squamous cell carcinoma

CT Texture Analysis Potentially Predicts Local Failure in Head and Neck Squamous Cell Carcinoma Treated with Chemoradiotherapy

Fellows’ Journal Club

This was a retrospective study including 62 patients diagnosed with primary head and neck squamous cellcarcinoma who underwent contrast-enhanced CT examinations for staging, followed by chemoradiotherapy. CT texture features of thewhole primary tumor were measured using an in-house developed Matlab-based texture analysis program. Histogram, gray-level co-occurrence matrix, gray-level run-length, gray-level gradient matrix, and Laws features were used for texture feature extraction. Three histogram features (geometric mean, harmonic, and fourth moment) and 4 gray-level run-length features (short-run emphasis, gray-level nonuniformity, run-length nonuniformity, and short-run low gray-level emphasis) were significant predictors of outcome.

Apparent Diffusion Coefficient Histograms of Human Papillomavirus–Positive and Human Papillomavirus–Negative Head and Neck Squamous Cell Carcinoma: Assessment of Tumor Heterogeneity and Comparison with Histopathology

Fellows’ Journal Club

One hundred five consecutive patients with primary oropharyngeal and oral cavity head and neck squamous cell carcinoma underwent MR imaging with anatomic and DWI sequences. The collected tumor voxels from the contoured ROIs provided histograms from which position, dispersion, and form parameters were computed. Histogram data were correlated with histopathology, p16-immunohistochemistry, and polymerase chain reaction for human papillomavirus DNA. Diffusion phenotypes of human papillomavirus–positive and human papillomavirus–negative head and neck squamous cell carcinomas showed significant differences, which reflect their distinct degree of tumor heterogeneity.

Usefulness of Pseudocontinuous Arterial Spin-Labeling for the Assessment of Patients with Head and Neck Squamous Cell Carcinoma by Measuring Tumor Blood Flow in the Pretreatment and Early Treatment Period

Editor’s Choice

Editor’s Comment

Forty-one patients with head and neck squamous cell carcinoma were evaluated by using pseudocontinuous ASL. Quantitative tumor blood flow was calculated at the pretreatment and the early treatment periods. Pretreatment tumor blood flow in patients in the treatment failure group was significantly lower than that in patients in the local control group. The use of the percentage change of tumor blood flow combined with the percentage change of tumor volume had high diagnostic accuracy for predicting local control.

Abstract

BACKGROUND AND PURPOSE

For the assessment of the treatment response in non-surgical treatment, tumor blood flow provides the functional information of the tumor which is different from the morphological information such as tumor volume. The purpose of this study was to evaluate the diagnostic value of tumor blood flow values obtained by pseudocontinuous arterial spin-labeling in patients with head and neck squamous cell carcinoma.

MATERIALS AND METHODS

Forty-one patients with head and neck squamous cell carcinoma were evaluated by using pseudocontinuous arterial spin-labeling. Quantitative tumor blood flow was calculated at the pretreatment and the early treatment periods in all the patients, and the percentage change of tumor blood flow between the two was calculated. At the early treatment period, based on their tumor volume reduction rate, we divided the patients into stable disease and partial response groups for a subgroup analysis. The local control or failure was confirmed either by histopathology or by radiologic evaluation within the follow-up.

RESULTS

Pretreatment tumor blood flow in patients in the failure group was significantly lower than that in patients in the local control group. In the subgroup analysis of patients with stable disease, the percentage change of tumor blood flow was significantly larger (due to the tumor blood flow increase from pretreatment value) in the local control group than in

Accuracy of Preoperative Imaging in Detecting Nodal Extracapsular Spread in Oral Cavity Squamous Cell Carcinoma

Fellows’ Journal Club

Editor’s Comment

A group of 111 consecutive patients with untreated oral cavity squamous cell carcinoma and available preoperative imaging and subsequent lymph node dissection was studied. Twenty nine subjects had radiographically determined extracapsular spread. Imaging sensitivity and specificity for extracapsular spread were 68% and 88%, respectively. Necrosis, irregular borders, and gross invasion were independently correlated with pathologically proved extracapsular spread.

Abstract

A, A right level IIA lymph node (arrow) in a patient with OCSCC. This rounded low-attenuation node has irregular borders and fat stranding. Imaging prospectively diagnosed ECS, which was confirmed with pathologic examination (true-positive result). B, A right level IIA lymph node (arrow) in a patient with OCSCC. This small 1-cm lymph node shows subtle fat stranding. Imaging prospectively diagnosed ECS, which was confirmed with pathologic examination (true-positive result). C, A right level IIA lymph node (arrows) in a patient with OCSCC. This large necrotic node demonstrates invasion of the adjacent sternocleidomastoid muscle. Imaging prospectively diagnosed ECS, which was confirmed with pathologic examination (true-positive result).
A, A right level IIA lymph node (arrow) in a patient with OCSCC. This rounded low-attenuation node has irregular borders and fat stranding. Imaging prospectively diagnosed ECS, which was confirmed with pathologic examination (true-positive result). B, A right level IIA lymph node (arrow) in a patient with OCSCC. This small 1-cm lymph node shows subtle fat stranding. Imaging prospectively diagnosed ECS, which was confirmed with pathologic examination (true-positive result). C, A right level IIA lymph node (arrows) in a patient with OCSCC. This large necrotic node demonstrates invasion of the adjacent sternocleidomastoid muscle. Imaging prospectively diagnosed ECS, which was confirmed with pathologic examination (true-positive result).

Background and Purpose

The increasing impact of diagnosing extracapsular spread by using imaging, especially in patients with oropharyngeal squamous cell carcinoma, highlights the need to rigorously evaluate the diagnostic accuracy of imaging. Previous analysis suggested 62.5%–80.9% sensitivity and 60%–72.7% specificity. Our goals were to evaluate the accuracy of imaging in diagnosing extracapsular spread in a cohort of patients with oral cavity squamous cell carcinoma (pathologic confirmation of extracapsular spread routinely available), as a proxy for oropharyngeal squamous cell carcinoma, and to independently assess the reliability of imaging features (radiographic lymph node necrosis, irregular borders/stranding, gross invasion, and/or node size) in predicting pathologically proven extracapsular spread.

Materials and Methods

One hundred eleven consecutive patients with untreated oral cavity squamous cell carcinoma and available …