Role of CT Perfusion in Monitoring and Prediction of Response to Therapy of Head and Neck Squamous Cell Carcinoma

Abstract

This review aims to summarize the technique and clinical applications of CT perfusion (CTp) of head and neck cancer. The most common pathologic type (90%) of head and neck cancer is squamous cell carcinoma (HNSCC): its diagnostic workup relies on CT and MRI, as they provide an accurate staging for the disease by determining tumour volume, assessing its extension, and detecting of lymph node metastases. Compared with conventional CT and MRI, CTp allows for obtaining measures of tumour vascular physiology and functional behaviour, and it has been demonstrated to be a feasible and useful tool in predicting local outcomes in patients undergoing radiation therapy and chemotherapy and may help monitor both treatments.

Combined PET/CT-perfusion in patients with head and neck cancers might predict failure after radio-chemotherapy: a proof of concept study

“…After chemo-radiotherapy the CTP-values in these patients decreased to levels not significantly different from those patients without recurrent disease. This is partly contradictive to the studies discussed above where in patients with initially higher CT-perfusion values a favourable outcome was reported [ 28 ]. However, on the other side our results are in line with studies discussed in the overview from Preda and co-workers where CTP-parameters showed significant correlation with therapy response.…”

Dual-energy CT perfusion imaging for differentiating WHO subtypes of thymic epithelial tumors

“…The perfusion parameters reflect tissue vascularization and angiogenesis 26 . In theory, tumours from different tissues or different pathological types of the same tumour can be identified using these parameters.…”

Role of perfusion CT in the evaluation of functional primary tumour response after radiochemotherapy in head and neck cancer: preliminary findings

“…Differently, most of the earlier studies report contradictory findings regarding the changes in PS and MTT values induced by treatment, with no significant variations in the post-treatment vs pre-treatment values found in most reports. 32 It should also be noted that MTT seems to have a pivotal role in the interpretation of tumour response to treatment. In particular, Petralia et al 28 reported a significant increase in the MTT values induced by treatment, a finding that the authors interpret as due to the reduction of the amount of arterovenous neoplastic shunts, combined with reduction of the BV and BF values.…”