title: Head and neck squamous cell carcinoma: CT perfusion can help noninvasively predict intratumoral microvessel density.
abstract: OBJECTIVE
  To determine the correlation between computed tomographic (CT) perfusion parameters and intratumoral microvessel density (MVD) in the evaluation of head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  This prospective HIPAA-compliant study was performed with institutional review board approval, and informed written consent was obtained from each patient prior to enrollment. Thirteen consecutive patients with advanced HNSCC (stage III or IV) underwent contrast material-enhanced neck CT, CT perfusion imaging, and endoscopic biopsy of the primary tumor site. The average patient age was 57.4 years (range, 41-78 years). Intratumoral MVD was determined after mouse antihuman CD31 antibody immunostaining. The mean number of stained microvessels from 10 high-power fields (x400) per specimen was recorded. CT perfusion parameters, including capillary permeability, blood volume (BV), blood flow (BF), and mean transit time (MTT), were calculated at the primary site. In the statistical analysis, Pearson and Spearman correlation coefficients were calculated.
  
  
  RESULTS
  Spearman rank correlation showed positive but not statistically significant correlation between vessel count and BF (r = 0.30, P = .316) and a positive correlation between vessel count and BV (r = 0.59, P = .035). No significant correlation was observed between vessel count and capillary permeability or between vessel count and MTT.
  
  
  CONCLUSIONS
  Our findings demonstrate a positive correlation between BF and BV parameters from CT perfusion of the neck and MVD in HNSCC.
authors.affiliation: Department of Radiology, Division of NeuroradiologyUniversity of Michigan Health Systems, 1500 E Medical Center Drive, Ann Arbor, MI 48109-0030, USA. lorrainemash@gmail.com
authors.forename: Lorraine
authors.initials: L
authors.lastname: Ash
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Teknos
authors.forename: Dheerhaj
authors.initials: D
authors.lastname: Gandhi
authors.forename: Samip
authors.initials: S
authors.lastname: Patel
authors.forename: Suresh K
authors.initials: SK
authors.lastname: Mukherji
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000098:blood supply* / Q000000981:diagnostic imaging*; D006258:Head and Neck Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging*; D006801:Humans; D055806:Microvessels / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D010477:Perfusion / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*