Jackson Hamilton
Imaging-genomic correlation is a hot area of research interest. Imaging biomarkers can be clinically useful for prognostic and therapeutic decisions in other tumors. We thought it would be worth exploring this concept in head and neck cancer. Oral cavity cancer was a natural choice, given that many are first treated by surgical resection. By identifying CT imaging characteristics that correlate with vascular endothelial growth factor (VEGF) receptor subtypes, EGF (epidermal growth factor) receptor, etc, there is potential for recognizing the morphologic changes that may predict genetic subtypes and, importantly, when these might have changed in response to treatment. We have furthered the work by performing additional genetic markers as well as adding CT texture analysis, findings that were published in Medical Physics.1
In future works, it will be important to determine whether the morphologic markers identified for genetic expression could predict therapeutic response. For instance, could the degree of enhancement (normalized to submandibular gland to control for contrast bolus) predict response to VEGF inhibitors for neoadjuvant therapy? Do changes in the imaging biomarkers predict genomic change on revision/redo surgery? Do these same biomarkers work in other head and neck subsites, such as the oropharynx or larynx?
References
- Fried D, Pickering C, Rao A, et al. Imaging biomarkers of CT textural analysis correlate to genomic expression in oral cavity squamous cell carcinoma. Med Phys 2013;40:377, 10.1118/1.4815172