Measurement of tumor blood flow in head and neck squamous cell carcinoma by pseudo-continuous arterial spin labeling: comparison with dynamic contrast-enhanced MRI.
OBJECTIVE
To investigate the feasibility of tumor blood flow (TBF) measurement in head and neck squamous cell carcinoma (HNSCC) using pseudo-continuous arterial spin labeling (pCASL) in a comparison with dynamic contrast-enhanced (DCE) perfusion.


METHODS
We prospectively scanned 18 patients with HNSCC using 3T magnetic resonance imaging (MRI) with both pCASL and DCE perfusion. Quantitative TBF value in the whole-tumor region of interest (ROI), and regional TBF in the ROIs of the central and peripheral areas in the tumor were respectively measured. Relative TBF value in the whole-tumor ROI was also calculated. We determined the correlation and agreement between each measured TBF by pCASL and DCE perfusion using Pearson's correlation coefficients, intraclass correlation coefficients (ICC), and Bland-Altman analysis.


RESULTS
In the whole-tumor ROIs, significant correlation was observed between the absolute TBF values (r = 0.72, P < 0.01), with an ICC of 0.72; moreover, higher correlation was observed in the relative TBF (r = 0.79). The correlation was higher in the peripheral ROI (r = 0.70) than the central ROI (r = 0.65), with an ICC of 0.62 and 0.54, respectively. Bland-Altman plots revealed the underestimation of TBF by pCASL in central ROIs.


CONCLUSIONS
TBF measurement by pCASL was feasible in patients with HNSCC.
Department of Radiology, Hokkaido University Hospital, Sapporo, Japan.
Noriyuki
N
Fujima
Kohsuke
K
Kudo
Akiko
A
Tsukahara
Daisuke
D
Yoshida
Tomohiro
T
Sakashita
Akihiro
A
Homma
Khin Khin
KK
Tha
Hiroki
H
Shirato
D000368:Aged; D001783:Blood Flow Velocity; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D003287:Contrast Media; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels; D000077195:Squamous Cell Carcinoma of Head and Neck
D003287:Contrast Media; D013113:Spin Labels
dynamic contrast-enhanced perfusion; head and neck squamous cell carcinoma; pseudo-continuous arterial spin labeling; tumor blood flow