Quantitative measurements of perfusion and permeability of oropharyngeal and oral cavity cancer, recurrent disease, and associated lymph nodes using first-pass contrast-enhanced computed tomography studies.
OBJECTIVE
We sought to evaluate the routine clinical use of perfusion computed tomography in the detection and differentiation of primary and recurrent oropharynx and oral cavity tumors as well as of nodal disease.


METHODS
A total of 77 patients with primary cancer as well as suspected recurrent disease and lymph nodes were evaluated. A dynamic acquisition (4 x 6-mm slices) of the largest axial tumor surface was performed and the tumor blood flow (BF), blood volume (BV), and mean transit time (MTT) were calculated by using a modified deconvolution-based analysis taking into account the extravasation of the contrast agent for permeability surface area product imaging (PS). Tumor volume was calculated and region of interest analysis was performed on the pathologic and normal tissue.


RESULTS
The mean BF, BV, and PS values in the primary tumors (77.48 mL/min/100 g tissue; 5.29 mL/min; 13.33 mL/min/100 g tissue, respectively) were highly significantly different (P < 0.01) than those obtained in the normal structures. Mean MTT values (9.01 seconds) also were significantly lowered in the tumors compared with normal tissue (P < 0.05). There was no statistical difference in the perfusion values between the primary and the recurrent tumors. Recurrent disease could be differentiated on the basis of BF (P < 0.05) from tissue changes after chemo-radiation-treatment (mean BF: 69.71 versus 45.31 mL/min/100 g tissue, respectively). Differentiation of the lymph nodes was not possible by means of perfusion values. Tumor volume did not significantly correlate with any perfusion parameter.


CONCLUSIONS
Perfusion CT of oropharyngeal and oral cavity cancer in clinical routine is feasible and helps outlining the malignant tissue as well as differentiating recurrent disease from nonspecific post-therapeutic changes.
Bisdas
Sotirios
S
Department of Radiology, Johann Wolfgang Goethe University Hospital, Frankfurt, Germany. sbisdas@yahoo.com
Baghi
Mehran
M
Smolarz
Agnieszka
A
Pihno
Nicole Chambron
NC
Lehnert
Thomas
T
Knecht
Rainald
R
Mack
Martin G
MG
Vogl
Thomas J
TJ
Tuerkay
Sehib
S
Koh
Tong San
TS
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D003287:Contrast Media; D005240:Feasibility Studies; D006801:Humans; D008198:Lymph Nodes / Q000098:blood supply / Q000473:pathology*; D008297:Male; D009055:Mouth / Q000473:pathology; D009062:Mouth Neoplasms / Q000098:blood supply / Q000473:pathology*; D009364:Neoplasm Recurrence, Local; D009959:Oropharyngeal Neoplasms / Q000098:blood supply / Q000473:pathology*; D009960:Oropharynx / Q000473:pathology; D010477:Perfusion; D010539:Permeability; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media