MR Dynamic Imaging and Spectroscopy in Head & Neck Cancers

描述（由申请方提供）：本项目旨在评价1H-MR波谱（MRS）和动态对比增强MRI（DCE-MRI）在头颈部鳞状细胞癌（HNSCC）治疗中的预后效用。HNSCC是全球第五大常见恶性肿瘤，每年在美国影响超过29，370人。尽管积极的手术和放射治疗（XRT），这可能会导致主要的功能丧失，HNSCC患者的生存率在过去的30年中保持相对不变。为了提高生存率，化疗已被纳入新诊断病例的初始非手术治疗中。不幸的是，没有早期或先验标志物可预测治疗失败/反应。肿瘤微环境在恶性肿瘤进展和治疗抵抗中起着关键作用。已显示与治疗结果相关的微环境参数包括肿瘤细胞缺氧和增殖。已经表明，通过1H-MRS和DCE-MRI变化进行的预处理乳酸检测可以预测肿瘤缺氧和结局。我们建议评估1H-MRS和DCE-MRI的价值，为更好地选择患者提供工具。我们的假设是，光谱变化和/或DCE-MRI的变化之前，或早期的化疗过程中，XRT可以预测治疗反应和/或长期无病生存的患者化疗XRT或手术治疗。该项目的目标是1。评价先验或早期1 H-MRS（胆碱和乳酸盐）和DCE-MRI（Akep和Ktranss）变化可以可靠预测肿瘤明显消退和/或长期无病生存期前的化疗临床反应的假设。2.确定先验1 H-MRS和DCE-MRI变化是否与18 F-MISO PET（18氟-米索咪唑正电子发射断层扫描）研究相关。3.确定先验1H-MRS和DCE-MRI变化是否与选定的增殖、缺氧分子标志物和基因阵列分析相关。4.确定1 H-MRS和DCE-MRI结果与潜在的分子和临床指标相比是否是肿瘤缓解和/或长期无病生存期的上级和独立标志物。如果成功，它将提供化疗失败/反应和/或长期无病生存的先验预测因子，从而导致可能提高结局的患者特异性治疗。

DESCRIPTION (provided by applicant): This project is designed to evaluate the prognostic utility of 1H- MR Spectroscopy (MRS) and Dynamic Contrast Enhanced MRI (DCE-MRI) in the management of squamous cell carcinoma of the head and neck (HNSCC). HNSCC is the fifth most common malignancy worldwide and affects more than 29,370 persons in the United States annually. Despite agressive surgery and radiation therapy (XRT), which may result in major functional loss, the survival rate of patients with HNSCC has remained relatively unchanged over the past 3 decades. In an effort to improve survival, chemotherapy has been incorporated in the initial non- surgical management of newly diagnosed cases. Unfortunately, there are no early or a priori markers that are predictive of treatment failure/response. The tumor microenvironment plays a critical role in malignant tumor progression and treatment resistance. Microenvironment parameters that have shown to be relevant for treatment outcome include tumor cell hypoxia and proliferation. It has been suggested that pretreatment lactate detection by 1H-MRS and DCE-MRI changes are predictive of tumor hypoxia and outcome. We propose to asssess the value of 1H-MRS and DCE-MRI for providing tools for better selection of patients. Our hypothesis is that spectroscopic changes and/or DCE-MRI changes prior to, or early in the course of chemotherapy-XRT can predict response to treatment and/or long term disease-free survival in patients treated with chemotherapy-XRT or surgery. The goals of this project are to 1. Evaluate the hypothesis that a priori or early 1 H- MRS (choline and lactate) and DCE-MRI (Akep and Ktrans) changes can reliably predict chemotherapy clinical response before apparent tumor regression and/or long term disease-free survival. 2. Determine whether the a priori 1 H-MRS and DCE-MRI changes correlate with 18F-MISO PET (18Fluoro - misonidazole Positron Emission Tomography) studies. 3. Determine whether the a priori 1 H-MRS and DCE-MRI changes correlate with selected proliferative, hypoxia molecular markers and gene array analysis. 4. Determine if the 1 H-MRS and DCE-MRI results are superior and independent markers of tumor response and/or long term disease-free survival compared to potential molecular and clinical prognosticators. If successful, it will provide an a priori predictor of failure/response to chemotherapy and/or long term disease free-survival, resulting in patient specific treatment which will likely enhance outcome.