TY - JOUR
T1 - Magnetic resonance imaging of swallowing-related structures in nasopharyngeal carcinoma patients receiving IMRT
T2 - Longitudinal dose-response characterization of quantitative signal kinetics
AU - Messer, Jay A.
AU - Mohamed, Abdallah S.R.
AU - Hutcheson, Katherine A.
AU - Ding, Yao
AU - Lewin, Jan S.
AU - Wang, Jihong
AU - Lai, Stephen Y.
AU - Frank, Steven J.
AU - Garden, Adam S.
AU - Sandulache, Vlad
AU - Eichelberger, Hillary
AU - French, Chloe C.
AU - Colen, Rivka R.
AU - Phan, Jack
AU - Kalpathy-Cramer, Jayashree
AU - Hazle, John D.
AU - Rosenthal, David I.
AU - Gunn, G. Brandon
AU - Fuller, Clifton D.
N1 - Funding Information:
Dr. Fuller received/receives grant support from the National Institutes of Health/National Cancer Institute Paul Calabresi Clinical Oncology Award Program (K12 CA088084-06) and Clinician Scientist Loan Repayment Program (L30 CA136381-02); the National Institutes of Health R56 grant (DE025248-01); the SWOG Hope Foundation Dr. Charles A. Coltman, Jr. Fellowship in Clinical Trials; Elekta AB/MD Anderson Consortium Seed Grant; GE Medical Systems/MD Anderson Center for Advanced Biomedical Imaging In-Kind Award; the MD Anderson Center for Radiation Oncology Research Seed Grant; and the MD Anderson Institutional Research Grant Program Award. Dr. Mohamed received support via the Union for International Cancer Control American Cancer Society International Fellowships for Beginning Investigators. These listed funders/supporters played no role in the study design, collection, analysis, interpretation of data, manuscript writing, or decision to submit the report for publication. Special thanks to Ann Sutton in scientific publications department whose assistance with editing was helpful in execution of this manuscript.
Funding Information:
Dr. Fuller received/receives grant support from the National Institutes of Health / National Cancer Institute Paul Calabresi Clinical Oncology Award Program (K12 CA088084-06 ) and Clinician Scientist Loan Repayment Program (L30 CA136381-02 ); the National Institutes of Health R56 grant ( DE025248-01 ); the SWOG Hope Foundation Dr. Charles A. Coltman, Jr. Fellowship in Clinical Trials; Elekta AB/MD Anderson Consortium Seed Grant; GE Medical Systems/MD Anderson Center for Advanced Biomedical Imaging In-Kind Award; the MD Anderson Center for Radiation Oncology Research Seed Grant; and the MD Anderson Institutional Research Grant Program Award. Dr. Mohamed received support via the Union for International Cancer Control American Cancer Society International Fellowships for Beginning Investigators. These listed funders/supporters played no role in the study design, collection, analysis, interpretation of data, manuscript writing, or decision to submit the report for publication.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - 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 <5 Gy. Results All structures had a significant increase in T2 SIs early after treatment, irrespective of the mean dose given. At last follow-up, the increase in T2 SI subsided completely for SPC and partially for SP. The T1 SI did not change significantly in early follow-up images of both structures; on late follow-up, patients with mean doses >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.
AB - 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 <5 Gy. Results All structures had a significant increase in T2 SIs early after treatment, irrespective of the mean dose given. At last follow-up, the increase in T2 SI subsided completely for SPC and partially for SP. The T1 SI did not change significantly in early follow-up images of both structures; on late follow-up, patients with mean doses >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.
KW - Dose-response
KW - Dysphagia
KW - IMRT
KW - Magnetic resonance imaging
KW - Nasopharyngeal carcinoma
KW - Superior pharyngeal constrictor
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U2 - 10.1016/j.radonc.2016.01.011
DO - 10.1016/j.radonc.2016.01.011
M3 - Article
C2 - 26830697
AN - SCOPUS:84960355993
SN - 0167-8140
VL - 118
SP - 315
EP - 322
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 2
ER -