Abstract
Purpose : The purpose of this study is to assess the value of MR perfusion studies using dynamic MRI and pharmacokinetic analysis for the prediction of patient outcome in head and neck cancers before conventional radiation therapy.Materials and methods : Dynamic MRI of eighteen, until that time clinically untreated, T2 head and neck tumors were performed. The raw data of time/signal intensity curve from each tumor was analyzed and pharmacokinetically defined permeability index (k), and extracellular space/vascular space ratio (f) were estimated. All 41 patients were treated with definitive radiation therapy (60-72 Gy) using 3MV linac X-ray. The initial radiation effect was determined at four weeks after the termination of radiation therapy. MR parameters and initial radiation effects were correlated.Results : Ten tumors showed complete response (CR), three of which showed early recurrence within 6 months, six tumors showed partial response (PR), and two tumors showed no change (NC) after radiation therapy. There was a significant difference in the permeability index (k) between CR group and PR/NC group (CR group; 0.0352±0.0133 vs PR/NC group; 0.0176±0.0078, p<0.05).Conclusions : Pharmacokinetic analysis of pretreatment dynamic MRI scans of head and neck tumors is a non-invasive and potential method to predict tumor radiation response.
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