Centre for Functioning & Health Research, Metro South Hospital & Health Service.
School of Health and Rehabilitation Sciences, The University of Queensland.
Curr Opin Otolaryngol Head Neck Surg. 2023 Dec 1;31(6):368-373. doi: 10.1097/MOO.0000000000000918. Epub 2023 Aug 4.
Radiological imaging is an essential component of head/neck cancer (HNC) care. Advances in imaging modalities (including CT, PET, MRI and ultrasound) and analysis have enhanced our understanding of tumour characteristics and prognosis. However, the application of these methods to evaluate treatment-related toxicities and functional burden is still emerging. This review showcases recent literature applying advanced imaging and radiomics to the assessment and management of sequelae following chemoradiotherapy for HNC.
Whilst primarily early-stage/exploratory studies, recent investigations have showcased the feasibility of using radiological imaging, particularly advanced/functional MRI (including diffusion-weighted and dynamic contrast-enhanced MRI), to quantify treatment-induced tissue change in the head/neck musculature, and the clinical manifestation of lymphoedema/fibrosis and dysphagia. Advanced feature analysis and radiomic studies have also begun to give specific focus to the prediction of functional endpoints, including dysphagia, trismus and fibrosis.
There is demonstrated potential in the use of novel imaging techniques, to help better understand pathophysiology, and improve assessment and treatment of functional deficits following HNC treatment. As larger studies emerge, technologies continue to progress, and pathways to clinical translation are honed, the application of these methods offers an exciting opportunity to transform clinical practices and improve outcomes for HNC survivors.
目的综述：放射影像学是头颈部癌症（HNC）治疗的重要组成部分。成像方式（包括 CT、PET、MRI 和超声）和分析技术的进步增强了我们对肿瘤特征和预后的理解。然而，这些方法在评估与治疗相关的毒性和功能负担方面的应用仍在不断发展。本综述展示了应用先进的影像学和放射组学方法评估和管理头颈部放化疗后后遗症的最新文献。
最新发现：虽然主要是早期/探索性研究，但最近的研究表明，使用放射影像学，特别是先进/功能 MRI（包括扩散加权和动态对比增强 MRI）来量化头颈部肌肉组织中治疗引起的组织变化，以及评估和管理放射性纤维化和吞咽困难的可行性。高级特征分析和放射组学研究也开始特别关注预测吞咽困难、牙关紧闭和纤维化等功能终点。
总结：使用新型成像技术具有很大的潜力，可以帮助更好地理解病理生理学，并改善头颈部癌症治疗后功能缺陷的评估和治疗。随着更大规模的研究出现，技术不断进步，临床转化途径不断完善，这些方法的应用为改变临床实践和提高头颈部癌症幸存者的预后提供了令人兴奋的机会。
