2864 - Dual-Energy and Perfusion CT in Predicting Response of Head and Neck Cancer Treated by Chemo-Radiotherapy: A Preliminary Study
Presenter(s)
B. Van Honacker1, Y. Lefebvre2, M. Paesmans3, M. Burghelea4, D. Van Gestel5, and T. Dragan6; 1Department of Radiology, Hôpitaux Iris-Sud (HIS), Université libre de Bruxelles (ULB), Brussels, Belgium, 2Department of Radiology, Institut Jules Bordet, Hopital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles,, Brussels, Belgium, 33Information Management Unit, Institut Jules Bordet, Hopital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, Brussels, Belgium, 4Medical Physics Department, Institut Jules Bordet, Hopital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, Brussels, Belgium, 5Université libre de Bruxelles (ULB), Brussels, Belgium, 6Department of Radiation Oncology (Head and Neck Unit), Institut Jules Bordet, Hopital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, Brussels, Belgium
Purpose/Objective(s): Head and neck cancer (HNC) is a significant global health issue, often associated with smoking, alcohol use, and viruses (human papilloma virus (HPV), Epstein- Barr virus (EBV)). Dual-energy computed tomography (DECT) and perfusion computed tomography (PCT) have emerged as promising tools for predicting treatment outcomes in advanced HNC, yet their clinical utility remains underexplored. In this prospective study we will assess the ability of DECT and PCT quantitative parameters (QPs) to predict complete response (CR) at 12 months post chemo-radiotherapy (RT).
Materials/Methods: Patients with HNC were enrolled and categorized as CR or non-CR (NCR) based on RECIST 1.1 criteria at one year. Imaging was performed at baseline, 3 weeks, 3 months, and 12 months, using DECT and PCT QPs, such as blood flow (BF), blood volume (BV), and contrast media attenuation (CMA). Data analysis involved statistical comparisons between CR and NCR groups and within HPV subgroups.
Results: Among the 36 recruited HNC patients, Significant differences were found between CR and NCR, with CR subjects (n=26) showing higher blood flow (BF_3W; p<0.01 and blood volume (BV_3W; p<0.01) at 3 weeks, higher mean transit time (MTT_3W; p<0.03) at 3 months, and lower contrast media attenuation at 3 months (CMA_3M; p<0.03). HPV-positive patients exhibited significantly higher BF and BV in the CR group (both p<0.02) compared to NCR ones. Additional analysis involving deltas values revealed no significant differences other than ? CMA (3W-0) between HPV-positive and negative patients (p<0.04), with the latter being smaller.
Conclusion: Our results suggest DECT and PCT QPs to have significant predictive value of HNC response to chemo-RT, particularly at early treatment stages. These findings underscore the potential of integrating these imaging modalities into personalized treatment strategies, offering clinicians a tool for early prediction of therapeutic efficacy, hence enabling timely treatment adaptation.