Volumetric CT perfusion assessment of treatment response in head and neck squamous cell carcinoma: Comparison of CT perfusion parameters before and after chemoradiation therapy

Rana, Lokesh; Sharma, Sanjeev; Sood, Shilpa; Singh, Balraj; Gupta, Manoj Kumar; Minhas, Roshni; Jhobta, Anupam; Bhatia, Vikas; Venkat, Bargavee

doi:10.1016/j.ejro.2015.02.001

Cited by 12 publications

(9 citation statements)

References 19 publications

(23 reference statements)

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“…In theory, tumours from different tissues or different pathological types of the same tumour can be identified using these parameters. CT perfusion imaging has been used in the differential diagnosis of squamous cell carcinoma of the head and neck, as well as in the prognosis and posttreatment response evaluation of neck lymphoma [27][28][29] . Each pure substance has a specific spectral attenuation curve, and X-ray attenuation in various tissues can be expressed by a pair of known pure substances 30,31 .…”

Section: Discussionmentioning

confidence: 99%

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

Zhang

et al. 2020

Sci Rep

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To evaluate the role of conventional contrast-enhanced CT (CECT) imaging and dual-energy spectral CT (DECT) perfusion imaging in differentiating the WHO histological subtypes of thymic epithelial tumours (TETs). Eighty-eight patients with TETs who underwent DECT perfusion scans (n = 51) and conventional CT enhancement scans (n = 37) using a GE Discovery CT750 HD scanner were enrolled in this study. The mean maximal contrast-enhanced range (mean CEmax) and the perfusion and spectral parameters of the lesions were analysed. Among the six WHO subtypes (Type A, AB, B1, B2, and B3 thymoma and thymic carcinoma), the mean CEmax values and most of the perfusion and spectral parameter values of Type A and Type AB were significantly higher than those of the other subtypes (all P < 0.05), and there was no difference among Type B1, B2 and B3 (all P > 0.05). The mean CEmax value was not different between Type B (including Type B1, B2, and B3) and thymic carcinoma (P = 1.000). The PS, IC, NIC and λ HU values in the optimal venous phase of thymic carcinoma were higher than those of Type B (all p < 0.05). The parameters of conventional CECT imaging and DECT perfusion imaging can help identify the subtype of TETs, especially those of DECT perfusion imaging in type B thymomas and thymic carcinomas.

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Section: Discussionmentioning

confidence: 99%

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

Zhang

et al. 2020

Sci Rep

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“…The majority of studies included mixed tumour sites while two studies reported the role of pCT in OPC . Serial scans including mid‐treatment scans were performed in three studies while two studies reviewed the utility of pCT after induction chemotherapy to decide whether primary surgery or primary RT would be performed. All studies showed significant association between at least one parameter tested with the endpoints (response to therapy, LC or survival).…”

Section: Resultsmentioning

confidence: 99%

A review of the predictive role of functional imaging in patients with mucosal primary head and neck cancer treated with radiation therapy

et al. 2016

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Advanced radiotherapy techniques, such as intensity-modulated radiotherapy, have been reported to reduce toxicities by improving the dose conformity in mucosal primary head and neck cancer (MPHNC). However, to further optimize the therapeutic ratio, details on individual patient and disease characteristics may be necessary to tailor treatments. This is likely to include identifying poor responders for treatment intensification and good responders for de-escalation strategies. Non-invasive, repeatable imaging biomarkers are attractive modalities in both pre-treatment and intra-treatment response prediction with a view to individualized treatment options. This review has assessed the current literature on the prognostic/predictive role of widely available functional imaging (FI) studies such as fMRI(functional magnetic resonance imaging), functional computed tomography (fCT) and positron-emission-tomography(PET). A literature search was carried out using Medline, Embase and PubMed. Studies were included if imaging was undertaken pre and/or during radiotherapy (with or without the addition of chemotherapy and/or surgery). A total of 99 relevant studies were identified: 14 fMRI, 10 fCT, 59 FDG-PET and 16 non-FDG-PET studies. These articles were reviewed to identify imaging parameters demonstrating a correlation with patient outcome or a factor considered to impact on patient outcome and thus likely to be of potential predictive value in MPHNC and associated future radiotherapy treatment directions. Several studies have demonstrated that both pre-treatment and mid-treatment FDG-PET is predictive of outcomes. However, further studies are required to confirm the role of other imaging studies including fMRI and PET using other tracers. There is large heterogeneity within and between published studies, including tumour sites, treatment options, outcome endpoints and parameters assessed. We propose a minimum set of factors that should be reported and make recommendations for studies evaluating the predictive utility in MPHNC.

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“…Prior literature has shown that CT perfusion features are promising for assessing treatment response with chemoradiation [14,15]. A study prospectively conducted by Rana et al [14] evaluated neck CT perfusion characteristics in 24 patients and found that blood flow alone was 83.3% predictive of response to chemoradiation irrespective of stage.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Disease Free Survival in Laryngeal and Hypopharyngeal Cancers Using CT Perfusion and Radiomic Features: A Pilot Study

et al. 2021

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(1) Purpose: The objective was to evaluate CT perfusion and radiomic features for prediction of one year disease free survival in laryngeal and hypopharyngeal cancer. (2) Method and Materials: This retrospective study included pre and post therapy CT neck studies in 36 patients with laryngeal/hypopharyngeal cancer. Tumor contouring was performed semi-autonomously by the computer and manually by two radiologists. Twenty-six radiomic features including morphological and gray-level features were extracted by an internally developed and validated computer-aided image analysis system. The five perfusion features analyzed included permeability surface area product (PS), blood flow (flow), blood volume (BV), mean transit time (MTT), and time-to-maximum (Tmax). One year persistent/recurrent disease data were obtained following the final treatment of definitive chemoradiation or after total laryngectomy. We performed a two-loop leave-one-out feature selection and linear discriminant analysis classifier with generation of receiver operating characteristic (ROC) curves and confidence intervals (CI). (3) Results: 10 patients (28%) had recurrence/persistent disease at 1 year. For prediction, the change in blood flow demonstrated a training AUC of 0.68 (CI 0.47–0.85) and testing AUC of 0.66 (CI 0.47–0.85). The best features selected were a combination of perfusion and radiomic features including blood flow and computer-estimated percent volume changes-training AUC of 0.68 (CI 0.5–0.85) and testing AUC of 0.69 (CI 0.5–0.85). The laryngoscopic percent change in volume was a poor predictor with a testing AUC of 0.4 (CI 0.16–0.57). (4) Conclusions: A combination of CT perfusion and radiomic features are potential predictors of one-year disease free survival in laryngeal and hypopharyngeal cancer patients.

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Volumetric CT perfusion assessment of treatment response in head and neck squamous cell carcinoma: Comparison of CT perfusion parameters before and after chemoradiation therapy

Cited by 12 publications

References 19 publications

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

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

A review of the predictive role of functional imaging in patients with mucosal primary head and neck cancer treated with radiation therapy

Prediction of Disease Free Survival in Laryngeal and Hypopharyngeal Cancers Using CT Perfusion and Radiomic Features: A Pilot Study

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