头颈部放射治疗后颈部纤维化的定量超声中谷成像
Quantitative Ultrasonic Nakagami Imaging of Neck Fibrosis After Head and Neck Radiation Therapy.
作者信息
Yang Xiaofeng, Yoshida Emi, Cassidy Richard J, Beitler Jonathan J, Yu David S, Curran Walter J, Liu Tian
机构信息
Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia.
Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California.
出版信息
Int J Radiat Oncol Biol Phys. 2015 Jun 1;92(2):407-14. doi: 10.1016/j.ijrobp.2015.01.006. Epub 2015 Mar 25.
PURPOSE
To investigate the feasibility of ultrasound Nakagami imaging to quantitatively assess radiation-induced neck fibrosis, a common sequela of radiation therapy (RT) to the head and neck.
METHODS AND MATERIALS
In a pilot study, 40 study participants were enrolled and classified into 3 subgroups: (1) a control group of 12 healthy volunteers; (2) an asymptomatic group of 11 patients who had received intensity modulated RT for head and neck cancer and had experienced no neck fibrosis; and (3) a symptomatic group of 17 post-RT patients with neck fibrosis. Each study participant underwent 1 ultrasound study in which scans were performed in the longitudinal orientation of the bilateral neck. Three Nakagami parameters were calculated to quantify radiation-induced tissue injury: Nakagami probability distribution function, shape, and scaling parameters. Physician-based assessments of the neck fibrosis were performed according to the Radiation Therapy Oncology Group late morbidity scoring scheme, and patient-based fibrosis assessments were rated based on symptoms such as pain and stiffness.
RESULTS
Major discrepancies existed between physician-based and patient-based assessments of radiation-induced fibrosis. Significant differences in all Nakagami parameters were observed between the control group and 2 post-RT groups. Moreover, significant differences in Nakagami shape and scaling parameters were observed among asymptomatic and symptomatic groups. Compared with the control group, the average Nakagami shape parameter value increased by 32.1% (P<.001), and the average Nakagami scaling parameter increased by 55.7% (P<.001) for the asymptomatic group, whereas the Nakagami shape parameter increased by 74.1% (P<.001) and the Nakagami scaling parameter increased by 83.5% (P<.001) for the symptomatic group.
CONCLUSIONS
Ultrasonic Nakagami imaging is a potential quantitative tool to characterize radiation-induced asymptomatic and symptomatic neck fibrosis.
目的
探讨超声中谷成像定量评估放射性颈部纤维化的可行性，放射性颈部纤维化是头颈部放射治疗（RT）常见的后遗症。
方法和材料
在一项初步研究中，招募了40名研究参与者并分为3个亚组：（1）12名健康志愿者组成的对照组；（2）11名接受过头颈部癌调强放疗且未出现颈部纤维化的无症状患者组；（3）17名放疗后出现颈部纤维化的有症状患者组。每位研究参与者均接受1次超声检查，在双侧颈部的纵向方向进行扫描。计算3个中谷参数以量化放射性组织损伤：中谷概率分布函数、形状和尺度参数。根据放射治疗肿瘤学组的晚期发病率评分方案进行基于医生的颈部纤维化评估，并根据疼痛和僵硬等症状进行基于患者的纤维化评估。
结果
基于医生和基于患者的放射性纤维化评估之间存在重大差异。在对照组和2个放疗后组之间，所有中谷参数均观察到显著差异。此外，在无症状组和有症状组之间，中谷形状和尺度参数也观察到显著差异。与对照组相比，无症状组的中谷形状参数平均值增加了32.1%（P<0.001），中谷尺度参数平均值增加了55.7%（P<0.001），而有症状组的中谷形状参数增加了74.1%（P<0.001），中谷尺度参数增加了83.5%（P<0.001）。
结论
超声中谷成像可能是一种用于表征放射性无症状和有症状颈部纤维化的定量工具。
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