Inproceedings: An article in a conference proceedings.
Dynamic contrast-enhanced MR Imaging : a reliable diagnostic tool for recurrent head and neck tumors : 3.05
Title of the conference
Swiss Radiological Congress 2008
St. Gallen, Switzerland, May 29-31, 2008
Swiss Medical Forum = Forum Médical Suisse
Purpose: To investigate the role of Dynamic Contrast-Enhanced MR Imaging (DCE-MRI) in the follow-up of patients with head and neck tumors. Material and methods: Twenty seven patients were recruited. DCE-MRI was performed as a part of regular posttherapy follow-up (n = 20) or for clinical suspicion of local disease recurrence (n = 7). Axial dynamic T1-weighted fat sat sequences were performed in a 3-T MR scanner for a total duration of 10 minutes after contrast administration. An operator-defined region of interest was placed in the maximal enhancement area(s) of the tumor bed in all patients. A time-intensity curve was constructed and analyzed. The time to maximal enhancement (Tmax), enhancement ratio at 3 min (ER3min), and washout ratio at 10 min (WR10min) were measured. Per-lesion DCE-MRI findings were correlated with histologic analysis or with clinical and radiological follow-up. Results: There was a significant difference between Tmax, ER3min and WR10min of recurrent lesions and those of posttherapy tissue remodeling (2.2 min, 19%, and 20% vs. 8.3 min, 12%, and 6%, P <0.05). Among 12 recurrent lesions in 9 patients, DCE-MRI detected 11/12 (91%) of these foci. One false negative result was due to microscopic disease residue within post-therapy scar tissue. Two radionecrotic lesions were responsible for false positive DCE-MRI results in 2 patients. These 2 lesions were characterized by indistinguishable Tmax, ER3min, and WR10min from those of recurrent tumor foci. In the remaining 16 patients, true negative DCE-MRI findings were confirmed. Accordingly, the sensitivity, specificity, and accuracy of DCE-MRI were 91%, 89% and 90%, respectively. Conclusion: DCE-MRI can be integrated as a valuable tool in the diagnostic work-up of patients with or without clinical or radiological suspicion of recurrent head and neck tumors.
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