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AJNR - American Journal of Neuroradiology

Publication Preview: Published October 29, 2009

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1852

HEAD & NECK

Perfusion CT in Squamous Cell Carcinoma of the Upper Aerodigestive Tract: Long-Term Predictive Value of Baseline Perfusion CT Measurements

S. Bisdas, Z. Rumboldt, K.. Popovi, M. Baghi, T.S. Koh, T.J. Vogl and M.G. Mack

From the Department of Neuroradiology (S.B.), Eberhard Karls University, Tübingen, Germany; Department of Radiology (Z.R.), Medical University of South Carolina, Charleston, South Carolina; Department of Radiology (K..P.), University Clinical Centre, Ljubljana, Slovenia; Center for Modelling and Control of Complex Systems (T.S.K.), Nanyang University, Singapore; and Departments of Radiology (T.J.V., M.G.M.) and Head and Neck Surgery (M.B.), Johann Wolfgang Goethe University, Frankfurt, Germany.

Please address correspondence to Sotirios Bisdas, MD, Department of Neuroradiology, Eberhard Karls University, Hoppe-Seyler-Str 3, D-72076 Tübingen, Germany; e-mail: Sotirios.Bisdas{at}med.uni-tuebingen.de

BACKGROUND AND PURPOSE: PCT studies hold short-term predictive value in patients treated with chemoradiotherapy. Our aim was to examine the long-term predictive value of baseline PCT studies for local tumor control and overall survival in SCCA of the upper aerodigestive tract treated with chemoradiotherapy.

MATERIALS AND METHODS: Eighty-four patients with advanced SCCA underwent PCT followed by concomitant chemoradiation. The acquired perfusion maps represented BF, BV, MTT, and PS. Visual analysis of the parametric maps for identification of tumor perfusion patterns was conducted. ROC curves, t tests, and Kaplan-Meier survival curves were plotted for local disease control and overall survival.

RESULTS: The median time of local tumor control was 24 months. The BF and PS values were significantly higher in patients who had no recurrence than in those with local failure (P .02). The BF and PS were predictive (P .0006) but BV and MTT held no significant predictive values for local tumor control. The patients with high BF and PS had a longer local tumor control than the patients with hypoperfused tumors (P = .0007). A visually detected BF-BV mismatch had a sensitivity/specificity of 63%/66% (P = .03) and 59%/69% (P = .03) for local tumor control and OS, respectively. Patients without mismatch lived significantly longer than patients with mismatch (P = .01).

CONCLUSIONS: BF, PS, and mismatch of BF-BV are significant predictors of local tumor control after chemoradiation in SCCA of the upper aerodigestive tract.

Abbreviations: SCCA, squamous cell carcinoma