Reber Brandon, He Renjie, Abdelaal Moamen R, Mohamed Abdallah, Mulder Sam, Humbert Vidan Laia, Fuller Clifton D, Lai Stephen Y, Brock Kristy
Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, US0041.
Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA.
medRxiv. 2025 Jul 25:2025.07.25.25332216. doi: 10.1101/2025.07.25.25332216.
Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is a functional imaging modality that can quantify tissue permeability and blood flow. Due to vasculature changes resulting from radiation therapy (RT), DCE-MRI quantitative parameters should be significantly different in regions receiving a high radiation dose compared to regions receiving a low radiation dose. This work sought to determine if a significant difference exists in post head and neck cancer (HNC)-RT DCE-MRI quantitative parameters and v between regions of the mandible receiving a high radiation dose and regions of the mandible receiving a low radiation dose.
DCE-MRI was acquired from HNC subjects post-RT. The DCE-MRI quantitative parameters and v were obtained through Tofts model fitting. Four mandible sections (left ramus, left body, right ramus, and right body) were delineated on subject mandible contours. Two Kruskal-Wallis tests comparing the mean and v in low dose (≤ 60 Gy) areas of the four mandible regions were computed. Next, two Wilcoxon signed-rank tests were used to determine if the means of and v between high dose (> 60 Gy) and low dose (≤ 60 Gy) mandible regions were significantly different. To account for multiple statistical tests, a Bonferroni corrected significance level for all statistical tests was used .
48 HNC subjects were included in the analysis. The Kruskal-Wallis tests showed no inherent significant difference in means between mandible regions ( , =0.13) and no inherent significant difference in v means between mandible regions ( , =0.82). No significant difference was found between high and low dose mandible means (=392, =0.044). A significant difference was found between high and low dose v mandible means (=214, =0.00013).
No inherent difference in DCE-MRI quantitative parameters was observed within subject mandibles, but a significant difference was observed between v means of high and low radiation dose mandible regions. These results provide evidence of the utility of DCE-MRI to monitor mandible vasculature changes resulting from head and neck cancer radiation therapy. Monitoring post HNC-RT mandible vasculature changes is important to initiate earlier toxicity management and ultimately improve HNC survivor quality of life.
动态对比增强磁共振成像（DCE-MRI）是一种功能成像方式，可量化组织通透性和血流情况。由于放射治疗（RT）导致的血管系统变化，与接受低辐射剂量的区域相比，接受高辐射剂量区域的DCE-MRI定量参数应该有显著差异。本研究旨在确定在接受高辐射剂量的下颌骨区域和接受低辐射剂量的下颌骨区域之间，头颈部癌（HNC）放疗后DCE-MRI定量参数以及v是否存在显著差异。
对HNC患者放疗后进行DCE-MRI检查。通过Tofts模型拟合获得DCE-MRI定量参数以及v。在患者下颌骨轮廓上划定四个下颌骨切片（左支、左体、右支和右体）。计算两个Kruskal-Wallis检验，比较四个下颌骨区域低剂量（≤60 Gy）区域的平均以及v。接下来，使用两个Wilcoxon符号秩检验来确定高剂量（>60 Gy）和低剂量（≤60 Gy）下颌骨区域之间的平均以及v是否存在显著差异。为了考虑多重统计检验，对所有统计检验使用Bonferroni校正的显著性水平。
48名HNC患者纳入分析。Kruskal-Wallis检验显示下颌骨区域之间的平均无固有显著差异（ ，=0.13），下颌骨区域之间的v平均无固有显著差异（ ，=0.82）。高剂量和低剂量下颌骨平均之间未发现显著差异（=392，=0.044）。高剂量和低剂量下颌骨v平均之间发现显著差异（=214，=0.00013）。
在患者下颌骨内未观察到DCE-MRI定量参数的固有差异，但在高辐射剂量和低辐射剂量下颌骨区域的v平均之间观察到显著差异。这些结果提供了DCE-MRI用于监测头颈部癌放疗导致的下颌骨血管系统变化的效用证据。监测HNC放疗后的下颌骨血管系统变化对于尽早开始毒性管理并最终改善HNC幸存者的生活质量很重要。
