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<meta name="DC.Title" content="Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during the Course of Concomitant Chemoradiotherapy" />
<meta name="DC.Identifier" content="10.3174/ajnr.A1859" />
<meta name="DC.Date" content="2010-03-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Concomitant chemoradiation is a promising therapy for the treatment of locoregionally advanced head and neck carcinoma. The purpose of this study was to prospectively evaluate early changes in primary tumor perfusion parameters during concomitant cisplatin-based chemoradiotherapy of locoregionally advanced SCCHN and to evaluate their predictive value for response of the primary tumor to therapy.

MATERIALS AND METHODS: Twenty patients with locoregionally advanced SCCHN underwent perfusion CT scans before therapy and after completion of 40 Gy and 70 Gy of chemoradiotherapy. BF, BV, MTT, and PS of primary tumors were quantified. Differences in perfusion and tumor volume values during the therapy as well as between responders and nonresponders were analyzed, and ROC curves were used to assess predictive value of the baseline and follow-up functional parameters.

RESULTS: The tumor volumes at 40 Gy and at 70 Gy were significantly lower compared with baseline values ( P = .014 and P = .007). In the 6 nonresponders, measurements after 40 Gy showed a nonsignificant trend of increased BF, BV, and PS values compared with the baseline values ( P = .06). In 14 responders, a significant reduction of BF values was recorded after 40 Gy ( P = .04) and after 70 Gy ( P = .01). In responders, BV values showed a reduction after 40 Gy followed by a plateau after 70 Gy ( P = .04), whereas in nonresponders there was a nonsignificant elevation of the BV. Baseline BV predicted short-term tumor response with a sensitivity of 60% and specificity of 100% ( P = .01). After completion of 40 Gy of concomitant chemoradiation BV was a more significant predictor than were BF and MTT.

CONCLUSIONS: The results suggest that in advanced SCCHN the perfusion CT monitoring might be of predictive value for identifying tumors that may respond to cisplatin-based chemoradiotherapy.

AUC
:   area under the curve
BF
:   blood flow
BV
:   blood volume
CECT
:   contrast-enhanced CT
LR
:   likelihood ratio
MTT
:   mean transit time
PCT
:   perfusion CT
PET
:   positron-emission tomography
PS
:   permeability surface area product
ROC
:   receiver operating characteristic
ROI
:   region of interest
SCCHN
:   squamous cell carcinoma of the head and neck
VEGF
:   vascular endothelial growth factor" />
<meta name="DC.Contributor" content="K. Šurlan-Popovič" />
<meta name="DC.Contributor" content="S. Bisdas" />
<meta name="DC.Contributor" content="Z. Rumboldt" />
<meta name="DC.Contributor" content="T.S. Koh" />
<meta name="DC.Contributor" content="P. Strojan" />
<meta name="article:published_time" content="2010-03-01" />
<meta name="article:section" content="Head and Neck" />
<meta name="citation_title" content="Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during the Course of Concomitant Chemoradiotherapy" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Concomitant chemoradiation is a promising therapy for the treatment of locoregionally advanced head and neck carcinoma. The purpose of this study was to prospectively evaluate early changes in primary tumor perfusion parameters during concomitant cisplatin-based chemoradiotherapy of locoregionally advanced SCCHN and to evaluate their predictive value for response of the primary tumor to therapy.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Twenty patients with locoregionally advanced SCCHN underwent perfusion CT scans before therapy and after completion of 40 Gy and 70 Gy of chemoradiotherapy. BF, BV, MTT, and PS of primary tumors were quantified. Differences in perfusion and tumor volume values during the therapy as well as between responders and nonresponders were analyzed, and ROC curves were used to assess predictive value of the baseline and follow-up functional parameters.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The tumor volumes at 40 Gy and at 70 Gy were significantly lower compared with baseline values (&lt;i&gt;P&lt;/i&gt; = .014 and &lt;i&gt;P&lt;/i&gt; = .007). In the 6 nonresponders, measurements after 40 Gy showed a nonsignificant trend of increased BF, BV, and PS values compared with the baseline values (&lt;i&gt;P&lt;/i&gt; = .06). In 14 responders, a significant reduction of BF values was recorded after 40 Gy (&lt;i&gt;P&lt;/i&gt; = .04) and after 70 Gy (&lt;i&gt;P&lt;/i&gt; = .01). In responders, BV values showed a reduction after 40 Gy followed by a plateau after 70 Gy (&lt;i&gt;P&lt;/i&gt; = .04), whereas in nonresponders there was a nonsignificant elevation of the BV. Baseline BV predicted short-term tumor response with a sensitivity of 60% and specificity of 100% (&lt;i&gt;P&lt;/i&gt; = .01). After completion of 40 Gy of concomitant chemoradiation BV was a more significant predictor than were BF and MTT.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The results suggest that in advanced SCCHN the perfusion CT monitoring might be of predictive value for identifying tumors that may respond to cisplatin-based chemoradiotherapy.&lt;/p&gt;" />
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<meta name="twitter:title" content="Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during the Course of Concomitant Chemoradiotherapy" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Concomitant chemoradiation is a promising therapy for the treatment of locoregionally advanced head and neck carcinoma. The purpose of this study was to prospectively evaluate early changes in primary tumor perfusion parameters during concomitant cisplatin-based chemoradiotherapy of locoregionally advanced SCCHN and to evaluate their predictive value for response of the primary tumor to therapy.

MATERIALS AND METHODS: Twenty patients with locoregionally advanced SCCHN underwent perfusion CT scans before therapy and after completion of 40 Gy and 70 Gy of chemoradiotherapy. BF, BV, MTT, and PS of primary tumors were quantified. Differences in perfusion and tumor volume values during the therapy as well as between responders and nonresponders were analyzed, and ROC curves were used to assess predictive value of the baseline and follow-up functional parameters.

RESULTS: The tumor volumes at 40 Gy and at 70 Gy were significantly lower compared with baseline values ( P = .014 and P = .007). In the 6 nonresponders, measurements after 40 Gy showed a nonsignificant trend of increased BF, BV, and PS values compared with the baseline values ( P = .06). In 14 responders, a significant reduction of BF values was recorded after 40 Gy ( P = .04) and after 70 Gy ( P = .01). In responders, BV values showed a reduction after 40 Gy followed by a plateau after 70 Gy ( P = .04), whereas in nonresponders there was a nonsignificant elevation of the BV. Baseline BV predicted short-term tumor response with a sensitivity of 60% and specificity of 100% ( P = .01). After completion of 40 Gy of concomitant chemoradiation BV was a more significant predictor than were BF and MTT.

CONCLUSIONS: The results suggest that in advanced SCCHN the perfusion CT monitoring might be of predictive value for identifying tumors that may respond to cisplatin-based chemoradiotherapy.

AUC
:   area under the curve
BF
:   blood flow
BV
:   blood volume
CECT
:   contrast-enhanced CT
LR
:   likelihood ratio
MTT
:   mean transit time
PCT
:   perfusion CT
PET
:   positron-emission tomography
PS
:   permeability surface area product
ROC
:   receiver operating characteristic
ROI
:   region of interest
SCCHN
:   squamous cell carcinoma of the head and neck
VEGF
:   vascular endothelial growth factor" />
<meta name="og-title" property="og:title" content="Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during the Course of Concomitant Chemoradiotherapy" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/3/570" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Concomitant chemoradiation is a promising therapy for the treatment of locoregionally advanced head and neck carcinoma. The purpose of this study was to prospectively evaluate early changes in primary tumor perfusion parameters during concomitant cisplatin-based chemoradiotherapy of locoregionally advanced SCCHN and to evaluate their predictive value for response of the primary tumor to therapy.

MATERIALS AND METHODS: Twenty patients with locoregionally advanced SCCHN underwent perfusion CT scans before therapy and after completion of 40 Gy and 70 Gy of chemoradiotherapy. BF, BV, MTT, and PS of primary tumors were quantified. Differences in perfusion and tumor volume values during the therapy as well as between responders and nonresponders were analyzed, and ROC curves were used to assess predictive value of the baseline and follow-up functional parameters.

RESULTS: The tumor volumes at 40 Gy and at 70 Gy were significantly lower compared with baseline values ( P = .014 and P = .007). In the 6 nonresponders, measurements after 40 Gy showed a nonsignificant trend of increased BF, BV, and PS values compared with the baseline values ( P = .06). In 14 responders, a significant reduction of BF values was recorded after 40 Gy ( P = .04) and after 70 Gy ( P = .01). In responders, BV values showed a reduction after 40 Gy followed by a plateau after 70 Gy ( P = .04), whereas in nonresponders there was a nonsignificant elevation of the BV. Baseline BV predicted short-term tumor response with a sensitivity of 60% and specificity of 100% ( P = .01). After completion of 40 Gy of concomitant chemoradiation BV was a more significant predictor than were BF and MTT.

CONCLUSIONS: The results suggest that in advanced SCCHN the perfusion CT monitoring might be of predictive value for identifying tumors that may respond to cisplatin-based chemoradiotherapy.

AUC
:   area under the curve
BF
:   blood flow
BV
:   blood volume
CECT
:   contrast-enhanced CT
LR
:   likelihood ratio
MTT
:   mean transit time
PCT
:   perfusion CT
PET
:   positron-emission tomography
PS
:   permeability surface area product
ROC
:   receiver operating characteristic
ROI
:   region of interest
SCCHN
:   squamous cell carcinoma of the head and neck
VEGF
:   vascular endothelial growth factor" />
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      <h1 class="highwire-cite-title" id="page-title">Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during the Course of Concomitant Chemoradiotherapy</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">K. Šurlan-Popovič</span>, <span class="highwire-citation-author" data-delta="1">S. Bisdas</span>, <span class="highwire-citation-author" data-delta="2">Z. Rumboldt</span>, <span class="highwire-citation-author" data-delta="3">T.S. Koh</span> and <span class="highwire-citation-author" data-delta="4">P. Strojan</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">March 2010,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">570-575; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A1859 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-9611--6217287882" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">K. Šurlan-Popovič </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.%2B%C5%A0urlan-Popovi%C4%8D%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=%C5%A0urlan-Popovi%C4%8D%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AK.%2B%25C5%25A0urlan-Popovi%25C4%258D%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">S. Bisdas </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BBisdas%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bisdas%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.%2BBisdas%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Z. Rumboldt </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Z.%2BRumboldt%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rumboldt%20Z&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AZ.%2BRumboldt%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">T.S. Koh </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.S.%2BKoh%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Koh%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.S.%2BKoh%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">P. Strojan </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BStrojan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Strojan%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AP.%2BStrojan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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<p id="p-4"><strong>BACKGROUND AND PURPOSE:</strong> Concomitant chemoradiation is a promising therapy for the treatment of locoregionally advanced head and neck carcinoma. The purpose of this study was to prospectively evaluate early changes in primary tumor perfusion parameters during concomitant cisplatin-based chemoradiotherapy of locoregionally advanced SCCHN and to evaluate their predictive value for response of the primary tumor to therapy.</p>
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<p id="p-5"><strong>MATERIALS AND METHODS:</strong> Twenty patients with locoregionally advanced SCCHN underwent perfusion CT scans before therapy and after completion of 40 Gy and 70 Gy of chemoradiotherapy. BF, BV, MTT, and PS of primary tumors were quantified. Differences in perfusion and tumor volume values during the therapy as well as between responders and nonresponders were analyzed, and ROC curves were used to assess predictive value of the baseline and follow-up functional parameters.</p>
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<p id="p-6"><strong>RESULTS:</strong> The tumor volumes at 40 Gy and at 70 Gy were significantly lower compared with baseline values (<em>P</em> = .014 and <em>P</em> = .007). In the 6 nonresponders, measurements after 40 Gy showed a nonsignificant trend of increased BF, BV, and PS values compared with the baseline values (<em>P</em> = .06). In 14 responders, a significant reduction of BF values was recorded after 40 Gy (<em>P</em> = .04) and after 70 Gy (<em>P</em> = .01). In responders, BV values showed a reduction after 40 Gy followed by a plateau after 70 Gy (<em>P</em> = .04), whereas in nonresponders there was a nonsignificant elevation of the BV. Baseline BV predicted short-term tumor response with a sensitivity of 60% and specificity of 100% (<em>P</em> = .01). After completion of 40 Gy of concomitant chemoradiation BV was a more significant predictor than were BF and MTT.</p>
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<p id="p-7"><strong>CONCLUSIONS:</strong> The results suggest that in advanced SCCHN the perfusion CT monitoring might be of predictive value for identifying tumors that may respond to cisplatin-based chemoradiotherapy.</p>
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</div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">AUC<span class="def-item-dt-sep"></span></dt><dd>area under the curve<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">BF<span class="def-item-dt-sep"></span></dt><dd>blood flow<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">BV<span class="def-item-dt-sep"></span></dt><dd>blood volume<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">CECT<span class="def-item-dt-sep"></span></dt><dd>contrast-enhanced CT<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">LR<span class="def-item-dt-sep"></span></dt><dd>likelihood ratio<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">MTT<span class="def-item-dt-sep"></span></dt><dd>mean transit time<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">PCT<span class="def-item-dt-sep"></span></dt><dd>perfusion CT<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">PET<span class="def-item-dt-sep"></span></dt><dd>positron-emission tomography<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">PS<span class="def-item-dt-sep"></span></dt><dd>permeability surface area product<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">ROC<span class="def-item-dt-sep"></span></dt><dd>receiver operating characteristic<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">ROI<span class="def-item-dt-sep"></span></dt><dd>region of interest<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">SCCHN<span class="def-item-dt-sep"></span></dt><dd>squamous cell carcinoma of the head and neck<span class="def-item-dd-sep"></span></dd><dt id="def-item-13">VEGF<span class="def-item-dt-sep"></span></dt><dd>vascular endothelial growth factor</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/31/3/570.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during the Course of Concomitant Chemoradiotherapy</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Šurlan-Popovič</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Bisdas</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Z.</span> <span class="nlm-surname">Rumboldt</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">T.S.</span> <span class="nlm-surname">Koh</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Strojan</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">570-575; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A1859 </span></div>
  
  
  
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      <div class="highwire-cite-title">Changes in Perfusion CT of Advanced Squamous Cell Carcinoma of the Head and Neck Treated during the Course of Concomitant Chemoradiotherapy</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">570-575; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A1859 </span></div>
  
  
  
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