Can Perfusion Computed Tomography Identify the Local Recurrence/Residual of Nasopharyngeal Carcinoma?

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Dittapong Songsaeng, MD
Krittachat Butnian, MD
Pittaya Dankulchai
Kullathorn Thepmonkol, MD
Janjira Petsuksiri, MD
Chualuck Boonma, MD
Anek Suwanbundit, MD
Sureerat Janpanich, MD

Abstract

OBJECTIVES: To demonstrate the usefulness of perfusion computed tomography (PCT) in the detection of local recurrent/residual (LR) tumor in patients with nasopharyngeal carcinoma (NPC) after radiotherapy.

MATERIALS AND METHOD: Over three years (from June 2010 to May 2013), 138 post-radiotherapy NPC patients were recruited for this prospective study. Patients were informed and consent was obtained for PCT of the nasopharynx additional to the routine contrast-enhanced CT scan of the nasopharynx. Two years follow-up after perfusion CT was performed, patients were divided into LR and non-LR groups. The perfusion CT parameters of the nasopharynx included, blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS). These parameters were analyzed and compared between the two groups.

RESULTS: There are significantly higher PCT parameters including: BF, BV, PS and significantly lower MTT (p < 0.05) in the LR group when compared to the non-LR groups and BF and BV also demonstrated high inter-observer agreement (ICC > 0.75) between two reviewers.

CONCLUSIONS: PCT is a useful method to identify local recurrent/residual tumor after radiotherapy in patients with NPC.

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How to Cite
1.
Songsaeng D, Butnian K, Dankulchai P, Thepmonkol K, Petsuksiri J, Boonma C, Suwanbundit A, Janpanich S. Can Perfusion Computed Tomography Identify the Local Recurrence/Residual of Nasopharyngeal Carcinoma?. BKK Med J [Internet]. 2019 Feb. 20 [cited 2024 Nov. 22];15(1):19. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/222612
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Original Article

References

1. Barnes L, Eveson JW, Reichart P, et al Pathology and Genetics of Head and Neck Tumours: World Health Organization Classification of Tumors, 3rd Edition, Volume 9, IARC Press, Lyon 2005.

2. Hwang HN. Nasopharyngeal carcinoma in the People’s Republic of China: incidence, treatment, and survival rates. Radiology 1983;149(1):305-9.

3. Chang ET, Adami HO. Review The enigmatic epidemiology of nasopharyngeal carcinoma. Cancer Epidemiol Biomarkers Prev 2006;15(10):1765-77.

4. Siriraj Cancer Center. Siriraj Cancer Registry 2009. www. si.mahidol.ac.th/th/department/cancer/dept_history.asp

5. Su SF, Han F, Zhao C, et al. Treatment outcomes for different subgroups of nasopharyngeal carcinoma patients treated with intensity-modulated radiation therapy. Chin J Cancer 2011;30(8):565-73.

6. Lee AW, Foo W, Law SC, et al. Recurrent nasopharyngeal carcinoma: the puzzles of long latency. Int J Radiat Oncol Biol Phys 1999;45(5):149-56.

7. Umasan P, Anchalee C, Thepmongkol K. Prediction for risk of recurrence and delayed metastases of nasopharyngeal carcinoma: an evaluation of CT scan. ASEAN J Radiology 2013:19(1):1-16.

8. Kalogera-Fountzila A, Karanikolas D, Katodritis N, et al. Prognostic factors and significance of the revised 6th edition of the AJCC classification in patients with locally advanced nasopharyngeal carcinoma. Strahlenther Onkol 2006;182(8): 458-66.

9. Kim JH, Lee JK. Prognostic value of tumor volume in nasopha- ryngeal carcinoma. Yonsei Med J 2005;46(2);221-7.

10. Luo DH, Zhou CW, Li EN, et al. Post-radiation CT changes and recurrent nasopharyngeal carcinoma. Chin Med J 2008;121(10):916-22.

11. Faggioni L, Neri E, Bartolozzi C. CT perfusion of head and neck tumors: how we do it.AJR Am J Roentgenol 2010;194(1):62-9.

12. Rumboldt Z, Al-Okaili R, Deveikis JP. Perfusion CT for head and neck tumors: pilot study. AJNR Am J Neuroradiol 2005;26(5):1178-85

13. Ash L, Teknos TN, Gandhi D, et al. Head and neck squamous cell carcinoma: CT perfusion can help noninvasively predict intratumoral microvessel density. Radiology 2009; 251(2):422-8.

14. Su D, Jin G, Xie D, et al. Identification of local recurrence and radiofibrosis by computed tomography perfusion on nasopha- ryngeal carcinoma after radiotherapy. Can Assoc Radiol J 2010;61(5):265-70.