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Yuan J, Lo G, King AD. Functional magnetic resonance imaging techniques and their development for radiation therapy planning and monitoring in the head and neck cancers. Quant Imaging Med Surg 2016; 6:430-448. [PMID: 27709079 PMCID: PMC5009093 DOI: 10.21037/qims.2016.06.11] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 05/27/2016] [Indexed: 01/05/2023]
Abstract
Radiation therapy (RT), in particular intensity-modulated radiation therapy (IMRT), is becoming a more important nonsurgical treatment strategy in head and neck cancer (HNC). The further development of IMRT imposes more critical requirements on clinical imaging, and these requirements cannot be fully fulfilled by the existing radiotherapeutic imaging workhorse of X-ray based imaging methods. Magnetic resonance imaging (MRI) has increasingly gained more interests from radiation oncology community and holds great potential for RT applications, mainly due to its non-ionizing radiation nature and superior soft tissue image contrast. Beyond anatomical imaging, MRI provides a variety of functional imaging techniques to investigate the functionality and metabolism of living tissue. The major purpose of this paper is to give a concise and timely review of some advanced functional MRI techniques that may potentially benefit conformal, tailored and adaptive RT in the HNC. The basic principle of each functional MRI technique is briefly introduced and their use in RT of HNC is described. Limitation and future development of these functional MRI techniques for HNC radiotherapeutic applications are discussed. More rigorous studies are warranted to translate the hypotheses into credible evidences in order to establish the role of functional MRI in the clinical practice of head and neck radiation oncology.
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Affiliation(s)
- Jing Yuan
- Department of Medical Physics and Research, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China
| | - Gladys Lo
- Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China
| | - Ann D. King
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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Wáng YXJ, De Baere T, Idée JM, Ballet S. Transcatheter embolization therapy in liver cancer: an update of clinical evidences. Chin J Cancer Res 2015; 27:96-121. [PMID: 25937772 PMCID: PMC4409973 DOI: 10.3978/j.issn.1000-9604.2015.03.03] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 02/05/2015] [Indexed: 12/20/2022] Open
Abstract
Transarterial chemoembolization (TACE) is a form of intra-arterial catheter-based chemotherapy that selectively delivers high doses of cytotoxic drug to the tumor bed combining with the effect of ischemic necrosis induced by arterial embolization. Chemoembolization and radioembolization are at the core of the treatment of liver hepatocellular carcinoma (HCC) patients who cannot receive potentially curative therapies such as transplantation, resection or percutaneous ablation. TACE for liver cancer has been proven to be useful in local tumor control, to prevent tumor progression, prolong patients' life and control patient symptoms. Recent evidence showed in patients with single-nodule HCC of 3 cm or smaller without vascular invasion, the 5-year overall survival (OS) with TACE was similar to that with hepatic resection and radiofrequency ablation. Although being used for decades, Lipiodol(®) (Lipiodol(®) Ultra Fluid(®), Guerbet, France) remains important as a tumor-seeking and radio-opaque drug delivery vector in interventional oncology. There have been efforts to improve the delivery of chemotherapeutic agents to tumors. Drug-eluting bead (DEB) is a relatively novel drug delivery embolization system which allows for fixed dosing and the ability to release the anticancer agents in a sustained manner. Three DEBs are available, i.e., Tandem(®) (CeloNova Biosciences Inc., USA), DC-Beads(®) (BTG, UK) and HepaSphere(®) (BioSphere Medical, Inc., USA). Transarterial radioembolization (TARE) technique has been developed, and proven to be efficient and safe in advanced liver cancers and those with vascular complications. Two types of radioembolization microspheres are available i.e., SIR-Spheres(®) (Sirtex Medical Limited, Australia) and TheraSphere(®) (BTG, UK). This review describes the basic procedure of TACE, properties and efficacy of some chemoembolization systems and radioembolization agents which are commercially available and/or currently under clinical evaluation. The key clinical trials of transcatheter arterial therapy for liver cancer are summarized.
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Schouten CS, de Bree R, van der Putten L, Noij DP, Hoekstra OS, Comans EFI, Witte BI, Doornaert PA, Leemans CR, Castelijns JA. Diffusion-weighted EPI- and HASTE-MRI and 18F-FDG-PET-CT early during chemoradiotherapy in advanced head and neck cancer. Quant Imaging Med Surg 2014; 4:239-50. [PMID: 25202659 DOI: 10.3978/j.issn.2223-4292.2014.07.15] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/25/2014] [Indexed: 01/10/2023]
Abstract
MAIN PROBLEM Diffusion-weighted MRI (DW-MRI) has potential to predict chemoradiotherapy (CRT) response in head and neck squamous cell carcinoma (HNSCC) and is generally performed using echo-planar imaging (EPI). However, EPI-DWI is susceptible to geometric distortions. Half-fourier acquisition single-shot turbo spin-echo (HASTE)-DWI may be an alternative. This prospective pilot study evaluates the potential predictive value of EPI- and HASTE-DWI and 18F-fluorodeoxyglucose PET-CT (18F-FDG-PET-CT) early during CRT for locoregional outcome in HNSCC. METHODS Eight patients with advanced HNSCC (7 primary tumors and 25 nodal metastases) scheduled for CRT, underwent DW-MRI (using both EPI- and HASTE-DWI) and 18F-FDG-PET(-CT) pretreatment, early during treatment and three months after treatment. Median follow-up time was 38 months. RESULTS No local recurrences were detected during follow-up. Median Apparent Diffusion Coefficient (ADC)EPI-values in primary tumors increased from 77×10(-5) mm(2)/s pretreatment, to 113×10(-5) mm(2)/s during treatment (P=0.02), whereas ADCHASTE did not increase (74 and 74 mm(2)/s, respectively). Two regional recurrences were diagnosed. During treatment, ADCEPI tended to be higher for patients with regional control [(117.3±12.1)×10(-5) mm(2)/s] than for patients with a recurrence [(98.0±4.2)×10(-5) mm(2)/s]. This difference was not seen with ADCHASTE. No correlations between ΔADCEPI and ΔSUV (Standardized Uptake Value) were found in the primary tumor or nodal metastases. CONCLUSIONS HASTE-DWI seems to be inadequate in early CRT response prediction, compared to EPI-DWI which has potential to predict locoregional outcome. EPI-DWI and 18F-FDG-PET-CT potentially provide independent information in the early response to treatment, since no correlations were found between ΔADCEPI and ΔSUV.
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Affiliation(s)
- Charlotte S Schouten
- 1 Department of Otolaryngology-Head and Neck Surgery, 2 Department of Radiology and Nuclear Medicine, 3 Department of Epidemiology and Biostatistics, 4 Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - Remco de Bree
- 1 Department of Otolaryngology-Head and Neck Surgery, 2 Department of Radiology and Nuclear Medicine, 3 Department of Epidemiology and Biostatistics, 4 Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - Lisa van der Putten
- 1 Department of Otolaryngology-Head and Neck Surgery, 2 Department of Radiology and Nuclear Medicine, 3 Department of Epidemiology and Biostatistics, 4 Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - Daniel P Noij
- 1 Department of Otolaryngology-Head and Neck Surgery, 2 Department of Radiology and Nuclear Medicine, 3 Department of Epidemiology and Biostatistics, 4 Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - Otto S Hoekstra
- 1 Department of Otolaryngology-Head and Neck Surgery, 2 Department of Radiology and Nuclear Medicine, 3 Department of Epidemiology and Biostatistics, 4 Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - Emile F I Comans
- 1 Department of Otolaryngology-Head and Neck Surgery, 2 Department of Radiology and Nuclear Medicine, 3 Department of Epidemiology and Biostatistics, 4 Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - Birgit I Witte
- 1 Department of Otolaryngology-Head and Neck Surgery, 2 Department of Radiology and Nuclear Medicine, 3 Department of Epidemiology and Biostatistics, 4 Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - Patricia A Doornaert
- 1 Department of Otolaryngology-Head and Neck Surgery, 2 Department of Radiology and Nuclear Medicine, 3 Department of Epidemiology and Biostatistics, 4 Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - C René Leemans
- 1 Department of Otolaryngology-Head and Neck Surgery, 2 Department of Radiology and Nuclear Medicine, 3 Department of Epidemiology and Biostatistics, 4 Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - Jonas A Castelijns
- 1 Department of Otolaryngology-Head and Neck Surgery, 2 Department of Radiology and Nuclear Medicine, 3 Department of Epidemiology and Biostatistics, 4 Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
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