Diffusion-weighted imaging as a follow-up modality for evaluation of major salivary gland function in nasopharyngeal carcinoma patients: a preliminary study.

Purpose: To investigate the value of diffusion-weighted imaging (DWI) in assessing dynamic changes of major salivary gland function during follow-up post radiotherapy (RT) in nasopharyngeal carcinoma (NPC) patients.Materials and Methods: 31 consecutive patients with pathologically confirmed NPC sche...

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Published in:Strahlentherapie und Onkologie Vol. 196; no. 6; pp. 530 - 542
Main Authors: Fan, Wen-jun, Teng, Feng, Luo, Yan-rong, Yu, Wei, Zhang, Qian, Lu, Yi-ping, Ma, Lin
Format: clinical trial research Journal Article
Published: Springer Nature Jun2020
Online Access:View this record in EBSCOhost
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      dt: Jun2020
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00066-020-01580-5
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        atl: Diffusion-weighted imaging as a follow-up modality for evaluation of major salivary gland function in nasopharyngeal carcinoma patients: a preliminary study.
      aug:
        au:
          Fan, Wen-jun
          Teng, Feng
          Luo, Yan-rong
          Yu, Wei
          Zhang, Qian
          Lu, Yi-ping
          Ma, Lin
        affil: Medical School of Chinese PLA, No. 28 Fuxing Road, 100853, Beijing, China
      sug:
        subj:
          Radiotherapy, Conformal
          Magnetic Resonance Imaging Methods
          Nasopharyngeal Neoplasms Therapy
          Salivary Glands
          Salivary Glands Physiopathology
          Radiotherapy
          Male
          Antineoplastic Agents, Combined Therapeutic Use
          Middle Age
          Aged
          Prospective Studies
          Female
          Young Adult
          Salivation Radiation Effects
          Xerostomia Etiology
          Human
          Radiation Injuries Etiology
          Adult
          Neoplasm Metastasis Radiotherapy
          Cisplatin Administration and Dosage
          Adolescence
          Clinical Trials
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Middle Aged: 45-64 years
          Aged: 65+ years
          Adult: 19-44 years
          Adolescent: 13-18 years
          Male
          Female
      ab: Purpose: To investigate the value of diffusion-weighted imaging (DWI) in assessing dynamic changes of major salivary gland function during follow-up post radiotherapy (RT) in nasopharyngeal carcinoma (NPC) patients.Materials and Methods: 31 consecutive patients with pathologically confirmed NPC scheduled for RT underwent six routine follow-up MRI examinations including DWI sequence prior to (pre-RT) and 1, 3, 6, 9, and 12 months post RT. Mean apparent diffusion coefficient (ADC) values of bilateral parotid glands (PGs) and submandibular glands (SMGs) were measured. Objective measurement of salivary flow rate (SFR) under unstimulated (uSFR) and stimulated conditions (sSFR) as well as subjective xerostomia assessment according to a patient-rated questionnaire were conducted before each MRI. Variance analysis was used to evaluate dynamic changes of ADC, SFR and xerostomia questionnaire summary scores (XQ-sum) at different timepoints and the correlation between ADC and XQ-sum. Pearson's correlation test was used to evaluate the correlations between pre- and post-RT changes of ADC (ΔADC) and SFR (ΔSFR) or mean RT dose.Results: At each timepoint, ADCs of PGs were significantly lower than of SMGs, uSFR was significantly lower than sSFR. For both PGs and SMGs, ADCpost-RT were all higher than ADCpre-RT, with significant differences. ADC1m-post-RT initially increased and changed little to ADC3m-post-RT, ADC6m-post-RT, ADC9m-post-RT, and ADC12m-post-RT, then gradually declined over time. The dynamic change trends of SFR were negatively paralleled to those of ADC, while that of XQ-sum was similar. Dose-response relationships were detected between salivary gland mean RT dose and ΔADC. In PGs, negative correlations between ΔsSFR9m-post-RT and ΔADC9m-post-RT, and ΔsSFR12m-post-RT and ΔADC12m-post-RT were detected. In SMGs, negative correlations between ΔsSFR12m-post-RT and ΔADC12m-post-RT, and ΔuSFR12m-post-RT and ΔADC12m-post-RT were also detected. The ADCs of patients with severe subjective xerostomia were significantly higher, while patients with moderate subjective xerostomia presented a tendency toward higher ADCs compared to those with mild xerostomia from 6 to 12 months post RT.Conclusion: As part of routine follow-up MRI in NPC patients, DWI might be a promising modality for follow-up assessing the dynamic changes of major salivary gland function and might be more powerful in the late post-RT period.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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