头颈部鳞状细胞癌淋巴结的氧增强R2*加权磁共振成像和扩散加权磁共振成像在预测放化疗后2年预后中的应用

Oxygen-Enhanced R2* Weighted MRI and Diffusion Weighted MRI of Head and Neck Squamous Cell Cancer Lymph Nodes in Prediction of 2-Year Outcome Following Chemoradiotherapy.

作者信息

Sidhu Harbir Singh, Price David, Beale Tim, Morley Simon, Adeleke Sola, Papoutsaki Marianthi-Vasiliki, Forster Martin, Carnell Dawn, Mendes Ruheena, Taylor Stuart Andrew, Punwani Shonit

机构信息

Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London W1W 7TS, UK.

Imaging Department, University College London Hospitals, 235 Euston Road, Ground Floor North, London NW1 2BU, UK.

出版信息

Cancers (Basel). 2025 Jul 14;17(14):2333. doi: 10.3390/cancers17142333.

DOI:10.3390/cancers17142333

PMID:40723218

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12293685/

Abstract

BACKGROUND

We evaluated the utility of HNSCC LN R2* relaxation times to infer the oxygenation status of LN non-invasively at baseline and when breathing air and 100% oxygen to predict chemoradiotherapeutic locoregional response at 2 years. Hypoxia within LNs has been associated with poorer outcomes following CRT. Deoxyhaemoglobin decreases MRI transverse relaxation time (T2*) (lengthening inverse, R2*).

METHODS

A total of 54 patients underwent 1.5T-MRI before CRT. Conventional MR sequences were supplemented with T2* sequences breathing both air and 100% oxygen; pathological nodes identified in consensus were volumetrically contoured to T2* parametric maps.

RESULTS

Patients followed-up with for >2 years were categorised by multidisciplinary consensus into post-therapy complete local response (CR; n = 32/54) and local nodal disease relapse (RD; n = 22/54). Our data demonstrated, by R2*, that nodes that sustained post-therapy CR are significantly more hypoxic compared with relapsing nodes and paradoxically demonstrate a significant increase in hypoxia on 100% oxygen. Pre-treatment LN short axis diameter, various qualitative descriptors of malignancy, and quantitative DWI were not useful in discriminating successful response to CRT.

CONCLUSIONS

This study demonstrates that a significant differential response to 100% oxygen and higher baseline R2* LN measurements could be exploited in risk stratification prior to CRT, and future work could be directed towards understanding the contrast mechanisms of R2* imaging, underpinning the observed differences in the context of hypoxia.

摘要

背景

我们评估了头颈部鳞状细胞癌（HNSCC）区域淋巴结（LN）的R2弛豫时间在基线时以及呼吸空气和100%氧气时非侵入性推断LN氧合状态的效用，以预测2年时放化疗的局部区域反应。LN内的缺氧与放化疗后的较差预后相关。脱氧血红蛋白会降低MRI横向弛豫时间（T2）（反向延长，即R2*）。

方法

共有54例患者在放化疗前接受了1.5T-MRI检查。常规MR序列补充了呼吸空气和100%氧气时的T2序列；经共识确定的病理性淋巴结在T2参数图上进行体积轮廓勾画。

结果

随访超过2年的患者经多学科共识分为治疗后局部完全缓解（CR；n = 32/54）和局部淋巴结疾病复发（RD；n = 22/54）。我们的数据通过R2*表明，与复发的淋巴结相比，维持治疗后CR的淋巴结缺氧程度明显更高，并且矛盾的是，在呼吸100%氧气时缺氧程度显著增加。治疗前LN短轴直径、各种恶性定性描述符和定量扩散加权成像（DWI）在区分放化疗的成功反应方面并无用处。