Squamous Cell Carcinoma of the Head and Neck Clinical Trial
Official title:
Functional ImaGing of Heterogeneity in Head and Neck Tumors - Validation From Surgical Specimens
The purpose of this study is to investigate if heterogeneity in head and neck squamous cell carcinoma as seen in functional imaging with PET/MR can be correlated to biologic heterogeneity in surgical specimens.
The following is a presentation of a prospective protocol, named FIGHHT, including patients
with squamous cell carcinoma of the head and neck (HNSCC) who are referred for surgery.
This is a prospective imaging/biomarker expression study where patients referred for surgery
for HNSCC will be included. The purpose of the study is to investigate if heterogeneity in
HNSCC as seen in functional imaging with PET/MR can be correlated to biologic heterogeneity
in surgical specimens.
Multiparametric imaging(MPI) is performed before surgery using a PET/MR system (Siemens
Biograph mMR) with a 3 T magnet using a head and neck coil. The scan protocol includes
diffusion weighted MRI, dynamic contrast enhanced perfusion MRI and FDG-PET (4 MBq/kg).
Morphometric imaging is performed with a 3D T2 weighted sequence (SPACE, voxel size 1.0 mm
isotropic in vivo and 0.5 mm isotropic for specimens).
The scans are evaluated by a radiologist and a specialist in nuclear medicine and regions of
interest and reference areas (anatomical landmarks) are marked. The tumor and if indicated
lymp nodes are removed en bloc and per-operatively the reference areas and other anatomical
landmarks are marked in the specimen with intravenous tubes. The specimen is fixed to a
corkboard and scanned morphometric (as described) using a knee coil before and after formalin
fixation within 1 hour after surgery. The whole surgical specimen is sectioned for
histological processing.
Tissue blocks will undergo microscopic pathological evaluation and IHC staining. The specific
selection of cancer related IHC biomarkers is based on their relationship with tumor cell
metabolism, radiotherapy resistance (proliferation and hypoxia), association with FDG
accumulation and institutional experience from a previous study.
The quantified measurements from the FDG PET, DWI and DCE scan will be correlated to the
expression of IHC biomarkers.
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