Noninvasive assessment of tumor microenvironment using dynamic contrast-enhanced magnetic resonance imaging and (18)F-fluoromisonidazole positron emission tomography imaging in neck nodal metastases Journal Article
| Authors: | Jansen, J. F. A.; Schoder, H.; Lee, N. Y.; Wang, Y.; Pfister, D. G.; Fury, M. G.; Stambuk, H. E.; Humm, J. L.; Koutcher, J. A.; Shukla-Dave, A. |
| Article Title: | Noninvasive assessment of tumor microenvironment using dynamic contrast-enhanced magnetic resonance imaging and (18)F-fluoromisonidazole positron emission tomography imaging in neck nodal metastases |
| Abstract: | Purpose: To assess noninvasively the tumor microenvironment of neck nodal metastases in patients with head-and-neck cancer by investigating the relationship between tumor perfusion measured using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and hypoxia measured by 18F-fluoromisonidazole (18F-FMISO) positron emission tomography (PET). Methods and Materials: Thirteen newly diagnosed head-and-neck cancer patients with metastatic neck nodes underwent DCE-MRI and 18F-FMISO PET imaging before chemotherapy and radiotherapy. The matched regions of interests from both modalities were analyzed. To examine the correlations between DCE-MRI parameters and standard uptake value (SUV) measurements from 18F-FMISO PET, the nonparametric Spearman correlation coefficient was calculated. Furthermore, DCE-MRI parameters were compared between nodes with 18F-FMISO uptake and nodes with no 18F-FMISO uptake using Mann-Whitney U tests. Results: For the 13 patients, a total of 18 nodes were analyzed. The nodal size strongly correlated with the 18F-FMISO SUV (ρ = 0.74, p < 0.001). There was a strong negative correlation between the median kep (redistribution rate constant) value (ρ = -0.58, p = 0.042) and the 18F-FMISO SUV. Hypoxic nodes (moderate to severe 18F-FMISO uptake) had significantly lower median Ktrans (volume transfer constant) (p = 0.049) and median kep (p = 0.027) values than did nonhypoxic nodes (no 18F-FMISO uptake). Conclusion: This initial evaluation of the preliminary results support the hypothesis that in metastatic neck lymph nodes, hypoxic nodes are poorly perfused (i.e., have significantly lower K trans and kep values) compared with nonhypoxic nodes. Copyright © 2010 Elsevier Inc. |
| Keywords: | adult; clinical article; aged; aged, 80 and over; middle aged; retrospective studies; squamous cell carcinoma; carcinoma, squamous cell; chemotherapy; nuclear magnetic resonance imaging; positron emission tomography; methodology; magnetic resonance imaging; lymph node metastasis; lymph nodes; lymphatic metastasis; radiopharmaceuticals; metabolism; image analysis; tumor volume; clinical assessment; pathology; retrospective study; physiology; hypoxia; diagnostic agent; tumors; head and neck neoplasms; lymph node; positron-emission tomography; radiopharmaceutical agent; drug derivative; scintiscanning; pet imaging; cell hypoxia; 1 fluoro 3 (2 nitro 1 imidazolyl) 2 propanol; misonidazole; fluorine 18; tongue cancer; larynx cancer; dynamic contrast-enhanced magnetic resonance imaging; statistics, nonparametric; rate constants; head and neck tumor; dce-mri; resonance; positrons; head-and-neck cancer; tumor perfusion; tumor microenvironment; 18f-fdg; neck metastasis; 18f-fmiso pet; dynamic contrast-enhanced-mri (dce-mri); f-fdg; f-fmiso pet; mann-whitney u test; negative correlation; nodal metastasis; non-invasive assessments; non-parametric; positron emission; regions of interest; spearman correlation; standard uptake values; volume transfer; gadolinium pentetate meglumine; tonsil cancer; nonparametric test |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 77 |
| Issue: | 5 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2010-08-01 |
| Start Page: | 1403 |
| End Page: | 1410 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2009.07.009 |
| PUBMED: | 19906496 |
| PROVIDER: | scopus |
| PMCID: | PMC2888682 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: IOBPD" - "Source: Scopus" |
