The diagnostic performance of perfusion CT in the detection of local tumor recurrence in head and neck cancer

Issue title: Selected papers of the 39th Conference of the German Society for Clinical Microcirculation and Hemorheology, 6-7 November 2020, Hannover, Germany

Guest editors: B. Hiebl, A. Krüger-Genge and F. Jung

Article type: Research Article

Authors: Troeltzsch, Daniel^{a; *} | Niehues, Stefan Markus^b | Fluegge, Tabea^a | Neckel, Norbert^a | Heiland, Max^a | Hamm, Bernd^b | Shnayien, Seyd^b

Affiliations: [a] Department of Oral and Maxillofacial Surgery, Charité -Universitätsmedizin Berlin, Berlin, Germany | [b] Department of Radiology Charité - Universitätsmedizin Berlin, Berlin, Germany

Correspondence: [*] Corresponding author: Daniel Troeltzsch, Department of Oral and Maxillofacial Surgery, Charité -Universitätsmedizin Berlin, Berlin, Germany. Tel.: +49 30 450 655386; Fax: +49 30 8445 4197; E-mail: Daniel.Troeltzsch@charite.de.

Abstract: BACKGROUND:Detecting local tumor recurrence from post-treatment changes in head and neck cancer (HNC) remains a challenge. Based on the hypothesis that post-therapeutically altered tissue is bradytroph, lower perfusion values are expected in perfusion CT (PCT) while higher perfusion values are expected in recurrent malignant tissue. OBJECTIVES:This prospective study investigates PCT for post-treatment recurrent HNC detection with a maximum slope algorithm. METHODS:A total of 80 patients who received PCT of the head and neck for post-therapy follow-up, of which 63 had no tumor recurrence and 17 presented a histopathologically confirmed recurrence were examined. Regions of interest were placed in the location of the initial tumor, in reference ipsilateral nuchal muscle tissue and the corresponding internal carotid artery. Perfusion was calculated using a single-input maximum slope algorithm. RESULTS:With PCT, recurrent HNC can be differentiated from post-treatment tissue (p < 0.05). It further allows delineating recurrent tumor tissue from benign nuchal tissue of reference (p < 0.05). PCT data of patients with and without recurrent HNC are comparable as perfusion values of reference tissues in patients with and without HNC do not differ (p > 0.05). CONCLUSIONS:PCT in combination with a commercially available maximum slope algorithm offers radiologists a reliable imaging tool to detect recurrent head and neck cancer within post-therapeutically altered tissue.

Keywords: Head and neck cancer, perfusion computed tomography, tumor recurrence

DOI: 10.3233/CH-209209

Journal: Clinical Hemorheology and Microcirculation, vol. 76, no. 2, pp. 171-177, 2020