Evaluation of Hypopharyngeal Squamous Cell Carcinoma Patients with MR Whole-Body Imaging, Diffusion-Weighted Imaging and Perfusion Imaging

Hypopharyngeal squamous cell carcinoma (SCC) tends to exhibit aggressive locoregional invasion and regional nodal metastasis at presentation. It also has a high risk of developing distant metastases and second primary tumors. Its survival is the lowest related to other head and neck tumors. Concurrent chemoradiotherapy becomes the primary treatment modality. CT and MRI are commonly used to evaluate the regional spread and metastatic adenopathy of the tumor. However, conventional CT and MRI are not absolutely reliable for the detection of metastatic lymph nodes. They are also inadequate to evaluate the distant sites status of hypopharyngeal SCC in a single examination session, and have difficulty to differentiate tumor recurrence from posttreatment changes. By virtue of its higher temporal and spatial resolutions, 3-tesla (T) MRI is more feasible than 1.5-T MRI in examining hypopharyngeal SCC with reduced swallowing and respiratory artifacts. The introduction of rolling patient platforms, matrix-coil technology and ultrafast data acquisition enables whole-body MRI possible within a single examination session. Functional techniques including diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) also becomes more feasible in the head and neck region. However, no study about integration of whole-body MRI, DWI and PWI in head and neck SCC has ever been reported. In this 3-year prospective study, we will take the advantages of 3T MRI (with integration of whole-body imaging, DWI plus functional diffusion maps, and PWI to conventional MRI) to evaluate 120 patients with hypopharyngeal SCC and compare with FDG-PET-CT. We aim to (1) early detection of distant malignancy, (2) more accurate determination of nodal metastasis, (3) recognition of biologic tumor markers for early treatment response assessment, and (4) identification of any surrogate markers for the correlation of patient outcome and for the selection for appropriate treatment modes. This project is pioneer in using functional diffusion maps to assess the therapeutic response of chemoradiaton as well as in integrating novel MRI techniques in an attempt to provide a comprehensive, one-stop shop imaging examination for hypopharyngeal SCC patients with the greatest cost-effectiveness.

Project ID:PC9907-0715
External Project ID:NSC99-2314-B182-039-MY3