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"
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MSK Authors
  1. Hilda Stambuk
    40 Stambuk
  2. Jacobus Jansen
    14 Jansen
  3. Nancy Y. Lee
    599 Lee
  4. Heiko Schoder
    311 Schoder
  5. David G Pfister
    285 Pfister
  6. Matthew G Fury
    99 Fury
  7. John Laurence Humm
    356 Humm
  8. Amita Dave
    85 Dave
  9. Jason A Koutcher
    241 Koutcher
  10. Ya Wang
    20 Wang