Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy

Xianhai Zhang; Zhifeng Xu; Yabin Jin; Linwen Huang; Wenxiu Wu; Mingyong Gao

doi:10.3892/ol.2024.14313

Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy

Oncol Lett. 2024 Feb 28;27(4):180. doi: 10.3892/ol.2024.14313. eCollection 2024 Apr.

Authors

Xianhai Zhang¹, Zhifeng Xu¹, Yabin Jin², Linwen Huang¹, Wenxiu Wu¹, Mingyong Gao¹

Affiliations

¹ Department of Radiology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China.
² Clinical Research Center, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China.

Abstract

The present study aimed to investigate the value of intravoxel incoherent motion imaging (IVIM) and three-dimensional pulsed continuous arterial spin labeling (ASL) in assessing dynamic changes of the parotid gland in patients with nasopharyngeal carcinoma (NPC) following radiotherapy (RT). A total of 18 patients with NPC who underwent intensity-modulated RT were enrolled in the present study. All patients underwent conventional magnetic resonance imaging, plus IVIM and ASL imaging of the bilateral parotid glands within 2 weeks prior to RT, and 1 week (1W) and 3 months (3M) following RT. Pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (F) and blood flow (BF) were analyzed. D and BF values were significantly increased from pre-RT to 1W post-RT [change rate: Median (IQR), ΔD_1W%: 39.28% (38.23%) and ΔBF_1W%: 60.84% (54.88%)] and continued to increase from 1W post-RT to 3M post-RT [55.44% (40.56%) and ΔBF%: 120.39% (128.74%)]. In addition, the F value was significantly increased from pre-RT to 1W post-RT, [change rate: Median (IQR), ΔF_1W%: 28.13% (44.66%)], and this decreased significantly from 1W post-RT to 3M post-RT. However, no significant differences were observed between pre-RT and 3M post-RT. Results of the present study also demonstrated that the D* value was significantly decreased from pre-RT to 1W post-RT and 3M post-RT [change rate: Median (IQR), ΔD*_1w%: -41.86% (51.71%) and ΔD*_3M: -29.11% (42.67%)]. No significant difference was observed between the different time intervals post-RT. There was a significant positive correlation between percentage change in ΔBF1W and radiation dose (ρ=0.548, P=0.001). Thus, IVIM-diffusion-weighted imaging and ASL may aid in the detection and prediction of radiation-induced parotid damage in the early stages following RT. They may contribute to further understanding the potential association between damage to the parotid glands and patient-/treatment-related variables, through the assessment of individual microcapillary perfusion and tissue diffusivity.

Keywords: ASL; IVIM; NPC; RT; parotid gland.

Grants and funding

The present study was supported by the Science Innovative Project of Foshan (grant no. FSOAA-KJ218-1301-0021) and The 14th Five-Year Plan Key Discipline Foundation Of Foshan (grant no. SGSP145036).