

Purpose: To evaluate whether a pharmacokinetic analysis is useful for monitoring the response of oral cancer to chemoradiotherapy (CRT).

Materials and methods: Twenty-nine patients were included. They underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) before and after CRT. The DCE-MRI data were analyzed using a Tofts and Kermode (TK) model. The histological evaluation of the effects of CRT was performed according to Ohboshi and Shimosato's classification.

Results: None of the pre-CRT parameters were significantly different between the responders and nonresponders. The post-CRT volume of the extravascular extracellular space (EES) per unit volume of tissue (v(e) ) of responders (0.397 ± 0.080) was higher than that of nonresponders (0.281 ± 0.076) (P = 0.01). The change of the v(e) between the pre- and post-CRT of the responders (0.154 ± 0.093) was larger than that of the nonresponders (0.033 ± 0.073) (P = 0.001). Therefore, the increase in the v(e) strongly suggested a good tumor response to CRT, which reflected an increase of the EES secondary to the destruction of the cancer nest. The changes in the volume transfer constant (K(trans) ) were significantly different between the responders and nonresponders (P = 0.018).

Conclusion: Both the increase of the v(e) and the elevation of permeability (K(trans) ) were indicative of a good tumor response to CRT. The pharmacokinetic analysis had potential for monitoring the histopathological response to CRT.

Publication types

  • Clinical Trial

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / metabolism*
  • Carcinoma, Squamous Cell / therapy*
  • Chemotherapy, Adjuvant / methods
  • Computer Simulation
  • Contrast Media / pharmacokinetics
  • Female
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Models, Biological
  • Mouth Neoplasms / diagnosis
  • Mouth Neoplasms / metabolism*
  • Mouth Neoplasms / therapy*
  • Oral Surgical Procedures*
  • Premedication
  • Preoperative Care
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Treatment Outcome

Substances

  • Contrast Media