Zhang Xianhai, Xu Zhifeng, Jin Yabin, Huang Linwen, Wu Wenxiu, Gao Mingyong
Department of Radiology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China.
Clinical Research Center, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China.
Oncol Lett. 2024 Feb 28;27(4):180. doi: 10.3892/ol.2024.14313. eCollection 2024 Apr.
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%: 39.28% (38.23%) and ΔBF%: 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%: 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*: -41.86% (51.71%) and ΔD*: -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.
本研究旨在探讨体素内不相干运动成像（IVIM）和三维脉冲连续动脉自旋标记（ASL）在评估鼻咽癌（NPC）患者放疗（RT）后腮腺动态变化中的价值。本研究共纳入18例接受调强放疗的NPC患者。所有患者均接受了常规磁共振成像，以及在放疗前2周内、放疗后1周（1W）和3个月（3M）对双侧腮腺进行的IVIM和ASL成像。分析了纯扩散系数（D）、伪扩散系数（D*）、灌注分数（F）和血流量（BF）。D和BF值从放疗前到放疗后1W显著增加[变化率：中位数（四分位数间距），ΔD%：39.28%（38.23%）和ΔBF%：60.84%（54.88%）]，并从放疗后1W持续增加到放疗后3M[55.44%（40.56%）和ΔBF%：120.39%（128.74%）]。此外，F值从放疗前到放疗后1W显著增加，[变化率：中位数（四分位数间距），ΔF%：28.13%（44.66%）]，并且从放疗后1W到放疗后3M显著降低。然而，放疗前和放疗后3M之间未观察到显著差异。本研究结果还表明，D值从放疗前到放疗后1W和放疗后3M显著降低[变化率：中位数（四分位数间距），ΔD：-41.86%（51.71%）和ΔD*：-29.11%（42.67%）]。放疗后不同时间间隔之间未观察到显著差异。ΔBF1W的百分比变化与辐射剂量之间存在显著正相关（ρ=0.548，P=0.001）。因此，IVIM扩散加权成像和ASL可能有助于在放疗后的早期阶段检测和预测放射性腮腺损伤。它们可能有助于通过评估个体微毛细血管灌注和组织扩散率，进一步了解腮腺损伤与患者/治疗相关变量之间的潜在关联。
