In Vivo Correlation of Glucose Metabolism, Cell Density and Microcirculatory Parameters in Patients with Head and Neck Cancer: Initial Results Using Simultaneous PET/MRI.

To demonstrate the feasibility of simultaneous acquisition of 18F-FDG-PET, diffusion-weighted imaging (DWI) and T1-weighted dynamic contrast-enhanced MRI (T1w-DCE) in an integrated simultaneous PET/MRI in patients with head and neck squamous cell cancer (HNSCC) and to investigate possible correlations between these parameters.17 patients that had given informed consent (15 male, 2 female) with biopsy-proven HNSCC underwent simultaneous 18F-FDG-PET/MRI including DWI and T1w-DCE. SUVmax, SUVmean, ADCmean, ADCmin and Ktrans, kep and ve were measured for each tumour and correlated using Spearman's ρ.Significant correlations were observed between SUVmean and Ktrans (ρ = 0.43; p ≤ 0.05); SUVmean and kep (ρ = 0.44; p ≤ 0.05); Ktrans and kep (ρ = 0.53; p ≤ 0.05); and between kep and ve (ρ = -0.74; p ≤ 0.01). There was a trend towards statistical significance when correlating SUVmax and ADCmin (ρ = -0.35; p = 0.08); SUVmax and Ktrans (ρ = 0.37; p = 0.07); SUVmax and kep (ρ = 0.39; p = 0.06); and ADCmean and ve (ρ = 0.4; p = 0.06).Simultaneous 18F-FDG-PET/MRI including DWI and T1w-DCE in patients with HNSCC is feasible and allows depiction of complex interactions between glucose metabolism, microcirculatory parameters and cellular density

Example of a 59-year old male patient depicting the different molecular parameters obtained by simultaneous PET/MRI.

<p>Note the biopsy-proven secondary squamous cell carcinoma of the base of the tongue on the right side. 23 months ago the patient was operated on a squamous cell carcinoma of the soft palate on the same side.</p

Flowchart of the study population.

<p>Flowchart of the study population.</p

Correlation map of the different molecular imaging parameters in HNSCC.

<p>Correlations between ¹⁸F-FDG-PET, T1w-DCE and DWI were computed using Spearman’s non-parametric rank sum correlation coefficient. Numbers in parentheses represent p-values. * p≤ 0.05; ** p≤ 0.01. Bar graphs indicate the distribution of values.</p

Patient and Tumor characteristics.

<p>Patient and Tumor characteristics.</p

Functional imaging parameters.

<p>Functional imaging parameters.</p