Clinical utility of combined assessments of 4D volumetric perfusion CT, diffusion-weighted MRI and 18F-FDG PET-CT for the prediction of outcomes of head and neck squamous cell carcinoma treated with chemoradiotherapy

Radiation Oncology

Research

Hiroyuki Tuji¹  Yuka Nishino²  Kiyotaka Ota²  Hirokazu Tsuchiya²  Mariko Doai²  Munetaka Matoba²  Hiroji Nagata³ 

[1] Department of Head and Neck Surgery, Kanazawa Medical University, Daigaku 1-1, 920-0293, Uchinada, Kahoku, Ishikawa, Japan;Department of Radiology, Kanazawa Medical University, Daigaku 1-1, 920-0293, Uchinada, Kahoku, Ishikawa, Japan;Section of Radiological Technology, Department of Medical Technology, Kanazawa Medical University, Daigaku 1-1, 920-0293, Uchinada, Kahoku, Ishikawa, Japan;

关键词: Head and neck cancer;    Chemoradiotherapy;    Prognostic prediction;    Multiparametric imaging;    Perfusion CT;   

DOI  :  10.1186/s13014-023-02202-x

 received in 2022-03-27, accepted in 2023-01-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMultiparametric imaging has been seen as a route to improved prediction of chemoradiotherapy treatment outcomes. Four-dimensional volumetric perfusion CT (4D PCT) is useful for whole-organ perfusion measurement, as it reflects the heterogeneity of the tumor and its perfusion parameters. However, there has been no study using multiparametric imaging including 4D PCT for the prognostic prediction of chemoradiotherapy. The purpose of this study was to determine whether combining assessments of 4D PCT with diffusion-weighted MRI (DWI) and 18F-fluorodeoxyglucose PET-CT could enhance prognostic accuracy in head and neck squamous cell carcinoma (HNSCC) patients treated with chemoradiotherapy.MethodsWe examined 53 patients with HNSCC who underwent 4D PCT, DWI and PET-CT before chemoradiotherapy. The imaging and clinical parameters were assessed the relations to locoregional control (LRC) and progression-free survival (PFS) by logistic regression analyses. A receiver operating characteristic (ROC) analysis was performed to assess the accuracy of the significant parameters identified by the multivariate analysis for the prediction of LRC and PFS. We additionally assessed using the scoring system whether these independent parameters could have a complementary role for the prognostic prediction.ResultsThe median follow-up was 30 months. In multivariate analysis, blood flow (BF; p = 0.02) and blood volume (BV; p = 0.04) were significant prognostic factors for LRC, and BF (p = 0.03) and skewness of the ADC histogram (p = 0.02) were significant prognostic factors for PFS. A significant positive correlation was found between BF and BV (ρ = 0.6, p < 0.001) and between BF and skewness (ρ = 0.46, p < 0.01). The ROC analysis showed that prognostic accuracy for LRC of BF, BV, and combination of BF and BV were 77.8%, 70%, and 92.9%, and that for PFS of BF, skewness, and combination of BF and skewness were 55.6%, 63.2%, and 77.5%, respectively. The scoring system demonstrated that the combination of higher BF and higher BV was significantly associated with better LRC (p = 0.04), and the combination of lower BF and lower skewness was significantly associated with worse PFS (p = 0.004).ConclusionA combination of parameters derived from 4DPCT and ADC histograms may enhance prognostic accuracy in HNSCC patients treated with chemoradiotherapy.

【 授权许可】

CC BY   
© The Author(s) 2023

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