Evaluation of Salivary Gland Function Using Diffusion-Weighted Magnetic Resonance Imaging for Follow-Up of Radiation-Induced Xerostomia.
10.3348/kjr.2018.19.4.758
- Author:
Yunyan ZHANG
1
;
Dan OU
;
Yajia GU
;
Xiayun HE
;
Weijun PENG
Author Information
1. Department of Radiology, Shanghai Proton and Heavy Ion Center, Shanghai 201321, China.
- Publication Type:Original Article
- Keywords:
Salivary glands;
Diffusion-weighted imaging;
Magnetic resonance;
Xerostomia;
Radiotherapy;
Head and neck cancer;
Functional imaging
- MeSH:
Diffusion;
Follow-Up Studies*;
Head and Neck Neoplasms;
Humans;
Magnetic Resonance Imaging*;
Multivariate Analysis;
Odds Ratio;
Parotid Gland;
Radiotherapy;
Salivary Glands*;
Submandibular Gland;
Xerostomia*
- From:Korean Journal of Radiology
2018;19(4):758-766
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate the value of diffusion-weighted magnetic resonance imaging (DW-MRI) as a noninvasive tool to assess salivary gland function for follow-up of patients with radiation-induced xerostomia. MATERIALS AND METHODS: This study included 23 patients with nasopharyngeal carcinoma who had been treated with parotid-sparing radiotherapy (RT). Salivary function was assessed by DW-MRI pre-treatment and one week and one year post-RT, respectively. The maximum apparent diffusion coefficient (ADC) of parotid glands (pADCmax) and the time to peak ADC of parotid glands (pTmax) during stimulation were obtained. Multivariate analysis was used to analyze factors correlated with the severity of radiation-induced xerostomia. RESULTS: The ADCs of parotid and submandibular glands (1.26 ± 0.10 × 10−3 mm2/s and 1.32 ± 0.07 × 10−3 mm2/s pre-RT, respectively) both showed an increase in all patients at one week post-RT (1.75 ± 0.16 × 10−3 mm2/s, p < 0.001 and 1.70 ± 0.16 × 10−3 mm2/s, p < 0.001, respectively), followed by a decrease in parotid glands at one year post-RT(1.57 ± 0.15 × 10−3 mm2/s, p < 0.001) but not in submandibular glands (1.69 ± 0.18 × 10−3 mm2/s, p = 0.581). An improvement in xerostomia was found in 13 patients at one year post-RT. Multivariate analysis revealed 4 significant predictors for the improvement of xerostomia, including dose to parotid glands (p = 0.009, odds ratio [OR] = 0.639), the ADC of submandibular glands (p = 0.013, OR = 3.295), pADCmax (p = 0.024, OR = 0.474), and pTmax (p = 0.017, OR = 0.729) at one week post-RT. CONCLUSION: The ADC value is a sensitive indicator for salivary gland dysfunction. DW-MRI is potentially useful for noninvasively predicting the severity of radiation-induced xerostomia.
