增强氧 MRI 评估头颈部癌症肿瘤缺氧在临床环境中是可行且耐受良好的。

Oxygen-enhanced MRI assessment of tumour hypoxia in head and neck cancer is feasible and well tolerated in the clinical setting.

机构信息

Academic Unit of Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.

Department of Clinical Oncology, Nottingham University Hospitals NHS Trust, City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK.

出版信息

Eur Radiol Exp. 2024 Mar 6;8(1):27. doi: 10.1186/s41747-024-00429-1.

DOI:10.1186/s41747-024-00429-1

PMID:38443722

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10914657/

Abstract

BACKGROUND

Tumour hypoxia is a recognised cause of radiotherapy treatment resistance in head and neck squamous cell carcinoma (HNSCC). Current positron emission tomography-based hypoxia imaging techniques are not routinely available in many centres. We investigated if an alternative technique called oxygen-enhanced magnetic resonance imaging (OE-MRI) could be performed in HNSCC.

METHODS

A volumetric OE-MRI protocol for dynamic T1 relaxation time mapping was implemented on 1.5-T clinical scanners. Participants were scanned breathing room air and during high-flow oxygen administration. Oxygen-induced changes in T1 times (ΔT1) and R* rates (ΔR*) were measured in malignant tissue and healthy organs. Unequal variance t-test was used. Patients were surveyed on their experience of the OE-MRI protocol.

RESULTS

Fifteen patients with HNSCC (median age 59 years, range 38 to 76) and 10 non-HNSCC subjects (median age 46.5 years, range 32 to 62) were scanned; the OE-MRI acquisition took less than 10 min and was well tolerated. Fifteen histologically confirmed primary tumours and 41 malignant nodal masses were identified. Median (range) of ΔT1 times and hypoxic fraction estimates for primary tumours were -3.5% (-7.0 to -0.3%) and 30.7% (6.5 to 78.6%) respectively. Radiotherapy-responsive and radiotherapy-resistant primary tumours had mean estimated hypoxic fractions of 36.8% (95% confidence interval [CI] 17.4 to 56.2%) and 59.0% (95% CI 44.6 to 73.3%), respectively (p = 0.111).

CONCLUSIONS

We present a well-tolerated implementation of dynamic, volumetric OE-MRI of the head and neck region allowing discernment of differing oxygen responses within biopsy-confirmed HNSCC.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04724096 . Registered on 26 January 2021.

RELEVANCE STATEMENT

MRI of tumour hypoxia in head and neck cancer using routine clinical equipment is feasible and well tolerated and allows estimates of tumour hypoxic fractions in less than ten minutes.

KEY POINTS

• Oxygen-enhanced MRI (OE-MRI) can estimate tumour hypoxic fractions in ten-minute scanning. • OE-MRI may be incorporable into routine clinical tumour imaging. • OE-MRI has the potential to predict outcomes after radiotherapy treatment.

摘要

背景

肿瘤缺氧是导致头颈部鳞状细胞癌（HNSCC）放疗抵抗的公认原因。目前，许多中心都没有常规使用基于正电子发射断层扫描的缺氧成像技术。我们研究了一种名为氧增强磁共振成像（OE-MRI）的替代技术是否可用于 HNSCC。

方法

在 1.5-T 临床扫描仪上实施了用于动态 T1 弛豫时间映射的容积 OE-MRI 方案。参与者在呼吸室气和高流量氧气给药期间进行扫描。测量恶性组织和健康器官中的氧诱导 T1 时间（ΔT1）和 R* 率（ΔR*）变化。使用不等方差 t 检验。对患者进行 OE-MRI 方案体验调查。

结果

对 15 例 HNSCC 患者（中位年龄 59 岁，范围 38 至 76 岁）和 10 例非 HNSCC 患者（中位年龄 46.5 岁，范围 32 至 62 岁）进行了扫描；OE-MRI 采集时间不到 10 分钟，并且耐受性良好。共确认了 15 个组织学证实的原发性肿瘤和 41 个恶性淋巴结肿块。原发性肿瘤的中位（范围）ΔT1 时间和缺氧分数估计值分别为-3.5%（-7.0 至-0.3%）和 30.7%（6.5 至 78.6%）。放疗反应性和放疗抵抗性原发性肿瘤的平均估计缺氧分数分别为 36.8%（95%置信区间 [CI] 17.4 至 56.2%）和 59.0%（95% CI 44.6 至 73.3%）（p=0.111）。