Magnetic resonance imaging of swallowing-related structures in nasopharyngeal carcinoma patients receiving IMRT: Longitudinal dose-response characterization of quantitative signal kinetics

Jay A. Messer, Abdallah S R Mohamed, Katherine A. Hutcheson, Yao Ding, Jan S. Lewin, Jihong Wang, Stephen Y. Lai, Steven J. Frank, Adam S. Garden, Vlad Sandulache, Hillary Eichelberger, Chloe C. French, Rivka R. Colen, Jack Phan, Jayashree Kalpathy-Cramer, John D. Hazle, David I. Rosenthal, G. Brandon Gunn, Clifton D. Fuller

Research output: Contribution to journalArticle

11 Scopus citations

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 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.

Original languageEnglish (US)
Pages (from-to)315-322
Number of pages8
JournalRadiotherapy and Oncology
Volume118
Issue number2
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

Keywords

  • Dose-response
  • Dysphagia
  • IMRT
  • Magnetic resonance imaging
  • Nasopharyngeal carcinoma
  • Superior pharyngeal constrictor

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

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    Messer, J. A., Mohamed, A. S. R., Hutcheson, K. A., Ding, Y., Lewin, J. S., Wang, J., Lai, S. Y., Frank, S. J., Garden, A. S., Sandulache, V., Eichelberger, H., French, C. C., Colen, R. R., Phan, J., Kalpathy-Cramer, J., Hazle, J. D., Rosenthal, D. I., Gunn, G. B., & Fuller, C. D. (2016). Magnetic resonance imaging of swallowing-related structures in nasopharyngeal carcinoma patients receiving IMRT: Longitudinal dose-response characterization of quantitative signal kinetics. Radiotherapy and Oncology, 118(2), 315-322. https://doi.org/10.1016/j.radonc.2016.01.011