An Exploratory Study Into the Role of Dynamic Contrast-Enhanced Magnetic Resonance Imaging or Perfusion Computed Tomography for Detection of Intratumoral Hypoxia in Head-and-Neck Cancer

Newbold, Kate; Castellano, Isabel; Charles-Edwards, Elizabeth; Mears, Dorothy; Sohaib, Aslam; Leach, Martin O.; Rhys‐Evans, Peter; Clarke, Peter; Fisher, Cyril; Harrington, Kevin; Nutting, Christopher M.

doi:10.1016/j.ijrobp.2008.07.039

Cited by 83 publications

(58 citation statements)

References 24 publications

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“…Five blood volume fractions in the range 1–30 ml/100g were considered, including values typical for muscle (BV = 1 ml/100g30, HNSCC (BV = 5 ml/100g31, and highly vascular tumors (BV > 10 ml/100g24. Equation (1) was used to calculate sets of BV‐specific coefficients A*, B*, and C* and to plot the dependence of blood oxygen saturation on

T_{2}^{*}

values.…”

Section: Methodsmentioning

confidence: 99%

Repeatability and sensitivity of measurements in patients with head and neck squamous cell carcinoma at 3T

Panek

Welsh

Dunlop

et al. 2016

Magnetic Resonance Imaging

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PurposeTo determine whether quantitation of T2* is sufficiently repeatable and sensitive to detect clinically relevant oxygenation levels in head and neck squamous cell carcinoma (HNSCC) at 3T.Materials and MethodsTen patients with newly diagnosed locally advanced HNSCC underwent two magnetic resonance imaging (MRI) scans between 24 and 168 hours apart prior to chemoradiotherapy treatment. A multiple gradient echo sequence was used to calculate T2* maps. A quadratic function was used to model the blood transverse relaxation rate as a function of blood oxygenation. A set of published coefficients measured at 3T were incorporated to account for tissue hematocrit levels and used to plot the dependence of fractional blood oxygenation (Y) on T2* values, together with the corresponding repeatability range. Repeatability of T2* using Bland–Altman analysis, and calculation of limits of agreement (LoA), was used to assess the sensitivity, defined as the minimum difference in fractional blood oxygenation that can be confidently detected.Results T2* LoA for 22 outlined tumor volumes were 13%. The T2* dependence of fractional blood oxygenation increases monotonically, resulting in increasing sensitivity of the method with increasing blood oxygenation. For fractional blood oxygenation values above 0.11, changes in T2* were sufficient to detect differences in blood oxygenation greater than 10% (Δ T2* > LoA for ΔY > 0.1).ConclusionQuantitation of T2* at 3T can detect clinically relevant changes in tumor oxygenation within a wide range of blood volumes and oxygen tensions, including levels reported in HNSCC. J. Magn. Reson. Imaging 2016;44:72–80.

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T_{2}^{*}

values.…”

Section: Methodsmentioning

confidence: 99%

Repeatability and sensitivity of measurements in patients with head and neck squamous cell carcinoma at 3T

Panek

Welsh

Dunlop

et al. 2016

Magnetic Resonance Imaging

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“…In addition, this inefficiency causes increased interstitial fluid pressure, which ultimately reduces tumor perfusion, further facilitating tumor hypoxia. 64 Although a study by Newbold indicated that tumors with higher K trans were associated with hypoxia defined by pimonidazole and carbonic anhydrase staining, and hence poor outcome, 46 others reported that tumors with lower K trans were associated with poor response. 27,29,61,65 K trans generally reflects a combination of perfusion and permeability.…”

Section: Clinical Applications Of Dce-mr Imaging In Head and Neck Cancermentioning

confidence: 99%

“…[27][28][29]41,46,61 We searched MEDLINE, PubMed, and Google for the literature published during the most recent 6-year interval (2008 -2013) containing all of the following: DCE-MR imaging, HNC, and quantitative (model-based) analysis of dynamic data for pretreatment assessment and/or monitoring treatment response. The Online Table summarizes various studies in the literature and their respective contributions to DCE-MR imaging of HNC by using various quantitative methods.…”

mentioning

confidence: 99%

Dynamic Contrast-Enhanced MR Imaging in Head and Neck Cancer: Techniques and Clinical Applications

Gaddikeri

Tailor

et al. 2015

AJNR Am J Neuroradiol

104

117

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SUMMARY:In the past decade, dynamic contrast-enhanced MR imaging has had an increasing role in assessing the microvascular characteristics of various tumors, including head and neck cancer. Dynamic contrast-enhanced MR imaging allows noninvasive assessment of permeability and blood flow, both important features of tumor hypoxia, which is a marker for treatment resistance for head and neck cancer. Dynamic contrast-enhanced MR imaging has the potential to identify early locoregional recurrence, differentiate metastatic lymph nodes from normal nodes, and predict tumor response to treatment and treatment monitoring in patients with head and neck cancer. Quantitative analysis is in its early stage and standardization and refinement of technique are essential. In this article, we review the techniques of dynamic contrast-enhanced MR imaging data acquisition, analytic methods, current limitations, and clinical applications in head and neck cancer. ABBREVIATIONS:AIF ϭ arterial input function; DCE-MR imaging ϭ dynamic contrast-enhanced MR imaging; EES ϭ extracellular extravascular space; GCA ϭ

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“…The gadolinium concentration-time curve can also be fitted to a twocompartment pharmacokinetic model to yield various kinetic and volumetric parameters such as the transfer coefficient from plasma to the interstitial space (K trans ), the extracellular extravascular volume fraction (V e ) and plasma volume fraction (V p ). 55,56 One of the first studies to evaluate the relationship between tumour perfusion and local control (LC) using DCE MRI in patients with HNC was published by Hoskin et al 57 13 patients underwent DCE MRI before and on completion of accelerated radiotherapy. LC was found to be related to maximum tumour enhancement following radiotherapy and the difference in time taken to reach maximum tumour enhancement pre-and post-radiotherapy.…”

Section: Functional Mri Sequencesmentioning

confidence: 99%

The emerging potential of magnetic resonance imaging in personalizing radiotherapy for head and neck cancer: an oncologist's perspective

Wong

Panek

Bhide

et al. 2017

The British Journal of Radiology

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Head and neck cancer (HNC) is a challenging tumour site for radiotherapy delivery owing to its complex anatomy and proximity to organs at risk (OARs) such as the spinal cord and optic apparatus. Despite significant advances in radiotherapy planning techniques, radiation-induced morbidities remain substantial. Further improvement would require high-quality imaging and tailored radiotherapy based on intratreatment response. For these reasons, the use of MRI in radiotherapy planning for HNC is rapidly gaining popularity. MRI provides superior soft-tissue contrast in comparison with CT, allowing better definition of the tumour and OARs. The lack of additional radiation exposure is another attractive feature for intratreatment monitoring. In addition, advanced MRI techniques such as diffusion-weighted, dynamic contrast-enhanced and intrinsic susceptibility-weighted MRI techniques are capable of characterizing tumour biology further by providing quantitative functional parameters such as tissue cellularity, vascular permeability/perfusion and hypoxia. These functional parameters are known to have radiobiological relevance, which potentially could guide treatment adaptation based on their changes prior to or during radiotherapy. In this article, we first present an overview of the applications of anatomical MRI sequences in head and neck radiotherapy, followed by the potentials and limitations of functional MRI sequences in personalizing therapy. INTRODUCTIONRadical radiotherapy (RT) is integral to the management of head and neck cancer (HNC) in both the primary and adjuvant settings. Advances in computer-assisted radiological techniques over the past two decades have in turn revolutionized radiotherapy planning. Development of advanced radiotherapy planning techniques such as intensity-modulated radiotherapy (IMRT) and volumetricmodulated arc therapy have allowed for better dose conformation to the tumour target and sparing of surrounding normal tissues. HNC was one of the first tumour sites where IMRT was widely implemented owing to a significant reduction in radiation-induced xerostomia in comparison with three-dimensional conformal planning.

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An Exploratory Study Into the Role of Dynamic Contrast-Enhanced Magnetic Resonance Imaging or Perfusion Computed Tomography for Detection of Intratumoral Hypoxia in Head-and-Neck Cancer

Cited by 83 publications

References 24 publications

Repeatability and sensitivity of measurements in patients with head and neck squamous cell carcinoma at 3T

Repeatability and sensitivity of measurements in patients with head and neck squamous cell carcinoma at 3T

Dynamic Contrast-Enhanced MR Imaging in Head and Neck Cancer: Techniques and Clinical Applications

The emerging potential of magnetic resonance imaging in personalizing radiotherapy for head and neck cancer: an oncologist's perspective

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