Dynamic Contrast Enhanced (DCE) -MRI and 18Fluoromisonidazole (18F MISO) PET Imaging in Head and Neck Squamous Cell Carcinoma: Initial Evaluation of Perfusion and Hypoxia in Nodal Metastasis

The tumor microenvironment in squamous cell carcinoma of the head and neck (HNSCC) plays a critical role in malignant tumor progression and treatment resistance. Among the microenvironment parameters that have shown to be relevant for treatment outcome are tumor cell hypoxia and proliferation. The DCE-MRI data provides insight into the tumor microenvironment (1). With proper compartmental modelling, the data may yield results on tumor-vessel permeability, and extracellular-extravascular volume fraction, i.e. data relating to the tumor microenvironment. Targeting hypoxia as a marker of outcome in HNSCC has shown its promises and challenges. The radiopharmaceuticals containing imidazole moiety such as F-misonidazole (F-MISO) has shown promise as a potential agent for hypoxia imaging (2). The present study has been designed to compare perfusion and hypoxic status of the nodal metastasis in HNSCC using Dynamic Contrast Enhanced (DCE) -MRI and Fluoromisonidazole (F MISO) PET imaging prior to treatment.