Abstract
This review aims to summarize the technique and clinical applications of CT perfusion (CTp) of head and neck cancer. The most common pathologic type (90%) of head and neck cancer is squamous cell carcinoma (HNSCC): its diagnostic workup relies on CT and MRI, as they provide an accurate staging for the disease by determining tumour volume, assessing its extension, and detecting of lymph node metastases. Compared with conventional CT and MRI, CTp allows for obtaining measures of tumour vascular physiology and functional behaviour, and it has been demonstrated to be a feasible and useful tool in predicting local outcomes in patients undergoing radiation therapy and chemotherapy and may help monitor both treatments.
Highlights
Head and neck cancers represent about 5% of all malignancies newly diagnosed each year
This review aims to summarize the technique and clinical applications of CT perfusion (CTp) of head and neck cancer
The most common pathologic type (90%) of head and neck cancer is squamous cell carcinoma (HNSCC): its diagnostic workup relies on CT and MRI, as they provide an accurate staging for the disease by determining tumour volume, assessing its extension, and detecting of lymph node metastases
Summary
Head and neck cancers represent about 5% of all malignancies newly diagnosed each year. Most head and neck patients present in a locally advanced stage with a poor prognosis In this setting various strategies have been tried to improve outcomes of the two main standard treatments (surgery and radiotherapy). A monoclonal antibody against epidermal growth factor receptor, showed significant efficacy in locoregional control of disease and in overall survival either in the curative setting [6] or in the recurrent/metastatic HNSCC [7] Given all these new therapeutic approaches, there remains the fact that a subset of patients obtain a major or complete response, especially from induction chemotherapy and target therapy, and we do not have predictive markers to anticipate this and to personalize the therapeutic strategy in order to improve outcomes or reduce toxicity. CTp advantages include high spatial resolution and wide availability, having the use of ionizing radiation, need of iodinated contrast medium injection, and relatively limited coverage as its major limitations
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