Possibilities of CT perfusion in the assessment of squamous cell carcinoma in the head and neck region

Purpose of the study: to evaluate the parameters obtained during CT-perfusion and to develop criteria to judge the presence of squamous cell carcinoma in the tissues of the head and neck. Materials and Methods. This work is based on the analysis of case histories, standard CT scans and CT perfusion of 120 patients who were examined between 2022 and 2023. The study included patients with first diagnosed squamous cell cancer of oropharynx, larynx, pharynx and tongue and control group patients who were examined with suspicion of malignant neoplasm, but according to the results of examination there were no signs of malignant process in the area of interest. During image processing, tissue density was measured in the afferent artery and in the area of interest to obtain a time/density curve and construct perfusion maps. Results. Equivalent blood flow volume (Equiv BV) (p=0.004) and arterial blood flow velocity (AF) (p=0.002) were significant in detecting primary squamous cell carcinoma of the head and neck. Regression analysis of AF provided a means to calculate the risk of having squamous cell carcinoma. A 70.9% probability of squamous cell carcinoma could be said to be present when AF values (ml/min/100 ml) ≥ 56.6. A high-risk level of up to 100.0% for squamous cell cancer is based on the combination of AF (ml/min/100 ml) ≥ 56.6 and Equiv BV (ml/100 ml) ≥ 32.3. Conclusion. Perfusion computed tomography is a relatively simple diagnostic method to judge the presence of squamous cell cancer in the tissues of the head and neck, which allows a more accurate determination of the stage of the disease and the choice of treatment tactics.