Role of Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) in Prediction and Monitoring of Treatment Response in Head and Neck Squamous Cell Carcinomas and Their Nodal Metastasis

Abstract

Background: Cancers of squamous cell type are of growing incidence, especially those affecting the head and neck. Emerging non-invasive radiological tools can now aid in predicting and monitoring response of tumor tissue to treatment, hence improving the whole treatment plan. One of these emerging modalities is dynamic contrast enhanced magnetic resonance imaging (DCE-MRI), which is further investigated as regards its accuracy in predicting disease prognosis and monitoring changes in tumor characteristics with treatment. Methods: DCE-MRI perfusion was performed for 14 patients before and after receiving non-invasive treatment for different types of head and neck squamous cell carcinoma. Pharmakokinentic parameters were measures and compared before and after treatment including (Ktrans, Kep, Vp and iAUC). Results: 8 patients with a total of 34 lesions were included in the study. In all primary and nodal sites, Ktrans values were significantly lower in normal tissue compared to tumoral sites with a p value as low as 0. Pre-treatment values for Ktrans, Kep and iAuc showed statistically significant lower values in post-treatment scans compared to pre-treatment scans as regards Ktrans, Kep and iAUC values with p values of about 0. Conclusion: Ktrans, Kep and IAUC can be used as significant markers for assessment of tumor response in patients with HNSCC, Further studies are required to correlate the values between responders and non-responders.