Perfusion Computed Tomography for Monitoring Induction Chemotherapy in Patients With Squamous Cell Carcinoma of the Upper Aerodigestive Tract: Correlation Between Changes in Tumor Perfusion and Tumor Volume

Objective: The aim of this study was to assess the potential of perfusion computed tomography (CTp) for monitoring induction chemotherapy in patients with squamous cell carcinoma (SCCA) of the upper aerodigestive tract. Materials and Methods: Twenty-five patients with advanced SCCA underwent CTp and volumetric CT before and after induction chemotherapy. Perfusion CT parameters were calculated in the tumor, normal tissue, and muscles and correlated with tumor volume. Results: The blood flow (BF), blood volume (BV), and permeability surface were significantly higher, and the mean transit time was significantly lower in the tumor than in the normal tissue. The tumor BF and BV significantly decreased, and the mean transit time significantly increased after the therapy; decrease in BF and BV correlated with tumor volume reduction after chemotherapy. The baseline tumor BV was significantly lower in nonresponders compared with that in responders. Conclusions: In patients with SCCA, CTp showed potential for monitoring induction chemotherapy, reduction in tumor BF and BV correlated with reduction of tumor volume after chemotherapy, and baseline tumor BV may predict response to chemotherapy.

[1]  P Lambin,et al.  Changes in the oxygenation of head and neck tumors during carbogen breathing. , 1993, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[2]  K. Miles,et al.  Perfusion CT for the assessment of tumour vascularity: which protocol? , 2003, The British journal of radiology.

[3]  C. Jaffe Measures of response: RECIST, WHO, and new alternatives. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  Thomas Lehnert,et al.  Quantitative Measurements of Perfusion and Permeability of Oropharyngeal and Oral Cavity Cancer, Recurrent Disease, and Associated Lymph Nodes Using First-Pass Contrast-Enhanced Computed Tomography Studies , 2007, Investigative radiology.

[5]  M. Bellomi,et al.  Measurement by multidetector CT scan of the volume of hypopharyngeal and laryngeal tumours: accuracy and reproducibility , 2007, European Radiology.

[6]  C. Kremser,et al.  Assessing tumor perfusion and treatment response in rectal cancer. , 2006, Radiology.

[7]  W Van den Bogaert,et al.  Tumoural perfusion as measured by dynamic computed tomography in head and neck carcinoma. , 1999, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[8]  S Saini,et al.  Tumour size measurement in an oncology clinical trial: comparison between off-site and on-site measurements. , 2003, Clinical radiology.

[9]  Steve Halligan,et al.  Quantitative Colorectal Cancer Perfusion Measurement Using Dynamic Contrast-Enhanced Multidetector-Row Computed Tomography: Effect of Acquisition Time and Implications for Protocols , 2005, Journal of computer assisted tomography.

[10]  K. Engels,et al.  FDG uptake after intraarterial chemotherapy in head and neck cancer , 2006, Nuklearmedizin.

[11]  S. Mukherji,et al.  Can pretreatment CT perfusion predict response of advanced squamous cell carcinoma of the upper aerodigestive tract treated with induction chemotherapy? , 2007, AJNR. American journal of neuroradiology.

[12]  M. Kies Induction chemotherapy for squamous cancer of the head and neck , 2007, Current oncology reports.

[13]  Zoran Rumboldt,et al.  Perfusion CT for head and neck tumors: pilot study. , 2005, AJNR. American journal of neuroradiology.

[14]  E. Ozyar,et al.  Induction chemotherapy with cisplatin and 5‐fluorouracil followed by chemoradiotherapy or radiotherapy alone in the treatment of locoregionally advanced resectable cancers of the larynx and hypopharynx: Results of single‐center study of 45 patients , 2005, Head & neck.

[15]  H. Lennernäs,et al.  Chemotherapy and Antiangiogenesis , 2003, Acta oncologica.

[16]  L. Sobin,et al.  TNM Classification of Malignant Tumours , 1987, UICC International Union Against Cancer.

[17]  A. Kovács Response to intraarterial induction chemotherapy: A prognostic parameter in oral and oropharyngeal cancer , 2006, Head & neck.

[18]  Philippe Lambin,et al.  Tumor perfusion rate determined noninvasively by dynamic computed tomography predicts outcome in head-and-neck cancer after radiotherapy. , 2003, International journal of radiation oncology, biology, physics.

[19]  S. Mukherji,et al.  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. , 2006, AJNR. American journal of neuroradiology.

[20]  A. Eisbruch,et al.  Single-cycle induction chemotherapy selects patients with advanced laryngeal cancer for combined chemoradiation: a new treatment paradigm. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[21]  Mannudeep K Kalra,et al.  A 45-second CT perfusion protocol for rectal cancers may not be adequate to infer vascular permeability--surface area products. , 2006, Radiology.

[22]  T. Vogl,et al.  Functional CT of squamous cell carcinoma in the head and neck: repeatability of tumor and muscle quantitative measurements, inter- and intra-observer agreement , 2008, European Radiology.

[23]  K. Engels,et al.  The prognostic value of FDG PET in head and neck cancer. Correlation with histopathology. , 2005, The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of....

[24]  T-Y Lee,et al.  CT imaging of angiogenesis. , 2003, The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology.

[25]  E. Raymond,et al.  Preoperative sequential chemotherapy in locally advanced squamous cell carcinoma of the head and neck , 2005, Head & neck.

[26]  L. Peters,et al.  Clinical impact of, and prognostic stratification by, F‐18 FDG PET/CT in head and neck mucosal squamous cell carcinoma , 2007, Head & neck.

[27]  D. Sahani,et al.  Assessing tumor perfusion and treatment response in rectal cancer with multisection CT: initial observations. , 2005, Radiology.

[28]  Ruth C Carlos,et al.  Computed Tomography Perfusion of Squamous Cell Carcinoma of the Upper Aerodigestive Tract: Initial Results , 2003, Journal of computer assisted tomography.