Document Detail


An exploratory study into the role of dynamic contrast-enhanced magnetic resonance imaging or perfusion computed tomography for detection of intratumoral hypoxia in head-and-neck cancer.
MedLine Citation:
PMID:  19036529     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Hypoxia in patients with head-and-neck cancer (HNC) is well established and known to cause radiation resistance and treatment failure in the management of HNC. This study examines the role of parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and perfusion computed tomography (CT) as surrogate markers of intratumoral hypoxia, defined by using the exogenous marker of hypoxia pimonidazole and the endogenous marker carbonic anhydrase 9 (CA9). METHODS AND MATERIALS: Patients with HNC underwent preoperative DCE-MRI, perfusion CT, and pimonidazole infusion. Imaging parameters were correlated with pimonidazole and CA9 staining. The strength of correlations was tested by using a two-tailed Spearman's rank correlation coefficient. RESULTS: Twenty-three regions of interest were analyzed from the 7 patients who completed the DCE-MRI studies. A number of statistically significant correlations were seen between DCE-MRI parameters (volume transfer between blood plasma and extracellular extravascular space [EES], volume of EES, rate constant between EES and blood plasma, time at arrival of contrast inflow, time to peak, average gradient, and time to onset) and areas with a pimonidazole score of 4. In the case of CA9 staining, only a weak correlation was shown with wash-in rate. There were no significant correlations between perfusion CT parameters and pimonidazole staining or CA9 expression. CONCLUSION: Intratumoral hypoxia in patients with HNC may be predicted by using DCE-MRI; however, perfusion CT requires further investigation.
Authors:
Kate Newbold; Isabel Castellano; Elizabeth Charles-Edwards; Dorothy Mears; Aslam Sohaib; Martin Leach; Peter Rhys-Evans; Peter Clarke; Cyril Fisher; Kevin Harrington; Christopher Nutting
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-11-25
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  74     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-13     Completed Date:  2009-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  29-37     Citation Subset:  IM    
Affiliation:
The Royal Marsden Hospital, Sutton, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Aged
Carbonic Anhydrases / analysis,  metabolism
Cell Hypoxia*
Contrast Media / pharmacokinetics
Female
Head and Neck Neoplasms / blood supply,  metabolism*,  surgery
Humans
Iohexol / pharmacokinetics
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Nitroimidazoles / diagnostic use,  pharmacokinetics
Radiation Tolerance
Radiation-Sensitizing Agents / diagnostic use,  pharmacokinetics
Statistics, Nonparametric
Tomography, Spiral Computed / methods*
Tumor Markers, Biological / metabolism
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Nitroimidazoles; 0/Radiation-Sensitizing Agents; 0/Tumor Markers, Biological; 66108-95-0/Iohexol; 70132-51-3/pimonidazole; EC 4.2.1.1/Carbonic Anhydrases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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