Venla Loimu1, Tiina Seppälä2, Mika Kapanen3, Laura Tuomikoski2, Heidi Nurmi2, Antti Mäkitie4, Mikko Tenhunen2, Kauko Saarilahti2. 1. Helsinki University Central Hospital, Cancer Center, Department of Radiation Oncology, Finland. Electronic address: venla.loimu@hus.fi. 2. Helsinki University Central Hospital, Cancer Center, Department of Radiation Oncology, Finland. 3. Helsinki University Central Hospital, Cancer Center, Department of Radiation Oncology, Finland; Tampere University Central Hospital, Department of Medical Physics, Finland. 4. Helsinki University Central Hospital, Department of Otorhinolaryngology and Head and Neck Surgery, Finland; Karolinska Institutet, Karolinska University Hospital, Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Sweden.
Abstract
BACKGROUND AND PURPOSES: Permanent xerostomia as a result of radiation-induced salivary gland damage remains a common side effect of radiotherapy (RT) of the head and neck. The purpose of this study was to evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DW-MRI) in assessing the post-RT salivary gland function in patients with head and neck cancer (HNC). MATERIALS AND METHODS: In this prospective study, 20 HNC patients scheduled for bilateral neck chemoradiotherapy (CRT) with weekly cisplatin went through diffusion-weighted magnetic resonance imaging (DW-MRI) and salivary gland scintigraphy (SGS) prior to and at a mean of six months after completing the treatment. The changes in apparent diffusion coefficient (ADC) before and after treatment were compared with ejection fraction (EF) measured with SGS and the radiation dose absorbed by the salivary glands. RESULTS: As a result of gustatory stimulation with ascorbic acid, the ADC showed a biphasic response with an initial increase and subsequent decrease. This pattern was seen both before and after RT. Post-RT ADC increased as a function of RT dose absorbed by the salivary glands. A moderate statistical correlation between pre- and post-RT ADCs at rest and EF measured with SGS was found. CONCLUSIONS: DW-MRI seems a promising tool for detection of physiological and functional changes in major salivary glands after RT.
BACKGROUND AND PURPOSES: Permanent xerostomia as a result of radiation-induced salivary gland damage remains a common side effect of radiotherapy (RT) of the head and neck. The purpose of this study was to evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DW-MRI) in assessing the post-RT salivary gland function in patients with head and neck cancer (HNC). MATERIALS AND METHODS: In this prospective study, 20 HNC patients scheduled for bilateral neck chemoradiotherapy (CRT) with weekly cisplatin went through diffusion-weighted magnetic resonance imaging (DW-MRI) and salivary gland scintigraphy (SGS) prior to and at a mean of six months after completing the treatment. The changes in apparent diffusion coefficient (ADC) before and after treatment were compared with ejection fraction (EF) measured with SGS and the radiation dose absorbed by the salivary glands. RESULTS: As a result of gustatory stimulation with ascorbic acid, the ADC showed a biphasic response with an initial increase and subsequent decrease. This pattern was seen both before and after RT. Post-RT ADC increased as a function of RT dose absorbed by the salivary glands. A moderate statistical correlation between pre- and post-RT ADCs at rest and EF measured with SGS was found. CONCLUSIONS: DW-MRI seems a promising tool for detection of physiological and functional changes in major salivary glands after RT.
Authors: Kaitlyn Re; Shrey Patel; Jason Gandhi; Yiji Suh; Inefta Reid; Gunjan Joshi; Noel L Smith; Sardar Ali Khan Journal: Med Gas Res Date: 2019 Apr-Jun