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Role of CT perfusion in monitoring and prediction of response to therapy of head and neck squamous cell carcinoma.

Preda L, Calloni SF, Moscatelli ME, Cossu Rocca M, Bellomi M - Biomed Res Int (2014)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Division of Radiology, European Institute of Oncology, University of Milan, Via Ripamonti 435, 20141 Milan, Italy.

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.

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Squamous cell carcinoma of hypopharynx in a responder patient: CT scan (a) obtained before chemotherapy shows the lesion involving the right piriform sinus. On the same section, functional maps of BF (b), BV (c), MTT (d), and PS (e) are automatically generated by the software, showing the values calculated in each pixel of the image in a color scale. CT scan obtained in the same patient after chemotherapy and radiotherapy showing a complete disappearance of the tumour (f).
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fig1: Squamous cell carcinoma of hypopharynx in a responder patient: CT scan (a) obtained before chemotherapy shows the lesion involving the right piriform sinus. On the same section, functional maps of BF (b), BV (c), MTT (d), and PS (e) are automatically generated by the software, showing the values calculated in each pixel of the image in a color scale. CT scan obtained in the same patient after chemotherapy and radiotherapy showing a complete disappearance of the tumour (f).

Mentions: Few studies (Table 1) investigated the value of CT-determined tumour perfusion in this specific clinical setting in a similar way to what demonstrated for tumours located in other body regions. This is based on the theory that changes produced by radiotherapy and chemotherapeutic agents on tumour vascularity can be identified by changes in CTp measured tumour perfusion. Treatment, specifically, induced reduction of microvessels inside the tumour could be identified as a decrease of BV values while a decrease of BF could indicate a reduction of low resistance flow arteriovenous shunts in the microvasculature. The reduction of hyperpermeable capillary bed could be expressed with a decrease of PS values [29] (Figure 1).


Role of CT perfusion in monitoring and prediction of response to therapy of head and neck squamous cell carcinoma.

Preda L, Calloni SF, Moscatelli ME, Cossu Rocca M, Bellomi M - Biomed Res Int (2014)

Squamous cell carcinoma of hypopharynx in a responder patient: CT scan (a) obtained before chemotherapy shows the lesion involving the right piriform sinus. On the same section, functional maps of BF (b), BV (c), MTT (d), and PS (e) are automatically generated by the software, showing the values calculated in each pixel of the image in a color scale. CT scan obtained in the same patient after chemotherapy and radiotherapy showing a complete disappearance of the tumour (f).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129140&req=5

fig1: Squamous cell carcinoma of hypopharynx in a responder patient: CT scan (a) obtained before chemotherapy shows the lesion involving the right piriform sinus. On the same section, functional maps of BF (b), BV (c), MTT (d), and PS (e) are automatically generated by the software, showing the values calculated in each pixel of the image in a color scale. CT scan obtained in the same patient after chemotherapy and radiotherapy showing a complete disappearance of the tumour (f).
Mentions: Few studies (Table 1) investigated the value of CT-determined tumour perfusion in this specific clinical setting in a similar way to what demonstrated for tumours located in other body regions. This is based on the theory that changes produced by radiotherapy and chemotherapeutic agents on tumour vascularity can be identified by changes in CTp measured tumour perfusion. Treatment, specifically, induced reduction of microvessels inside the tumour could be identified as a decrease of BV values while a decrease of BF could indicate a reduction of low resistance flow arteriovenous shunts in the microvasculature. The reduction of hyperpermeable capillary bed could be expressed with a decrease of PS values [29] (Figure 1).

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Division of Radiology, European Institute of Oncology, University of Milan, Via Ripamonti 435, 20141 Milan, Italy.

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.

Show MeSH
Related in: MedlinePlus