Dynamische Magnetresonanztomographie (dMRT): Wertigkeit bei fortgeschrittenen Kopf-Hals-Tumoren unter Radiochemotherapie

Purpose. With the help of dynamic magnetic resonance tomography (dMRT) the status of tissue microcirculation can be visualized. Methods. Dynamic MRI was performed in 13 patients with advanced, nonresectable oro- or hypopharynx carcinoma at the beginning and the end of therapy. Maximal signal intensity and exchange rate constant in the tissue of the tumor and the lymph node metastases were analyzed using a pharmacokinetic two-compartment model. Results. In all six patients with clinical complete response (CR),the maximal signal intensity increased after therapy in the tissue of the primary tumor and the lymph node metastases. Furthermore, a high decrease in the parameter k 21 was associated with a better prognosis and could be observed especially after combined radiochemotherapy. Conclusion. Our first results indicate that contrast-enhanced dynamic MRI studies before and after radio- or combined radiochemotherapy offer important information about the changes of microcirculation in the tissue of the tumor and lymph node metastases.Furthermore,this information seems to be a promising predictor for clinical outcome of therapy.