Seminars

Standard and hyperpolarised MRI for detecting normal tissue toxicity and antitumor activity of ionizing radiation

by Vlad Sandulache (Baylor College of Medicine, Houston, USA)

Europe/Bucharest
Description
Standard and hyperpolarised MRI for detecting normal tissue toxicity and
antitumor activity of ionizing radiation Head and Neck Squamous Cell Carcinoma
(HNSCC) affects approximately
500,000 patients around the world each year. Mortality for advanced HNSCC
continues to exceed 50% even in the United States and Europe. Survivors of
HNSCC treatment often exhibit significant sequela of treatment (surgery,
ionizing radiation (IR), chemotherapy) including difficulties speaking,
swallowing, cosmetic deformity and chronic pain. The increasing
utilization of IR in the treatment of HNSCC over the last 2 decades has
resulted in a complex, and highly unpredictable pattern of sub-acute and
chronic toxicity which remains a difficult clinical dilemma.
Over the last 10 years our group has begun to define a role for MRI in
refining IR algorithms for HNSCC in order to maximize antitumor efficacy
and minimize normal tissue toxicity. Pre-clinical animal models have
demonstrated that dynamic contrast-enhanced (DCE) MRI can detect treatment
effects acutely within the tumor volume. In patients, diffusion weighted
(DW) MRI can identify rapid changes in tumor size and viability during IR.
Finally, using pre-clinical cancer models we showed that hyperpolarized
(HP) MRI can be used to measure acute changes in oxidative stress within
the tumor volume following IR administration. Taken together, these data
suggest that multi-parametric (mp) MRI can be developed into a predictive
tool for IR-based treatment regimens in HNSCC. In parallel, we have begun
to show that mp MRI, particularly DCE-MRI can detect acute, subacute and
chronic changes in normal tissue vascularity, inflammation and viability
during and following IR-based treatment.
Based on our preliminary data, we believe that integration of mp MRI into
clinical application can potentially revolutionize the effectiveness of
IR-based treatment for HNSCC and allow us to develop truly personalized
IR-regimens.

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