Jay A Messer1, Abdallah S R Mohamed2, Katherine A Hutcheson3, Yao Ding4, Jan S Lewin3, Jihong Wang5, Stephen Y Lai3, Steven J Frank5, Adam S Garden5, Vlad Sandulache3, Hillary Eichelberger6, Chloe C French6, Rivka R Colen7, Jack Phan5, Jayashree Kalpathy-Cramer8, John D Hazle9, David I Rosenthal5, G Brandon Gunn5, Clifton D Fuller10. 1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; The University of Texas Medical School at Houston, USA. Electronic address: Jay.A.Messer@uth.tmc.edu. 2. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, Egypt. Electronic address: asmohamed@mdanderson.org. 3. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA. 4. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, USA. 5. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. 6. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; The University of Texas Medical School at Houston, USA. 7. Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA. 8. Department of Radiology, Harvard Medical School, Boston, USA. 9. Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, USA. 10. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: cdfuller@mdanderson.org.
Abstract
BACKGROUND: We aim to characterize serial (i.e., acute and late) MRI signal intensity (SI) changes in dysphagia-associated structures as a function of radiotherapy (RT) in nasopharyngeal cancer (NPC) patients. MATERIALS AND METHODS: We retrospectively extracted data on 72 patients with stage III-IV NPC treated with intensity-modulated RT (IMRT). The mean T1- and T2-weighted MRI SIs were recorded for the superior pharyngeal constrictor (SPC) and soft palate (SP) at baseline, early-after IMRT, and last follow up, with normalization to structures receiving <5 Gy. RESULTS: All structures had a significant increase in T2 SIs early after treatment, irrespective of the mean dose given. At last follow-up, the increase in T2 SI subsided completely for SPC and partially for SP. The T1 SI did not change significantly in early follow-up images of both structures; on late follow-up, patients with mean doses >62.25 Gy had a significant decrease in the corresponding T1 SI for SPC (1.6 ± 0.4 vs. 1.3 ± 0.4, P=0.007) but decreased non-significantly for SP. CONCLUSIONS: Serial MRI acquisitions enable the identification of both early and late radiation-induced changes in swallowing structures after definitive IMRT for NPC. Dose dependent decrease in late T1 SI is associated with higher RT doses to the superior pharyngeal constrictor muscle; while dose independent increase in SI for both structures in early post-RT T2 images is observed and subsides after therapy. Further efforts will seek to elucidate the relationship between dose-dependent muscle SI changes and functional alteration of swallowing muscles. Published by Elsevier Ireland Ltd.
BACKGROUND: We aim to characterize serial (i.e., acute and late) MRI signal intensity (SI) changes in dysphagia-associated structures as a function of radiotherapy (RT) in nasopharyngeal cancer (NPC) patients. MATERIALS AND METHODS: We retrospectively extracted data on 72 patients with stage III-IV NPC treated with intensity-modulated RT (IMRT). The mean T1- and T2-weighted MRI SIs were recorded for the superior pharyngeal constrictor (SPC) and soft palate (SP) at baseline, early-after IMRT, and last follow up, with normalization to structures receiving <5 Gy. RESULTS: All structures had a significant increase in T2 SIs early after treatment, irrespective of the mean dose given. At last follow-up, the increase in T2 SI subsided completely for SPC and partially for SP. The T1 SI did not change significantly in early follow-up images of both structures; on late follow-up, patients with mean doses >62.25 Gy had a significant decrease in the corresponding T1 SI for SPC (1.6 ± 0.4 vs. 1.3 ± 0.4, P=0.007) but decreased non-significantly for SP. CONCLUSIONS: Serial MRI acquisitions enable the identification of both early and late radiation-induced changes in swallowing structures after definitive IMRT for NPC. Dose dependent decrease in late T1 SI is associated with higher RT doses to the superior pharyngeal constrictor muscle; while dose independent increase in SI for both structures in early post-RT T2 images is observed and subsides after therapy. Further efforts will seek to elucidate the relationship between dose-dependent muscle SI changes and functional alteration of swallowing muscles. Published by Elsevier Ireland Ltd.
Entities:
Keywords:
Dose–response; Dysphagia; IMRT; Magnetic resonance imaging; Nasopharyngeal carcinoma; Superior pharyngeal constrictor
Authors: Vinita Takiar; Dominic Ma; Adam S Garden; Jing Li; David I Rosenthal; Beth M Beadle; Steven J Frank; Clifton D Fuller; Gary B Gunn; William H Morrison; Kate Hutcheson; Adel K El-Naggar; Kathryn A Gold; Michael E Kupferman; Jack Phan Journal: Head Neck Date: 2015-07-18 Impact factor: 3.147
Authors: L Gaspar; C Scott; M Rotman; S Asbell; T Phillips; T Wasserman; W G McKenna; R Byhardt Journal: Int J Radiat Oncol Biol Phys Date: 1997-03-01 Impact factor: 7.038
Authors: N P Nguyen; C C Moltz; C Frank; P Vos; H J Smith; U Karlsson; S Dutta; F A Midyett; J Barloon; S Sallah Journal: Ann Oncol Date: 2004-03 Impact factor: 32.976
Authors: Chiaojung Jillian Tsai; Andrew Jackson; Jeremy Setton; Nadeem Riaz; Sean McBride; Jonathan Leeman; Alex Kowalski; Laura Happersett; Nancy Y Lee Journal: JCO Clin Cancer Inform Date: 2017-11
Authors: Travis C Salzillo; Nicolette Taku; Kareem A Wahid; Brigid A McDonald; Jarey Wang; Lisanne V van Dijk; Jillian M Rigert; Abdallah S R Mohamed; Jihong Wang; Stephen Y Lai; Clifton D Fuller Journal: Semin Radiat Oncol Date: 2021-10 Impact factor: 5.421