DYNAMIC CONTRAST-ENHANCED MAGNETIC RESONANCE IMAGING AS A PREDICTOR OF OUTCOME IN HEAD-AND-NECK SQUAMOUS CELL CARCINOMA PATIENTS WITH NODAL METASTASES

Amita Shukla-Dave*, Nancy Y. Lee, Jacobus F A Jansen, Howard T. Thaler, Hilda. E. Stambuk, Matthew G. Fury, Snehal G. Patel, Andre L. Moreira, Eric Sherman, Sasan Karimi, Ya Wang, Dennis H. Kraus, Jatin P. Shah, David G. Pfister, Jason A. Koutcher

*Corresponding author for this work

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Abstract

Dynamic contrast-enhanced MRI (DCE-MRI) can provide information regarding tumor perfusion and permeability and has shown prognostic value in certain tumors types. The goal of this study was to assess the prognostic value of pretreatment DCE-MRI in head and neck squamous cell carcinoma (HNSCC) patients with nodal disease undergoing chemoradiation therapy or surgery.Seventy-four patients with histologically proven squamous cell carcinoma and neck nodal metastases were eligible for the study. Pretreatment DCE-MRI was performed on a 1.5T MRI. Clinical follow-up was a minimum of 12 months. DCE-MRI data were analyzed using the Tofts model. DCE-MRI parameters were related to treatment outcome (progression-free survival [PFS] and overall survival [OS]). Patients were grouped as no evidence of disease (NED), alive with disease (AWD), dead with disease (DOD), or dead of other causes (DOC). Prognostic significance was assessed using the log-rank test for single variables and Cox proportional hazards regression for combinations of variables.At last clinical follow-up, for Stage III, all 12 patients were NED. For Stage IV, 43 patients were NED, 4 were AWD, 11 were DOD, and 4 were DOC. K(trans) is volume transfer constant. In a stepwise Cox regression, skewness of K(trans) (volume transfer constant) was the strongest predictor for Stage IV patients (PFS and OS: p
Original languageEnglish
Pages (from-to)1837-1844
JournalInternational Journal of Radiation Oncology Biology Physics
Volume82
Issue number5
DOIs
Publication statusPublished - 1 Apr 2012

Keywords

  • Dynamic contrast enhanced MRI (DCE-MRI)
  • Head and neck squamous cell carcinoma (HNSCC)
  • Volume transfer constant (K-trans)

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