Correlating Computed Tomography Perfusion Changes in the Pharyngeal Constrictor Muscles During Head-and-Neck Radiotherapy to Dysphagia Outcome

AbstractPurposeTo analyse interfraction setup using two different image guidance modalities for prostate and head-and-neck (H&N) cancer treatment.Materials and methodsSeventy-two prostate and 60 H&N cancer patients, imaged with kilovoltage cone beam computed tomography (KVCBCT) or megavoltage fan beam computed tomography (MVFBCT), were studied retrospectively. The daily displacements in mediolateral (ML), craniocaudal (CC) and anteroposterior (AP) dimensions were investigated. The setup errors were calculated to determine the clinical target volume to planning target volume (CTV-to-PTV) margins.ResultsBased on 1,606 KVCBCT and 2,054 MVFBCT scans, average interfraction shifts in ML, CC and AP direction for H&N cases were 0·5 ± 1·5, −0·3 ± 2·0, 0·3 ± 1·7 mm using KVCBCT, 0·2 ± 1·9, −0·2 ± 2·4 and 0·0 ± 1·7 mm using MVFBCT. For prostate cases, average interfraction displacements were −0·3 ± 3·9, 0·2 ± 2·4, 0·4 ± 3·8 mm for MVFBCT and −0·2 ± 2·7, −0·6 ± 2·9, −0·5 ± 3·4 mm for KVCBCT. The calculated CTV-to-PTV margins, if determined by image-guided radiotherapy (IGRT) data, were 5·6 mm (H&N) and 7·8 mm (prostate) for MVFBCT, compared with 4·8 mm and 7·2 mm for KVCBCT. We observed no statistically significant difference in daily repositioning using KVCBCT and MVFBCT in early, middle and late stages of the treatment course.ConclusionIn the absence of IGRT, the CTV-to-PTV margin determined using IGRT data, may be varied for different imaging modalities for prostate and H&N irradiation.

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Delineating brachial plexus, cochlea, pharyngeal constrictor muscles and optic chiasm in head and neck radiotherapy: a CT-based model atlas

La radiologia medica ◽

10.1007/s11547-014-0448-2 ◽

2014 ◽

Vol 120 (4) ◽

pp. 352-360 ◽

Cited By ~ 8

Author(s):

Domenico Genovesi ◽

Francesca Perrotti ◽

Marianna Trignani ◽

Angelo Di Pilla ◽

Annamaria Vinciguerra ◽

...

Keyword(s):

Brachial Plexus ◽

Head And Neck ◽

Optic Chiasm ◽

Pharyngeal Constrictor Muscles ◽

Head And Neck Radiotherapy

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Synthetic computed tomography data allows for accurate absorbed dose calculations in a magnetic resonance imaging only workflow for head and neck radiotherapy

Physics and Imaging in Radiation Oncology ◽

10.1016/j.phro.2020.12.007 ◽

2021 ◽

Vol 17 ◽

pp. 36-42

Author(s):

Emilia Palmér ◽

Anna Karlsson ◽

Fredrik Nordström ◽

Karin Petruson ◽

Carl Siversson ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Head And Neck ◽

Absorbed Dose ◽

Dose Calculations ◽

Resonance Imaging ◽

Head And Neck Radiotherapy ◽

Tomography Data

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The Changes in Pharyngeal Constrictor Muscles Related to Head and Neck Radiotherapy: A Systematic Review

Technology in Cancer Research & Treatment ◽

10.1177/1533033820945805 ◽

2020 ◽

Vol 19 ◽

pp. 153303382094580

Author(s):

Jakub Grepl ◽

Igor Sirak ◽

Milan Vosmik ◽

Ales Tichy

Keyword(s):

Magnetic Resonance Imaging ◽

Systematic Review ◽

Head And Neck Cancer ◽

Magnetic Resonance ◽

Head And Neck ◽

Signal Intensity ◽

Adaptive Radiotherapy ◽

Resonance Imaging ◽

Pharyngeal Constrictor Muscles ◽

Head And Neck Radiotherapy

It is well known that radiation damage of the pharyngeal constrictor muscles, the glottic larynx, and the supraglottic larynx may lead to dysphagia, an unwanted effect of head and neck radiotherapy. The reduction of radiotherapy-induced dysphagia might be achieved by adaptive radiotherapy. Although the number of studies concerning adaptive radiotherapy of head and neck cancer is continuously increasing, there are only a few studies concerning changes in dysphagia-related structures during radiotherapy. The goal of this review is to summarize the current knowledge about volumetric, dosimetric, and other changes of the pharyngeal constrictor muscles associated with head and neck radiotherapy. A literature search was performed in the MEDLINE database according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The conclusions of 8 studies that passed the criteria indicate a significant increase in the volume and the thickness of the pharyngeal constrictor muscles during radiotherapy. Moreover, the changes in magnetic resonance imaging signal intensity of the pharyngeal constrictor muscles correlate with the absorbed dose (typically higher than 50 Gy) and also with the grade of dysphagia. This systematic review presents 2 variables, which are suitable for estimation of radiotherapy-related pharyngeal constrictor muscles changes—magnetic resonance imaging signal intensity and the thickness. In the case of the thickness, there is no consensus in the level of the measurement—C2 vertebra, C3 vertebra, and the middle of the craniocaudal axis are used. It seems that reference to a position associated with a vertebral body could be more reproducible and beneficial for future research. Although late pharyngeal toxicity remains a challenge in head and neck cancer treatment, better knowledge of radiotherapy-related changes in the pharyngeal constrictor muscles contributes to adaptive radiotherapy development and thus improves the treatment results.

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The Diagnostic Value of Cervical Lymph Node Metastasis in Head and Neck Squamous Carcinoma by Using Diffusion-Weighted Magnetic Resonance Imaging and Computed Tomography Perfusion

BioMed Research International ◽

10.1155/2014/260859 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Jin Zhong ◽

Zonghong Lu ◽

Liang Xu ◽

Longchun Dong ◽

Hui Qiao ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Head And Neck ◽

Resonance Imaging ◽

Adc Value ◽

Computed Tomography Perfusion ◽

Diffusion Weighted ◽

Weighted Magnetic Resonance Imaging ◽

The Mean

Purpose.The aim of this study was to compare diffusion-weighted magnetic resonance imaging (DWI) with computed tomography perfusion (CTP) for preoperative detection of metastases to lymph nodes (LNs) in head and neck squamous cell carcinoma (SCC).Methods.Between May 2010 and April 2012, 30 patients with head and neck SCC underwent preoperative DWI and CTP. Two radiologists measured apparent diffusion coefficient (ADC) values and CTP parameters independently. Surgery and histopathologic examinations were performed on all patients.Results.On DWI, 65 LNs were detected in 30 patients. The mean ADC value of metastatic nodes was lower than benign nodes and the difference was statistically significant (P<0.05). On CTP images, the mean value in metastatic nodes of blood flow (BF) and blood volume (BV) was higher than that in benign nodes, and mean transit time (MTT) in metastatic nodes was lower than that in benign nodes. There were significant differences in BF and MTT values between metastatic and benign LNs (P<0.05). There were significant differences between the AUCs of DWI and CTP (Z=4.612,P<0.001).Conclusion.DWI with ADC value measurements may be more accurate than CTP for the preoperative diagnosis of cervical LN metastases.

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