Background: The sixth most prevalent cancer in the world is head and neck squamous cell carcinoma (HNSCC). In multiple combinations, surgery, radiation and chemotherapy are used in HNC control. As radiation-induced sa...Background: The sixth most prevalent cancer in the world is head and neck squamous cell carcinoma (HNSCC). In multiple combinations, surgery, radiation and chemotherapy are used in HNC control. As radiation-induced salivary gland damage and xerostomia is one of the most usual and distressing impacts,?diffusion-weighted magnetic resonance imaging (DW-MRI) is a promising technique for the assessment of alterations due to radiation therapy.?The aim of the study is?to evaluate the effect of Chemoradiotherapy either concurrent or sequential/RTH on salivary glands using DW-MRI performed before and after chemoradiotherapy/RTH,?correlation between DW-MRI changes?and delivered radiation dose to salivary glands,?study the acute toxicity of chemoradiotherapy/RTH on salivary glands and assess quality of life for patients with radiation-induced xerostomia.?Patients and Methods: This prospective study included 43 patients with Head and Neck squamous cell carcinoma treated with definitive radiotherapy, sequential therapy or concurrent chemoradiotherapy at Clinical Oncology and Nuclear Medicine Department, MRI diffusion scans were done at Diagnostic Radiology Department Tanta University Hospitals throughout the period from May 2016 to May 2019.?DW-MRI performed before and after RTH. For patients receiving CCRTH, DW sequence will be performed before starting RTH and 2?-?3 months post-RTH once at rest and then repeated continuously during salivary stimulation by ascorbic acid. In case of induction chemotherapy, DW-MRI was done before and after induction and 2?-?3 months post-RTH.?Results:?In all time periods, ADC values were lower for the PG than the SMG.?ADC change of PGs was higher in hypopharyngeal carcinoma, while ADC change of SMGs?were?higher in oropharyngeal carcinoma.?ADC change in PGs & SMGs was higher in advanced stage.?Conclusion:?To assess the radiation-induced xerostomia, DW-MRI can be used as non-invasive tool. Xerostomia questionnaire is helpful instrument for evaluating of quality of life for patients with radiatio展开更多
In this study, we established a Wistar rat model of right middle cerebral artery occlusion and observed pathological imaging changes （T2-weighted imaging [T2WI], T2FLAIR, and diffusion-weighted imaging [DWI]） follow...In this study, we established a Wistar rat model of right middle cerebral artery occlusion and observed pathological imaging changes （T2-weighted imaging [T2WI], T2FLAIR, and diffusion-weighted imaging [DWI]） following cerebral infarction. The pathological changes were divided into three phases： early cerebral infarction, middle cerebral infarction, and late cerebral infarction. In the early cerebral infarction phase （less than 2 hours post-infarction）, there was evidence of intracellular edema, which improved after reperfusion. This improvement was defined as the ischemic penumbra. In this phase, a high DWI signal and a low apparent diffusion coefficient were observed in the right basal ganglia region. By contrast, there were no abnormal T2WI and T2FLAIR signals. For the middle cerebral infarction phase （2-4 hours post-infarction）, a mixed edema was observed. After reperfusion, there was a mild improvement in cell edema, while the angioedema became more serious. A high DWI signal and a low apparent diffusion coefficient signal were observed, and some rats showed high T2WI and T2FLAIR signals. For the late cerebral infarction phase （4-6 hours post-infarction）, significant angioedema was visible in the infarction site. After reperfusion, there was a significant increase in angioedema, while there was evidence of hemorrhage and necrosis. A mixed signal was observed on DWI, while a high apparent diffusion coefficient signal, a high T2WI signal, and a high T2FLAIR signal were also observed. All 86 cerebral infarction patients were subjected to T2WI, T2FLAIR, and DWI. MRI results of clinic data similar to the early infarction phase of animal experiments were found in 51 patients, for which 10 patients （10/51） had an onset time greater than 6 hours. A total of 35 patients had MRI results similar to the middle and late infarction phase of animal experiments, of which eight patients （8/35） had an onset time less than 6 hours. These data suggest that defining the ＂therapeutic time window＂ as 展开更多
文摘Background: The sixth most prevalent cancer in the world is head and neck squamous cell carcinoma (HNSCC). In multiple combinations, surgery, radiation and chemotherapy are used in HNC control. As radiation-induced salivary gland damage and xerostomia is one of the most usual and distressing impacts,?diffusion-weighted magnetic resonance imaging (DW-MRI) is a promising technique for the assessment of alterations due to radiation therapy.?The aim of the study is?to evaluate the effect of Chemoradiotherapy either concurrent or sequential/RTH on salivary glands using DW-MRI performed before and after chemoradiotherapy/RTH,?correlation between DW-MRI changes?and delivered radiation dose to salivary glands,?study the acute toxicity of chemoradiotherapy/RTH on salivary glands and assess quality of life for patients with radiation-induced xerostomia.?Patients and Methods: This prospective study included 43 patients with Head and Neck squamous cell carcinoma treated with definitive radiotherapy, sequential therapy or concurrent chemoradiotherapy at Clinical Oncology and Nuclear Medicine Department, MRI diffusion scans were done at Diagnostic Radiology Department Tanta University Hospitals throughout the period from May 2016 to May 2019.?DW-MRI performed before and after RTH. For patients receiving CCRTH, DW sequence will be performed before starting RTH and 2?-?3 months post-RTH once at rest and then repeated continuously during salivary stimulation by ascorbic acid. In case of induction chemotherapy, DW-MRI was done before and after induction and 2?-?3 months post-RTH.?Results:?In all time periods, ADC values were lower for the PG than the SMG.?ADC change of PGs was higher in hypopharyngeal carcinoma, while ADC change of SMGs?were?higher in oropharyngeal carcinoma.?ADC change in PGs & SMGs was higher in advanced stage.?Conclusion:?To assess the radiation-induced xerostomia, DW-MRI can be used as non-invasive tool. Xerostomia questionnaire is helpful instrument for evaluating of quality of life for patients with radiatio
基金supported by the National Natural Science Foundation of China,No.30960399,and No.81160181
文摘In this study, we established a Wistar rat model of right middle cerebral artery occlusion and observed pathological imaging changes （T2-weighted imaging [T2WI], T2FLAIR, and diffusion-weighted imaging [DWI]） following cerebral infarction. The pathological changes were divided into three phases： early cerebral infarction, middle cerebral infarction, and late cerebral infarction. In the early cerebral infarction phase （less than 2 hours post-infarction）, there was evidence of intracellular edema, which improved after reperfusion. This improvement was defined as the ischemic penumbra. In this phase, a high DWI signal and a low apparent diffusion coefficient were observed in the right basal ganglia region. By contrast, there were no abnormal T2WI and T2FLAIR signals. For the middle cerebral infarction phase （2-4 hours post-infarction）, a mixed edema was observed. After reperfusion, there was a mild improvement in cell edema, while the angioedema became more serious. A high DWI signal and a low apparent diffusion coefficient signal were observed, and some rats showed high T2WI and T2FLAIR signals. For the late cerebral infarction phase （4-6 hours post-infarction）, significant angioedema was visible in the infarction site. After reperfusion, there was a significant increase in angioedema, while there was evidence of hemorrhage and necrosis. A mixed signal was observed on DWI, while a high apparent diffusion coefficient signal, a high T2WI signal, and a high T2FLAIR signal were also observed. All 86 cerebral infarction patients were subjected to T2WI, T2FLAIR, and DWI. MRI results of clinic data similar to the early infarction phase of animal experiments were found in 51 patients, for which 10 patients （10/51） had an onset time greater than 6 hours. A total of 35 patients had MRI results similar to the middle and late infarction phase of animal experiments, of which eight patients （8/35） had an onset time less than 6 hours. These data suggest that defining the ＂therapeutic time window＂ as
