Radiologic assessment of intranodal vascularity in head and neck squamous cell carcinoma. Correlation with histologic vascular density.
OBJECTIVE
Nodal response to chemotherapy in head and neck squamous cell carcinoma depends on the vascularization. The authors assessed different techniques in detecting nodal vascularization.


METHODS
Fourteen patients with head and neck tumor were included before surgical treatment. The largest metastatic lymph node (mean axial scanographic diameters 30 x 20 mm) was studied by color and pulsed Doppler, and dynamic magnetic resonance images, processed by factor analysis of medical image sequences (FAMIS), which estimates physiologic contrast enhancement kinetics (factors) and their spatial distributions (factor images). Results were compared with the histologic microvessel density (MVD). Using light microscopy, MVD was estimated by the vascular surface (by staining endothelial cells) to the stroma surface ratio x 100.


RESULTS
Three factors were identified by FAMIS: a constant factor in necrosis, an earlier F1 factor and a later F2 factor in normal lymphoid areas and neoplastic stroma. Color flow signal was detected when the MVD was greater than 6.36.


CONCLUSIONS
Only one model of vascularization was extracted by FAMIS, with no difference between neoplastic and spared lymphoid areas. The presence of color-flow signals could help predict the response of metastatic lymph nodes to chemotherapy.
Department of Imaging, Institut Gustave Roussy, Villejuif, France.
S
S
Lamer
R
R
Sigal
N
N
Lassau
J
J
Bosq
F
F
Frouin
M
M
Di Paola
G
G
Mamelle
J
J
Leclère
J
J
Bittoun
R
R
Di Paola
D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology*; D005163:Factor Analysis, Statistical; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000098:blood supply*; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography