Dynamic contrast-enhanced MRI detects acute radiotherapy-induced alterations in mandibular microvasculature: Prospective assessment of imaging biomarkers of normal tissue injury

Vlad C. Sandulache, Brian P. Hobbs, R. Abdallah S Mohamed, Steven J. Frank, Juhee Song, Yao Ding, Rachel Ger, Laurence E. Court, Jayashree Kalpathy-Cramer, John D. Hazle, Jihong Wang, Musaddiq J. Awan, David I. Rosenthal, Adam S. Garden, G. Brandon Gunn, Rivka R. Colen, Nabil Elshafeey, Mohamed Elbanan, Katherine A. Hutcheson, Jan S. LewinMark S. Chambers, Theresa M. Hofstede, Randal S. Weber, Stephen Y. Lai, Clifton D. Fuller

Research output: Contribution to journalArticle

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Abstract

Normal tissue toxicity is an important consideration in the continued development of more effective external beam radiotherapy (EBRT) regimens for head and neck tumors. The ability to detect EBRT-induced changes in mandibular bone vascularity represents a crucial step in decreasing potential toxicity. To date, no imaging modality has been shown to detect changes in bone vascularity in real time during treatment. Based on our institutional experience with multi-parametric MRI, we hypothesized that DCE-MRI can provide in-treatment information regarding EBRT-induced changes in mandibular vascularity. Thirty-two patients undergoing EBRT treatment for head and neck cancer were prospectively imaged prior to, mid-course, and following treatment. DCE-MRI scans were co-registered to dosimetric maps to correlate EBRT dose and change in mandibular bone vascularity as measured by K trans and V e. DCE-MRI was able to detect dose-dependent changes in both K trans and V e in a subset of patients. One patient who developed ORN during the study period demonstrated decreases in K trans and V e following treatment completion. We demonstrate, in a prospective imaging trial, that DCE-MRI can detect dose-dependent alterations in mandibular bone vascularity during chemoradiotherapy, providing biomarkers that are physiological correlates of acute of acute mandibular vascular injury and recovery temporal kinetics.

Original languageEnglish (US)
Article number29864
JournalScientific Reports
Volume6
DOIs
StatePublished - Aug 8 2016
Externally publishedYes

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Microvessels
Radiotherapy
Biomarkers
Wounds and Injuries
Bone and Bones
Mandibular Injuries
Therapeutics
Vascular System Injuries
Chemoradiotherapy
Head and Neck Neoplasms
Neck
Head
Magnetic Resonance Imaging
Neoplasms

ASJC Scopus subject areas

  • General

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Dynamic contrast-enhanced MRI detects acute radiotherapy-induced alterations in mandibular microvasculature : Prospective assessment of imaging biomarkers of normal tissue injury. / Sandulache, Vlad C.; Hobbs, Brian P.; Mohamed, R. Abdallah S; Frank, Steven J.; Song, Juhee; Ding, Yao; Ger, Rachel; Court, Laurence E.; Kalpathy-Cramer, Jayashree; Hazle, John D.; Wang, Jihong; Awan, Musaddiq J.; Rosenthal, David I.; Garden, Adam S.; Gunn, G. Brandon; Colen, Rivka R.; Elshafeey, Nabil; Elbanan, Mohamed; Hutcheson, Katherine A.; Lewin, Jan S.; Chambers, Mark S.; Hofstede, Theresa M.; Weber, Randal S.; Lai, Stephen Y.; Fuller, Clifton D.

In: Scientific Reports, Vol. 6, 29864, 08.08.2016.

Research output: Contribution to journalArticle

Sandulache, VC, Hobbs, BP, Mohamed, RAS, Frank, SJ, Song, J, Ding, Y, Ger, R, Court, LE, Kalpathy-Cramer, J, Hazle, JD, Wang, J, Awan, MJ, Rosenthal, DI, Garden, AS, Gunn, GB, Colen, RR, Elshafeey, N, Elbanan, M, Hutcheson, KA, Lewin, JS, Chambers, MS, Hofstede, TM, Weber, RS, Lai, SY & Fuller, CD 2016, 'Dynamic contrast-enhanced MRI detects acute radiotherapy-induced alterations in mandibular microvasculature: Prospective assessment of imaging biomarkers of normal tissue injury', Scientific Reports, vol. 6, 29864. https://doi.org/10.1038/srep29864
Sandulache, Vlad C. ; Hobbs, Brian P. ; Mohamed, R. Abdallah S ; Frank, Steven J. ; Song, Juhee ; Ding, Yao ; Ger, Rachel ; Court, Laurence E. ; Kalpathy-Cramer, Jayashree ; Hazle, John D. ; Wang, Jihong ; Awan, Musaddiq J. ; Rosenthal, David I. ; Garden, Adam S. ; Gunn, G. Brandon ; Colen, Rivka R. ; Elshafeey, Nabil ; Elbanan, Mohamed ; Hutcheson, Katherine A. ; Lewin, Jan S. ; Chambers, Mark S. ; Hofstede, Theresa M. ; Weber, Randal S. ; Lai, Stephen Y. ; Fuller, Clifton D. / Dynamic contrast-enhanced MRI detects acute radiotherapy-induced alterations in mandibular microvasculature : Prospective assessment of imaging biomarkers of normal tissue injury. In: Scientific Reports. 2016 ; Vol. 6.
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abstract = "Normal tissue toxicity is an important consideration in the continued development of more effective external beam radiotherapy (EBRT) regimens for head and neck tumors. The ability to detect EBRT-induced changes in mandibular bone vascularity represents a crucial step in decreasing potential toxicity. To date, no imaging modality has been shown to detect changes in bone vascularity in real time during treatment. Based on our institutional experience with multi-parametric MRI, we hypothesized that DCE-MRI can provide in-treatment information regarding EBRT-induced changes in mandibular vascularity. Thirty-two patients undergoing EBRT treatment for head and neck cancer were prospectively imaged prior to, mid-course, and following treatment. DCE-MRI scans were co-registered to dosimetric maps to correlate EBRT dose and change in mandibular bone vascularity as measured by K trans and V e. DCE-MRI was able to detect dose-dependent changes in both K trans and V e in a subset of patients. One patient who developed ORN during the study period demonstrated decreases in K trans and V e following treatment completion. We demonstrate, in a prospective imaging trial, that DCE-MRI can detect dose-dependent alterations in mandibular bone vascularity during chemoradiotherapy, providing biomarkers that are physiological correlates of acute of acute mandibular vascular injury and recovery temporal kinetics.",
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AU - Sandulache, Vlad C.

AU - Hobbs, Brian P.

AU - Mohamed, R. Abdallah S

AU - Frank, Steven J.

AU - Song, Juhee

AU - Ding, Yao

AU - Ger, Rachel

AU - Court, Laurence E.

AU - Kalpathy-Cramer, Jayashree

AU - Hazle, John D.

AU - Wang, Jihong

AU - Awan, Musaddiq J.

AU - Rosenthal, David I.

AU - Garden, Adam S.

AU - Gunn, G. Brandon

AU - Colen, Rivka R.

AU - Elshafeey, Nabil

AU - Elbanan, Mohamed

AU - Hutcheson, Katherine A.

AU - Lewin, Jan S.

AU - Chambers, Mark S.

AU - Hofstede, Theresa M.

AU - Weber, Randal S.

AU - Lai, Stephen Y.

AU - Fuller, Clifton D.

PY - 2016/8/8

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N2 - Normal tissue toxicity is an important consideration in the continued development of more effective external beam radiotherapy (EBRT) regimens for head and neck tumors. The ability to detect EBRT-induced changes in mandibular bone vascularity represents a crucial step in decreasing potential toxicity. To date, no imaging modality has been shown to detect changes in bone vascularity in real time during treatment. Based on our institutional experience with multi-parametric MRI, we hypothesized that DCE-MRI can provide in-treatment information regarding EBRT-induced changes in mandibular vascularity. Thirty-two patients undergoing EBRT treatment for head and neck cancer were prospectively imaged prior to, mid-course, and following treatment. DCE-MRI scans were co-registered to dosimetric maps to correlate EBRT dose and change in mandibular bone vascularity as measured by K trans and V e. DCE-MRI was able to detect dose-dependent changes in both K trans and V e in a subset of patients. One patient who developed ORN during the study period demonstrated decreases in K trans and V e following treatment completion. We demonstrate, in a prospective imaging trial, that DCE-MRI can detect dose-dependent alterations in mandibular bone vascularity during chemoradiotherapy, providing biomarkers that are physiological correlates of acute of acute mandibular vascular injury and recovery temporal kinetics.

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