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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.
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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.
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When used to evaluate head and neck cancer
Dynamic Contrast-Enhanced MR Imaging in Head and Neck Cancer
Section snippets
Key points
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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Role of MR Imaging in Head and Neck Squamous Cell Carcinoma
2022, Magnetic Resonance Imaging Clinics of North AmericaHead and neck imaging
2022, Clinical PET/MRINew and Advanced Magnetic Resonance Imaging Diagnostic Imaging Techniques in the Evaluation of Cranial Nerves and the Skull Base
2021, Neuroimaging Clinics of North AmericaCitation Excerpt :ASL is a technique capable of measuring perfusion and is based on measuring Gd-related dephasing on T2 or T2∗-weighted sequences.71 ASL offers the significant advantage of not requiring an exogenous contrast medium; instead, it involves the application of continuous, pulsed, or pseudocontinuous radiofrequency inversion pulses to magnetically label water within a volume of blood below the area of interest; the signal from the labeled blood can then be measured as it passes through the target area.71,72 Paragangliomas (PGLs) and nerve sheath tumors may be encountered at similar locations (eg, jugular foramen) and, although they can often be distinguished on conventional sequences, differentiation may be challenging.
Advanced Magnetic Resonance Imaging of the Skull Base
2021, Seminars in Ultrasound, CT and MRICitation Excerpt :This enables calculation of effective plasma volume Vp and characteristic transfer constants Ktrans (from plasma to EES) and Kep (from EES to plasma). Various perfusion parameters have been correlated with tumor histology, grade, vascularity, and other functional parameters.1-5,92-100 Dynamic imaging is also useful for the evaluation of pituitary microadenomas and parasellar lesions, demonstrating differential enhancement (usually hypoenhancement) relative to highly vascular pituitary parenchyma.
Technical Improvements in Head and Neck MR Imaging: At the Cutting Edge
2020, Neuroimaging Clinics of North AmericaCitation Excerpt :Commonly reported markers include capillary permeability, blood volume, blood flow, and mean transit time.62 These biomarkers show promise in better delineating the extent of head and neck tumor, identification of cervical lymph nodes, prediction of response to therapy, and differentiating recurrent tumor from post-therapeutic changes.62,67 There have been notable efforts to improve the standardization of perfusion imaging, with release of recommendations from the Quantitative Imaging Biomarkers Alliance.68
Disclosures: None.