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
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
复制标题
DOI：
10.1016/j.ijrobp.2008.07.039
复制
发表时间：
2009-05-01
影响因子：
7
通讯作者：
Nutting, Christopher
中科院分区：
文献类型：
--
作者：
Newbold, Kate;Castellano, Isabel;Nutting, Christopher
目的：头颈癌(HNC)患者的低氧是公认的，并且在HNC的治疗中会导致放射抵抗和治疗失败。本研究探讨动态增强磁共振成像(DCE-MRI)和灌注CT(CT)参数作为肿瘤内缺氧的替代标志物的作用，通过外源性缺氧标志物匹莫硝唑和内源性标志物碳酸酐酶9(CA9)来定义。方法：对HNC患者行术前动态增强磁共振成像(DCE-MRI)、灌注CT和匹莫硝唑输注。图像参数与匹莫硝唑和CA9染色相关。使用双尾Spearman等级相关系数检验相关性的强度。结果：完成DCE-MRI研究的7名患者共分析了23个感兴趣区域。DCE-MRI参数(血浆与细胞外血管外间隙之间的体积传递、EES体积、EES与血浆之间的速率常数、造影剂流入时间、达到峰值时间、平均梯度和起病时间)与匹莫硝唑评分为4的区域之间存在显著的相关性。在CA9染色的情况下，只有微弱的相关性与洗入率有关。结论：DCE-MRI可以预测HNC患者的瘤内缺氧，但灌注CT仍需进一步研究。(C)2009年爱思唯尔公司。
Purpose: Hypoxia in patients with head-and-neck cancer (HNC) is well established and known to cause radiation resistance and treatment failure in the management of HNC. This study examines the role of parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and perfusion computed tomography (CT) as surrogate markers of intratumoral hypoxia, defined by using the exogenous marker of hypoxia pimonidazole and the endogenous marker carbonic anhydrase 9 (CA9).Methods and Materials: Patients with HNC underwent preoperative DCE-MRI, perfusion CT, and pimonidazole infusion. Imaging parameters were correlated with pimonidazole and CA9 staining. The strength of correlations was tested by using a two-tailed Spearman's rank correlation coefficient.Results: Twenty-three regions of interest were analyzed from the 7 patients who completed the DCE-MRI studies. A number of statistically significant correlations were seen between DCE-MRI parameters (volume transfer between blood plasma and extracellular extravascular space [EES], volume of EES, rate constant between EES and blood plasma, time at arrival of contrast inflow, time to peak, average gradient, and time to onset) and areas with a pimonidazole score of 4. In the case of CA9 staining, only a weak correlation was shown with wash-in rate. There were no significant correlations between perfusion CT parameters and pimonidazole staining or CA9 expression.Conclusion: Intratumoral hypoxia in patients with HNC may be predicted by using DCE-MRI; however, perfusion CT requires further investigation. (C) 2009 Elsevier Inc.