Noninvasive Assessment of Tumor Microenvironment Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging and {sup 18}F-Fluoromisonidazole Positron Emission Tomography Imaging in Neck Nodal Metastases

Journal Article · Sun Aug 01 00:00:00 EDT 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.07.009· OSTI ID:21436113

Jansen, Jacobus ^[1]; Schoeder, Heiko ^[2]; Lee, Nancy Y ^[3]; Ya, Wang ^[1]

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1. Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
2. Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
3. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

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 {sup 18}F-fluoromisonidazole ({sup 18}F-FMISO) positron emission tomography (PET). Methods and Materials: Thirteen newly diagnosed head-and-neck cancer patients with metastatic neck nodes underwent DCE-MRI and {sup 18}F-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 {sup 18}F-FMISO PET, the nonparametric Spearman correlation coefficient was calculated. Furthermore, DCE-MRI parameters were compared between nodes with {sup 18}F-FMISO uptake and nodes with no {sup 18}F-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 {sup 18}F-FMISO SUV ({rho} = 0.74, p < 0.001). There was a strong negative correlation between the median k{sub ep} (redistribution rate constant) value ({rho} = -0.58, p = 0.042) and the {sup 18}F-FMISO SUV. Hypoxic nodes (moderate to severe {sup 18}F-FMISO uptake) had significantly lower median K{sup trans} (volume transfer constant) (p = 0.049) and median k{sub ep} (p = 0.027) values than did nonhypoxic nodes (no {sup 18}F-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{sup trans} and k{sub ep} values) compared with nonhypoxic nodes.

• OSTI ID: 21436113
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 77, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2009.07.009; PII: S0360-3016(09)01030-X; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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