Dynamic Contrast-Enhanced MR Imaging in Head and Neck Cancer

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Key points

  • Dynamic contrast-enhanced (DCE) MR imaging serves as an adjunct to conventional imaging by delineating information on the microvascular biologic function of tissues through quantification of pharmacokinetic parameters.

  • DCE-MR imaging allows for analysis of tissue kinetics using both quantitative analysis and semiquantitative analysis, both of which provide information to discriminate between entities that otherwise appear similar by conventional imaging.

  • When used to evaluate head and neck cancer

Dynamic Contrast-Enhanced MR Imaging

DCE-MR imaging is performed by obtaining rapid sequential T1-weighted MR images through an area of interest before, during, and after the intravenous administration of a gadolinium-based contrast agent. This allows for temporal acquisition of T1 intensity at each point in space within the area of interest. By incorporating baseline T1 mapping before contrast administration as well as the known relaxivity of the gadolinium contrast, DCE-MR imaging allows transformation of a time signal intensity

Tumor Hypoxia, Prediction, and Evaluation of Treatment Response

An important potential application of DCE-MR imaging for HNC is in characterizing tumor hypoxia, and using this characterization to predict treatment response of chemoradiation. It is well known that impaired tumor perfusion, which leads to tumor hypoxia, increases the likelihood of treatment failure. Specifically, tumor hypoxia is often the result of disordered angiogenesis through the release of VEGF. Rather than producing normal vessels, VEGF causes the formation of tortuous, leaky vessels

Summary

DCE-MR imaging serves as an adjunct to conventional head and neck imaging and demonstrates the potential to discriminate between entities that are otherwise indistinguishable by conventional imaging through the quantification of microvascular permeability parameters. The most important prospective clinical roles for DCE-MR imaging are distinguishing benign from malignant entities and predicting future treatment response, with literature thus far showing promising results. However, its routine

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    Disclosures: None.

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