Diagnostic Performance Of Dynamic Volume Perfusion Ct For Differentiation Of Head And Neck Cancer From Healthy Tissue And Post-Therapeutic Changes

BACKGROUND: Post-therapeutic tissue is bradytrophic and thus has low perfusion values in PCT. In contrast, malignant tissue is expected to show higher perfusion values as cancer growth partially depends on angiogenesis.OBJECTIVES: This prospective study investigates perfusion computed tomography (PCT) for the post-therapeutic detection of cancer in the head and neck region.METHODS: 85 patients underwent PCT for 1) initial work-up of head and neck cancer (HNC; n = 22) or 2) for follow-up (n = 63). Regions of interest (ROIs) were placed in confirmed tumour, a corresponding location of benign tissue, and reference tissue. Perfusion was calculated using a single input maximum slope algorithm. Statistical analysis was performed with the Mann-Whitney U-test.RESULTS: PCT allowed significant differentiation of malignant tissue from post-therapeutic tissue after treatment for HNC (p = 0.018). Significance was even greater after normalization of perfusion values (p = 0.007). PCT allowed highly significant differentiation of HNC from reference tissue (p < 0.001).CONCLUSIONS: PCT provides significantly distinct perfusion values for malignant and benign as well as post-therapeutically altered tissue in the head and neck area, thus allowing differentiation of cancer from healthy tissue. Our results show that PCT in conjunction with a standard algorithm is a potentially powerful HNC diagnostic tool.