Investigation of metastatis predictors in cervical head and neck squamous cell carcinoma metastases using magnetic resonance elastography and multiparametric ultrasound

• Applicant: Dr. Katharina Margherita Wakonig
• Subject Area: Otolaryngology, Phoniatrics and Audiology
• Term: since 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 548908318

Squamous cell carcinomas of the head and neck region (HNSCC) are the seventh most common type of cancer worldwide. Treatment is based on the tumor stage and may include surgery, radiation, and chemotherapy. A crucial factor for prognosis is lymphogenic metastasis, which increases the risk of recurrence and further metastasis. Despite intensive follow-up care, which includes regular ultrasound examinations of the cervical lymph nodes, there is currently no reliable marker for predicting the metastatic potential of a head and neck tumor. Research shows that in addition to biological properties, physical characteristics of the tumor, such as force establishment for spread, mechanical cell plasticity, and spatial cell heterogeneity, are crucial for tumor growth. These factors influence how a tumor develops and spreads, affecting the changes in tissue properties in its environment. Modern imaging techniques like multiparametric ultrasound (mpUS), shear wave elastography (SWE), and magnetic resonance elastography (MRE) allow for the visualization of these physical changes and could improve the diagnosis and monitoring of HNSCC in the future. The mpUS, in particular, which can assess tissue elasticity and microvascularization, shows potential in differentiating cervical HNSCC metastases. MRE offers similar capabilities by depicting tissue stiffness and fluidity and can examine not only the cervical metastases but also the primary tumor. For other types of tumors, MRE has already been shown to allow a more precise assessment of tumor extension and even an evaluation of the tumor's aggressiveness, thus acting as a metastasis predictor. This method has hardly been explored for HNSCC yet. Our project aims to develop a metastasis prediction marker for HNSCC using multiparametric imaging. We suspect that HNSCC and their metastases are characterized by increased fluidity and elasticity modules in MRE compared to healthy tissue. A significant difference between HNSCC primary tumors and healthy tissue, as well as between HNSCC with and without metastasis, is expected to derive a metastatic potential prediction marker. Furthermore, the correlation between mpUS parameters and MRE results of the cervical lymph nodes will be investigated to integrate the marker into clinical follow-up. This enables more efficient monitoring of patients at increased risk of metastasis. In the long term, an AI-based model is planned to enhance the analysis of MRE and US data, optimizing metastasis prediction and representation and supporting a time- and cost-efficient tumor follow-up.

• DFG Programme: Research Grants
• Co-Investigator: Professor Dr. Ingolf Sack