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Zhao DW, Fang XM, Zhou SH, Luo YR, Wei J, Liu K, Meng LL, Liu G, Li JF, Zang X, Li M, Qiang XF, Jiang HY, Fan WJ, Zhang XX, Ma L. Application of Diffusion Kurtosis Imaging in Evaluating Acute Xerostomia in Nasopharyngeal Carcinoma Treated With Induction Chemotherapy Plus Concurrent Chemoradiotherapy. Front Oncol 2022; 12:870315. [PMID: 35664750 PMCID: PMC9162117 DOI: 10.3389/fonc.2022.870315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 04/05/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose The aim of this study was to identify the efficacy of diffusion kurtosis imaging (DKI) in tracking and monitoring the dynamic change of parotid glands (PGs), submandibular glands (SMGs), sublingual glands (SLGs), and acute xerostomia in nasopharyngeal carcinoma (NPC) patients treated with induction chemotherapy (IC) plus concurrent chemoradiotherapy (CCRT). Methods The prospective study recruited 42 participants treated with IC+CCRT. All patients underwent DKI scanning six times: before IC, before RT, in the middle of the RT course, immediately after RT, and 1 and 3 months post-RT. Mean diffusion coefficient (MD) and mean kurtosis (MK) of PG, SMG, SLG, saliva flow rate measured under resting (uSFR) and stimulated condition (sSFR), and xerostomia questionnaire (XQ) scores were recorded. Results At each time point, sSFR was significantly higher than uSFR (p < 0.05 for all). MD of the salivary glands and XQ scores increased over time while MK, uSFR, and sSFR decreased. After IC, the significant differences were detected in MD and MK of bilateral SMG and MK of the left SLG (p < 0.05 for all), but not in MD and MK of PG, uSFR, sSFR, and XQ scores. After RT, sSFR at 1m-RT decreased significantly (p = 0.03) while no significant differences were detected in uSFR and XQ scores. Moderate-strong correlations were detected in ΔMD-PG-R%, ΔMK-PG-R%, ΔMD-PG-L%, ΔMK-PG-L%, ΔMD-SMG-R%, ΔMK-SMG-R%, ΔMD-SMG-L%, ΔMK-SMG-L%, and ΔMD-SLG-R%, with correlation coefficients (p < 0.05 for all) ranging from 0.401 to 0.714. ΔuSFR% was correlated with ΔMD-SMG% (p = 0.01, r = -0.39), ΔMD-SLG% (p < 0.001, r = -0.532), and ΔMK-SMG% (p < 0.001, r = -0.493). ΔsSFR% correlated with ΔMD-PG% (p = 0.001, r = -0.509), ΔMD-SMG% (p = 0.015, r = -0.221), and ΔMK-PG% (p < 0.001, r = 0.524). ΔXQ% was only correlated with ΔMK-PG% (p = 0.004, r = 0.433). Conclusion DKI is a promising tool for tracking and monitoring the acute damage of PG, SMG, and SLG induced by IC+CCRT in NPC patients.
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Affiliation(s)
- Da-Wei Zhao
- Medical School of Chinese PLA, Beijing, China
- Department of Radiology, Characteristic Medical Center of Chinese People’s Armed Police Force, Tianjin, China
- Department of Radiation Oncology, First Medical Center of PLA General Hospital, Beijing, China
| | - Xue-Mei Fang
- Department of Radiation Oncology, First Medical Center of PLA General Hospital, Beijing, China
- Department of Ultrasound, Tianjin Medical University General Hospital Airport Hospital, Tianjin, China
| | - Shu-Han Zhou
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Yan-Rong Luo
- Department of Radiation Oncology, First Medical Center of PLA General Hospital, Beijing, China
| | - Jian Wei
- Department of Otolaryngology, First Medical Center of PLA General Hospital, Beijing, China
| | - Kun Liu
- Department of Otolaryngology, First Medical Center of PLA General Hospital, Beijing, China
| | - Ling-Ling Meng
- Department of Radiation Oncology, First Medical Center of PLA General Hospital, Beijing, China
| | - Gang Liu
- Department of Radiology, First Medical Center of PLA General Hospital, Beijing, China
| | - Jin-Feng Li
- Department of Radiology, First Medical Center of PLA General Hospital, Beijing, China
| | - Xiao Zang
- Department of Radiology, First Medical Center of PLA General Hospital, Beijing, China
| | - Meng Li
- Department of Radiology, First Medical Center of PLA General Hospital, Beijing, China
| | - Xiao-Fei Qiang
- Department of Radiology, First Medical Center of PLA General Hospital, Beijing, China
- Department of Radiology, Helicopter Detachment of the Second Mobile Corps of the Armed Police, Chengdu, China
| | - Hua-Yong Jiang
- Department of Radiology, First Medical Center of PLA General Hospital, Beijing, China
- Department of Radiation Oncology, Fifth Medical Center of the PLA General Hospital, Beijing, China
| | - Wen-jun Fan
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, China
- Armed Police Forces Corps Hospital of Henan Province, Zhengzhou, China
| | - Xin-Xin Zhang
- Department of Otolaryngology, First Medical Center of PLA General Hospital, Beijing, China
| | - Lin Ma
- Department of Radiation Oncology, First Medical Center of PLA General Hospital, Beijing, China
- Department of Radiation Oncology, Fifth Medical Center of the PLA General Hospital, Beijing, China
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