Radiation-induced parotid changes in oropharyngeal cancer patients

The role of early functional imaging and patient-/treatment-related factors

Simona Marzi, Alessia Farneti, Antonello Vidiri, Francesca Di Giuliano, Laura Marucci, Filomena Spasiano, Irene Terrenato, Giuseppe Sanguineti

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Functional magnetic resonance imaging may provide several quantitative indices strictly related to distinctive tissue signatures with radiobiological relevance, such as tissue cellular density and vascular perfusion. The role of Intravoxel Incoherent Motion Diffusion Weighted Imaging (IVIM-DWI) and Dynamic Contrast-Enhanced (DCE) MRI in detecting/predicting radiation-induced volumetric changes of parotids both during and shortly after (chemo)radiotherapy of oropharyngeal squamous cell carcinoma (SCC) was explored. Methods: Patients with locally advanced oropharyngeal SCC were accrued within a prospective study offering both IVIM-DWI and DCE-MRI at baseline; IVIM-DWI was repeated at the 10th fraction of treatment. Apparent diffusion coefficient (ADC), tissue diffusion coefficient Dt, perfusion fraction f and perfusion-related diffusion coefficient D were estimated both at baseline and during RT. Semi-quantitative and quantitative parameters, including the transfer constant Ktrans, were calculated from DCE-MRI. Parotids were contoured on T2-weighted images at baseline, 10th fraction and 8th weeks after treatment end and the percent change of parotid volume between baseline/10th fr (-Vol10fr) and baseline/8th wk. (-Volpost) computed. Correlations among volumetric changes and patient-, treatment- and imaging-related features were investigated at univariate analysis (Spearman's Rho). Results: Eighty parotids (40 patients) were analyzed. Percent changes were 18.2 ± 10.7% and 31.3 ± 15.8% for -Vol10fr and -Volpost, respectively. Among baseline characteristics, -Vol10fr was correlated to body mass index, patient weight as well as the initial parotid volume. A weak correlation was present between parotid shrinkage after the first 2 weeks of treatment and dosimetric variables, while no association was found after radiotherapy. Percent changes of both ADC and Dt at the 10th fraction were also correlated to -Vol10fr. Significant relationships were found between -Volpost and baseline DCE-MRI parameters. Conclusions: Both IVIM-DWI and DCE-MRI can help to detect/predict early (during treatment) and shortly after treatment completion the parotid shrinkage. They may contribute to clarify the correlations between volumetric changes of parotid glands and patient-/treatment-related variables by assessing individual microcapillary perfusion and tissue diffusivity.

Original languageEnglish
Article number189
JournalRadiation Oncology
Volume13
Issue number1
DOIs
Publication statusPublished - Oct 1 2018

Fingerprint

Oropharyngeal Neoplasms
Radiation
Perfusion
Therapeutics
Squamous Cell Carcinoma
Radiotherapy
Parotid Gland
Blood Vessels
Body Mass Index
Magnetic Resonance Imaging
Prospective Studies
Weights and Measures

Keywords

  • Diffusion magnetic resonance imaging
  • Oropharyngeal Cancer
  • Parotid gland
  • Perfusion magnetic resonance imaging
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Radiation-induced parotid changes in oropharyngeal cancer patients : The role of early functional imaging and patient-/treatment-related factors. / Marzi, Simona; Farneti, Alessia; Vidiri, Antonello; Di Giuliano, Francesca; Marucci, Laura; Spasiano, Filomena; Terrenato, Irene; Sanguineti, Giuseppe.

In: Radiation Oncology, Vol. 13, No. 1, 189, 01.10.2018.

Research output: Contribution to journalArticle

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abstract = "Background: Functional magnetic resonance imaging may provide several quantitative indices strictly related to distinctive tissue signatures with radiobiological relevance, such as tissue cellular density and vascular perfusion. The role of Intravoxel Incoherent Motion Diffusion Weighted Imaging (IVIM-DWI) and Dynamic Contrast-Enhanced (DCE) MRI in detecting/predicting radiation-induced volumetric changes of parotids both during and shortly after (chemo)radiotherapy of oropharyngeal squamous cell carcinoma (SCC) was explored. Methods: Patients with locally advanced oropharyngeal SCC were accrued within a prospective study offering both IVIM-DWI and DCE-MRI at baseline; IVIM-DWI was repeated at the 10th fraction of treatment. Apparent diffusion coefficient (ADC), tissue diffusion coefficient Dt, perfusion fraction f and perfusion-related diffusion coefficient D∗ were estimated both at baseline and during RT. Semi-quantitative and quantitative parameters, including the transfer constant Ktrans, were calculated from DCE-MRI. Parotids were contoured on T2-weighted images at baseline, 10th fraction and 8th weeks after treatment end and the percent change of parotid volume between baseline/10th fr (-Vol10fr) and baseline/8th wk. (-Volpost) computed. Correlations among volumetric changes and patient-, treatment- and imaging-related features were investigated at univariate analysis (Spearman's Rho). Results: Eighty parotids (40 patients) were analyzed. Percent changes were 18.2 ± 10.7{\%} and 31.3 ± 15.8{\%} for -Vol10fr and -Volpost, respectively. Among baseline characteristics, -Vol10fr was correlated to body mass index, patient weight as well as the initial parotid volume. A weak correlation was present between parotid shrinkage after the first 2 weeks of treatment and dosimetric variables, while no association was found after radiotherapy. Percent changes of both ADC and Dt at the 10th fraction were also correlated to -Vol10fr. Significant relationships were found between -Volpost and baseline DCE-MRI parameters. Conclusions: Both IVIM-DWI and DCE-MRI can help to detect/predict early (during treatment) and shortly after treatment completion the parotid shrinkage. They may contribute to clarify the correlations between volumetric changes of parotid glands and patient-/treatment-related variables by assessing individual microcapillary perfusion and tissue diffusivity.",
keywords = "Diffusion magnetic resonance imaging, Oropharyngeal Cancer, Parotid gland, Perfusion magnetic resonance imaging, Radiotherapy",
author = "Simona Marzi and Alessia Farneti and Antonello Vidiri and {Di Giuliano}, Francesca and Laura Marucci and Filomena Spasiano and Irene Terrenato and Giuseppe Sanguineti",
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T2 - The role of early functional imaging and patient-/treatment-related factors

AU - Marzi, Simona

AU - Farneti, Alessia

AU - Vidiri, Antonello

AU - Di Giuliano, Francesca

AU - Marucci, Laura

AU - Spasiano, Filomena

AU - Terrenato, Irene

AU - Sanguineti, Giuseppe

PY - 2018/10/1

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N2 - Background: Functional magnetic resonance imaging may provide several quantitative indices strictly related to distinctive tissue signatures with radiobiological relevance, such as tissue cellular density and vascular perfusion. The role of Intravoxel Incoherent Motion Diffusion Weighted Imaging (IVIM-DWI) and Dynamic Contrast-Enhanced (DCE) MRI in detecting/predicting radiation-induced volumetric changes of parotids both during and shortly after (chemo)radiotherapy of oropharyngeal squamous cell carcinoma (SCC) was explored. Methods: Patients with locally advanced oropharyngeal SCC were accrued within a prospective study offering both IVIM-DWI and DCE-MRI at baseline; IVIM-DWI was repeated at the 10th fraction of treatment. Apparent diffusion coefficient (ADC), tissue diffusion coefficient Dt, perfusion fraction f and perfusion-related diffusion coefficient D∗ were estimated both at baseline and during RT. Semi-quantitative and quantitative parameters, including the transfer constant Ktrans, were calculated from DCE-MRI. Parotids were contoured on T2-weighted images at baseline, 10th fraction and 8th weeks after treatment end and the percent change of parotid volume between baseline/10th fr (-Vol10fr) and baseline/8th wk. (-Volpost) computed. Correlations among volumetric changes and patient-, treatment- and imaging-related features were investigated at univariate analysis (Spearman's Rho). Results: Eighty parotids (40 patients) were analyzed. Percent changes were 18.2 ± 10.7% and 31.3 ± 15.8% for -Vol10fr and -Volpost, respectively. Among baseline characteristics, -Vol10fr was correlated to body mass index, patient weight as well as the initial parotid volume. A weak correlation was present between parotid shrinkage after the first 2 weeks of treatment and dosimetric variables, while no association was found after radiotherapy. Percent changes of both ADC and Dt at the 10th fraction were also correlated to -Vol10fr. Significant relationships were found between -Volpost and baseline DCE-MRI parameters. Conclusions: Both IVIM-DWI and DCE-MRI can help to detect/predict early (during treatment) and shortly after treatment completion the parotid shrinkage. They may contribute to clarify the correlations between volumetric changes of parotid glands and patient-/treatment-related variables by assessing individual microcapillary perfusion and tissue diffusivity.

AB - Background: Functional magnetic resonance imaging may provide several quantitative indices strictly related to distinctive tissue signatures with radiobiological relevance, such as tissue cellular density and vascular perfusion. The role of Intravoxel Incoherent Motion Diffusion Weighted Imaging (IVIM-DWI) and Dynamic Contrast-Enhanced (DCE) MRI in detecting/predicting radiation-induced volumetric changes of parotids both during and shortly after (chemo)radiotherapy of oropharyngeal squamous cell carcinoma (SCC) was explored. Methods: Patients with locally advanced oropharyngeal SCC were accrued within a prospective study offering both IVIM-DWI and DCE-MRI at baseline; IVIM-DWI was repeated at the 10th fraction of treatment. Apparent diffusion coefficient (ADC), tissue diffusion coefficient Dt, perfusion fraction f and perfusion-related diffusion coefficient D∗ were estimated both at baseline and during RT. Semi-quantitative and quantitative parameters, including the transfer constant Ktrans, were calculated from DCE-MRI. Parotids were contoured on T2-weighted images at baseline, 10th fraction and 8th weeks after treatment end and the percent change of parotid volume between baseline/10th fr (-Vol10fr) and baseline/8th wk. (-Volpost) computed. Correlations among volumetric changes and patient-, treatment- and imaging-related features were investigated at univariate analysis (Spearman's Rho). Results: Eighty parotids (40 patients) were analyzed. Percent changes were 18.2 ± 10.7% and 31.3 ± 15.8% for -Vol10fr and -Volpost, respectively. Among baseline characteristics, -Vol10fr was correlated to body mass index, patient weight as well as the initial parotid volume. A weak correlation was present between parotid shrinkage after the first 2 weeks of treatment and dosimetric variables, while no association was found after radiotherapy. Percent changes of both ADC and Dt at the 10th fraction were also correlated to -Vol10fr. Significant relationships were found between -Volpost and baseline DCE-MRI parameters. Conclusions: Both IVIM-DWI and DCE-MRI can help to detect/predict early (during treatment) and shortly after treatment completion the parotid shrinkage. They may contribute to clarify the correlations between volumetric changes of parotid glands and patient-/treatment-related variables by assessing individual microcapillary perfusion and tissue diffusivity.

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KW - Oropharyngeal Cancer

KW - Parotid gland

KW - Perfusion magnetic resonance imaging

KW - Radiotherapy

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