Abstract
Node positive head and neck squamous cell carcinomas (HNSCCs) patients exhibit worse outcomes in terms of regional neck control, risk for distant metastases and overall survival. Smaller non-palpable lymph nodes may be inflammatory or may harbor clinically occult metastases, a characterization that can be challenging to make using routine imaging modalities. Ferumoxytol has been previously investigated as an intra-tumoral contrast agent for magnetic resonance imaging (MRI) for intracranial malignancies and lymph node agent in prostate cancer. Hence, our group was motivated to carry out a prospective feasibility study to assess the feasibility of ferumoxytol dynamic contrast enhanced (DCE)-weighted MRI relative to that of gadolinium-based DCE-MRI for nodal and primary tumor imaging in patients with biopsy-proven node-positive HNSCC or melanoma. Although this institutional review board (IRB)-approved study was prematurely terminated because of an FDA black box warning, the investigators sought to curate and publish this unique dataset of matched clinical, and anatomical and DCE MRI data for the enrolled five patients to be available for scientists interested in molecular imaging.
Highlights
Background & SummaryNeck nodal involvement in head and neck squamous cell carcinomas (HNSCCs) represents one of the most important features for head and neck malignancies risk stratification[1]
Pretreatment diagnosis of the neck disease relies on computed tomography (CT) and positron-emission tomography fused with CT (PET/CT) that have many limitations leading to uncertainty and the potential for both over- and under- treatment of patients[2]
Recent data suggest that primary tumor assessment with dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) may reveal quantitative assessments of the tumor environment that are germane to treatment selection and response evaluation[3]
Summary
Neck nodal involvement in head and neck squamous cell carcinomas (HNSCCs) represents one of the most important features for head and neck malignancies risk stratification[1]. As more recent enthusiasm for ferumoxytol as a potential (cancer) imaging agent has resurfaced, the potential utility of our extant, if limited, series prompts public dissemination of the extant data from this terminated trial, and we have opted to curate and publish this unique dataset of matched clinical and imaging data for these 5 patients[15]. To our knowledge, this is the first and only extant matched USPIO contrast-enhanced MRI scans –among other structural sequences- and clinical data of HNSCC patients where scans were acquired serially prior to radiotherapy (RT) course. This dataset represents a unique repository resource for scientists interested in molecular imaging of underlying tumor biology for other USPIO molecules, as well as those who may find capacity for additional development in HNSCC for ferumoxytol for similar applications
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