VOLUME

CAN PERFUSION COMPUTED TOMOGRAPHY IDENTIFY THE LOCAL RECURRENCE/RESIDUAL OF NASOPHARYNGEAL CARCINOMA?

FEBRUARY 2019 - VOL.15 | ORIGINAL ARTICLE

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.

Keywords:

perfNusion CT, nasopharyngeal carcinoma, local recurrence, prospective study

Received: October 30, 2018

Revision received: November 06, 2018

Accepted after revision: January 24, 2019

BKK Med J 2019;15(1): 19-27.

DOI: 10.31524/bkkmedj.2019.02.004

MEDIA

Table 1: Criteria for LR and non-LR groups

Table 2: Demographic data between the LR and non-LR groups (n = 138)

Table 3: Perfusion CT parameters between the LR and non-LR groups

Figure 1: Demonstration of the selection of ROI for vascular input and primary tumor (left side nasopharynx). A: The ROI for the artery and vein were placed at ipsilateral internal carotid artery (red arrow) and internal jugular vein (blue arrow). Perfusi

Figure 2: ROC curve for BF, BV and PS

Figure 3: ROC curve for MTT

Table 4: Sensitivity and specificity for perfusion CT parameters

Table 5: Intraclass correlation coefficient for each perfusion CT parameters

Figure 4: A 50-year-old woman with left nasopharyngeal carcinoma (T2N2M0) and complete chemoradiotion for 6 months.

Figure 5: A 56-year-old man with right nasopharyngeal carcinoma (T4N2M0) and complete chemoradiotion for 13 months.

Figure 6: A 78-year-old man with left nasopharyngeal carcinoma (T2N0M0) and complete chemoradiation for 3 months.

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