Quantitative tissue perfusion measurements in head and neck carcinoma patients before and during radiation therapy with a non-invasive MR imaging spin-labeling technique

Radiother Oncol. 2003 Apr;67(1):27-34. doi: 10.1016/s0167-8140(03)00024-0.


Purpose: Tumor blood flow, tumor tissue perfusion and oxygen supply have substantial influence on the responsiveness of tumors to radiotherapy. This study was aimed at implementing and evaluating a non-invasive functional magnetic resonance (MR) imaging spin-labeling technique at a main magnetic field strength of 2T for measuring tissue perfusion changes in head and neck carcinoma patients before and during radiotherapy.

Methods: Tissue perfusion was determined quantitatively in ten patients with head and neck cancer. Five patients were investigated twice during radiation therapy. For perfusion measurements, a non-invasive MR spin-labeling technique was employed: The longitudinal relaxation time T(1) was measured with segmented Snapshot-FLASH imaging after either slice-selective or non-selective spin inversion. Perfusion values were calculated pixelwise employing a two-compartment tissue model. With this technique no contrast agents are required so that repetitive measurements are possible. Perfusion images with a slice thickness of 10mm and an in-plane resolution of 1.9x2.8mm(2) were acquired at a total scan time of 8:30min per scan.

Results: With the non-invasive MR imaging technique it was possible to visualize tumor and normal tissue perfusion as well as perfusion changes in the course of radiotherapy with a spatial resolution of less than 3mm. Among the investigated subjects measured tumor perfusion and changes in perfusion were heterogenous. In 4/5 patients studied at the start and end of radiotherapy, perfusion decreased, while in one patient there was an increase.

Conclusions: A method is presented that allows non-invasive and repetitive characterization of tissue perfusion. This parameter may be used for treatment stratification, especially in treatments that use vasomodulation or anti-angiogenic agents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Blood Flow Velocity
  • Carcinoma / blood supply*
  • Carcinoma / radiotherapy
  • Computer Graphics
  • Head and Neck Neoplasms / blood supply*
  • Head and Neck Neoplasms / radiotherapy
  • Humans
  • Magnetic Resonance Imaging / methods*