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MRI staging using gadodiamide for soft-tissue tumors of the head and neck region. Results from a phase II trial and a 5-year clinical follow-up

Artikel i vetenskaplig tidskrift
Författare S. E. Ekholm
Thomas Björk-Eriksson
A. Western
H. Nellstrom
E. Jonsson
A. Johansson
Lars Lönn
Claes Mercke
P. O. Tollesson
Publicerad i Eur J Radiol
Volym 39
Nummer/häfte 3
Sidor 168-75
ISSN 0720-048X (Print)
Publiceringsår 2001
Publicerad vid Institutionen för särskilda specialiteter, Avdelningen för onkologi
Sidor 168-75
Språk en
Länkar www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Contrast Media, Female, Follow-Up Studies, Gadolinium DTPA/*diagnostic use, Head and Neck Neoplasms/*diagnosis, Humans, *Magnetic Resonance Imaging, Male, Middle Aged, Soft Tissue Neoplasms/*diagnosis, Time Factors
Ämneskategorier Cancer och onkologi

Sammanfattning

In order to document the safety, tolerability and efficacy of gadodiamide outside CNS, an open, non-drug comparative study was performed in patients with tumors of the head and neck region. Fifty adult patients were included and 48 patients received the contrast medium. The examinations were performed on a 1.5 T imager using transverse, non-enhanced T1- and PD-/T2-weighted conventional spin-echo sequences, followed by a contrast-enhanced transverse T1-weighted sequence. Post-contrast images provided more diagnostic information compared to unenhanced images in 33 of 48 patients (69%). This information was of significant help in four and of moderate help in 14 cases. Post-contrast images compared to non-enhanced T1-weighted showed improvement in lesion delineation for 29 of the 43 patients where a lesion was observed. Only in two patients was the diagnostic information lower post-contrast. A comparison between all pre-contrast images versus contrast medium enhanced showed post-contrast images to give more diagnostic information in 14 and less in nine patients. No patient experienced discomfort in relation to gadodiamide injection. Only one adverse event occurred which was described as thirst, being of moderate intensity. The 5-year clinical outcome was analyzed and compared with the pre-operative staging. The case-books of all patients were reviewed and in 44 patients all information could be found. Of those, 18 were still alive, one with active disease (AAD) and 17 with no evidence of disease (NED). Two of those four patients, where information was incomplete, showed NED and two had died. This trial showed that contrast-enhancement using gadodiamide for evaluation of soft tissue tumors in the head and neck region was safe and provided statistically significant more diagnostic information compared with unenhanced images. MRI, when compared with palpation/inspection, changed tumor staging in approximately 30% of all cases.

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