Head and Neck Squamous Cell Carcinoma: CT Perfusion Can Help Noninvasively Predict Intratumoral Microvessel Density

Purpose: To determine the correlation between computed tomographic (CT) perfusion parameters and intratumoral microvessel density (MVD) in the evaluation of head and neck squamous cell carcinoma (HNSCC). Materials and Methods: This prospective HIPAA-compliant study was performed with institutional review board approval, and informed written consent was obtained from each patient prior to enrollment. Thirteen consecutive patients with advanced HNSCC (stage III or IV) underwent contrast material enhanced neck CT, CT perfusion imaging, and endoscopic biopsy of the primary tumor site. The average patient age was 57.4 years (range, 41-78 years). Intratumoral MVD was determined after mouse antihuman CD31 antibody immunostaining. The mean number of stained microvessels from 10 high-power fields (x 400) per specimen was recorded. CT perfusion parameters, including capillary permeability, blood volume (BV), blood flow (BF), and mean transit time (MTT), were calculated at the primary site. In the statistical analysis, Pearson and Spearman correlation coefficients were calculated. Results: Spearman rank correlation showed positive but not statistically significant correlation between vessel count and BF (r = 0.30, P = .316) and a positive correlation between vessel count and BV (r = 0.59, P = .035). No significant correlation was observed between vessel count and capillary permeability or between vessel count and MTT. Conclusion: Our findings demonstrate a positive correlation between BF and BV parameters from CT perfusion of the neck and MVD in HNSCC.