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

N. Fujima; D. Yoshida; T. Sakashita; A. Homma; A. Tsukahara; K.K. Tha; K. Kudo; H. Shirato

doi:10.3174/ajnr.A4513

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Fig 1.
Tumor ROI delineation. An example of the tumor ROI delineation (a 68-year-old man with right maxillary cancer). A, The tumor was delineated on the axial T2WI with a polygonal ROI. B, After the delineation, the ROI was copied to the corresponding TBF map.
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Fig 2.
Pretreatment TBF in all the patients. A, The pretreatment TBF in patients in the failure group (109.6 ± 28.5 mL/100 g/min) was significantly lower than that in patients in the local control group (142.3 ± 34.5 mL/100 g/min) (P < .01) (A, *). B, The receiver operating characteristic curve analysis revealed the area under the curve of 0.77 (P < .01), with the best diagnostic accuracy of 0.83 (34/41), sensitivity of 0.87 (26/30), and specificity of 0.73 (8/11), with a threshold value of 115 mL/100 g/min (A, **).
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Fig 3.
Percentage change of TBF in the early treatment period in the subgroup analyses of patients with SD and patients with PR. A, Subgroup analysis of patients in the SD group (the patients with ≤30% TV reduction in the early treatment period); the percentage change of TBF in the failure group (−0.9% ± 11.9%) was significantly lower than that in the local control group (23.0% ± 17.2%) (P < .01) (*); the best diagnostic accuracy of 0.94 (16/17) with sensitivity of 1.0 (10/10) and specificity of 0.86 (6/7), with the threshold value 7% (**) was revealed by receiver operating characteristic analysis. B, Subgroup analysis of the PR patient group (the patients with >30% TV reduction in the early treatment period); the percentage change of TBF in the failure group (−9.2% ± 9.7%) was significantly higher than that in the local control group (−35.1% ± 21.0%) (P < .01) (*). The best diagnostic accuracy of 0.92 (22/24) with a sensitivity of 0.95 (19/20) and specificity of 0.75 (3/4), with a threshold value in the range −8.0% to −14.0% (**) was revealed by receiver operating characteristic analysis. C, Two-dimensional plot graph with the percentage change of TV on the vertical axis and the percentage change of TBF on the horizontal axis; when the threshold line was set to 7% (*) in the patients in the SD group, and the threshold was in the range −8.0% to −14.0% (**) in the PR patient group, the sensitivity, specificity, and accuracy for the division of failure and local control group were 0.97 (29/30), 0.82 (9/11), and 0.93 (38/41), respectively.