PURPOSE To assess the feasibility of CT perfusion imaging for functional evaluation of head and neck tumors (HNT) through quantitative analysis of perfusion parameters. METHOD AND MATERIALS Twelve patients with HNT (5 tongue carcinomas, 3 pharyngeal squamous cell carcinomas, 2 lymph node metastases from carcinoma of the oropharinx, 1 carcinoma of the maximally sinus, and 1 carcinoma of the hard palate) underwent a cine-mode CT perfusion study. The acquisition started 6 seconds after contrast material injection (40mL of 320mgI/mL iodixanol at 5mL/s flow rate) with a 50-second duration. CT perfusion data were exported to a workstation (Advantage Windows 4.4, General Electric, Milwaukee, WI), and regions of interest (ROI) were traced inside the neoplasm, on its contralateral side (CS), and on the ipsilateral sternocleidomastoid muscle (SM). By using the CT Perfusion 3 plug-in, the following perfusion parameters were computed: Blood Flow (BF), Blood Volume (BV), Mean Transit Time (MTT), and Permeability-Surface Product (PS). Values are expressed as mean ± standard deviation. RESULTS BF, BV, MTT, and PS were significantly different among the three groups (Kruskal-Wallis test: p<0.0001, p<0.00001, p=0.0228, and p<0.0001, respectively). Between individual groups, BF was significantly higher in HNT (124.9 ± 65.3) compared with CS (36.4 ± 27.6 ml/min/100g) and SM (17.9 ± 18.9 ml/min/100g) (Bonferroni-adjusted Mann-Whitney test: p=0.0015 and p=0.0003, respectively). Also BV was significantly increased (6.05 ± 2.26 ml/100g) compared with CS (1.97 ± 0.84 ml/100g, p=0.0003) and SM (1.02 ± 0.71 ml/100g, p=0.0003). MTT was significantly lower in HNT than in SM (4.71 ± 3.26 s vs 8.38 ± 5.85 s, p=0.0417), but not significantly so compared with CS (6.97 ± 3.48 s, p=0.18). Finally, PS was significantly higher in HNT (14.85 ± 9.52 ml/100g/min) than in CS (5.54 ± 5.53 ml/100g/min, p=0.0453) and in SM (2.33 ± 2.65 ml/100g/min, p=0.0006). In HNT, BF correlated significantly with BF (Spearman rank test: rs=0.6909, p=0.0186), and a statistically significant inverse correlation existed between MTT and BF (rs=-0.7818, p=0.0045). CONCLUSION CT-based quantitative evaluation of BV, BF, PS and, to a lesser extent, MTT allows to distinguish HNT from normal tissue. CLINICAL RELEVANCE/APPLICATION CT perfusion imaging has the potential to improve detectability and characterization of HNT.

CT PERFUSION OF HEAD AND NECK MALIGNANT NEOPLASMS: DIFFERENCES OF BLOOD FLOW, BLOOD VOLUME, MEAN TRANSIT TIME, AND PERMEABILITY-SURFACE PRODUCT PARAMETERS

NERI, EMANUELE;
2009-01-01

Abstract

PURPOSE To assess the feasibility of CT perfusion imaging for functional evaluation of head and neck tumors (HNT) through quantitative analysis of perfusion parameters. METHOD AND MATERIALS Twelve patients with HNT (5 tongue carcinomas, 3 pharyngeal squamous cell carcinomas, 2 lymph node metastases from carcinoma of the oropharinx, 1 carcinoma of the maximally sinus, and 1 carcinoma of the hard palate) underwent a cine-mode CT perfusion study. The acquisition started 6 seconds after contrast material injection (40mL of 320mgI/mL iodixanol at 5mL/s flow rate) with a 50-second duration. CT perfusion data were exported to a workstation (Advantage Windows 4.4, General Electric, Milwaukee, WI), and regions of interest (ROI) were traced inside the neoplasm, on its contralateral side (CS), and on the ipsilateral sternocleidomastoid muscle (SM). By using the CT Perfusion 3 plug-in, the following perfusion parameters were computed: Blood Flow (BF), Blood Volume (BV), Mean Transit Time (MTT), and Permeability-Surface Product (PS). Values are expressed as mean ± standard deviation. RESULTS BF, BV, MTT, and PS were significantly different among the three groups (Kruskal-Wallis test: p<0.0001, p<0.00001, p=0.0228, and p<0.0001, respectively). Between individual groups, BF was significantly higher in HNT (124.9 ± 65.3) compared with CS (36.4 ± 27.6 ml/min/100g) and SM (17.9 ± 18.9 ml/min/100g) (Bonferroni-adjusted Mann-Whitney test: p=0.0015 and p=0.0003, respectively). Also BV was significantly increased (6.05 ± 2.26 ml/100g) compared with CS (1.97 ± 0.84 ml/100g, p=0.0003) and SM (1.02 ± 0.71 ml/100g, p=0.0003). MTT was significantly lower in HNT than in SM (4.71 ± 3.26 s vs 8.38 ± 5.85 s, p=0.0417), but not significantly so compared with CS (6.97 ± 3.48 s, p=0.18). Finally, PS was significantly higher in HNT (14.85 ± 9.52 ml/100g/min) than in CS (5.54 ± 5.53 ml/100g/min, p=0.0453) and in SM (2.33 ± 2.65 ml/100g/min, p=0.0006). In HNT, BF correlated significantly with BF (Spearman rank test: rs=0.6909, p=0.0186), and a statistically significant inverse correlation existed between MTT and BF (rs=-0.7818, p=0.0045). CONCLUSION CT-based quantitative evaluation of BV, BF, PS and, to a lesser extent, MTT allows to distinguish HNT from normal tissue. CLINICAL RELEVANCE/APPLICATION CT perfusion imaging has the potential to improve detectability and characterization of HNT.
2009
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/135514
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