Pj. Hoskin et al., Dynamic contrast enhanced magnetic resonance scanning as a predictor of response to accelerated radiotherapy for advanced head and neck cancer, BR J RADIOL, 72(863), 1999, pp. 1093-1098
Citations number
9
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Tumour perfusion has been assessed in patients with advanced head and neck
cancer using dynamic contrast enhanced MRI prior to and at completion of ac
celerated radiotherapy, and related to local tumour control. Sequential MRI
scans, at 3 s intervals after intravenous injection of gadolinium using a
dynamic scan sequence through a tumour region of interest (ROI), were perfo
rmed in 13 patients with advanced head and neck cancer before and on comple
tion of radiotherapy. The scans have been analysed in terms of maximum tumo
ur enhancement (E), slope of the enhancement versus time curve and the time
taken to reach maximum tumour enhancement (T-max), and these parameters re
lated to tumour outcome after radiotherapy. Local tumour control was relate
d to the value of E on a post-radiotherapy scan and the difference in T-max
between a pre- and post-radiotherapy scan. Durable local control was seen
in those tumours with a post-radiotherapy value for E of less than 8 and a
mean fall in T-max of 27.3 s. These results imply that tumours with diminis
hed tumour perfusion at the end of radiotherapy are those most sensitive to
treatment and that those tumours which show greater tumour enhancement aft
er accelerated radiotherapy are likely to fail locally. This may reflect th
e persistence of viable perfused tumour at completion of radiotherapy.