Korean J Radiol.  2018 Apr;19(2):328-333. 10.3348/kjr.2018.19.2.328.

Early Changes in Apparent Diffusion Coefficient for Salivary Glands during Radiotherapy for Nasopharyngeal Carcinoma Associated with Xerostomia

• Zhang Q
• Wei YM
• Qi YG
• Li BS

• KMID: 2404930
• DOI: http://doi.org/10.3348/kjr.2018.19.2.328

Abstract

OBJECTIVE
To evaluate the early changes in the apparent diffusion coefficient (ADC) of the salivary glands during radiotherapy (RT) and their association with the degree of xerostomia at 6 months after RT in patients with nasopharyngeal carcinoma (NPC).
MATERIALS AND METHODS
We enrolled 26 patients with NPC who underwent RT. Each patient underwent diffusion-weighted MRI of the salivary glands at rest and with gustatory stimulation within 1 week before RT and 2 weeks after the beginning of RT. The ADC at rest (ADCR) and increase and increase rate with stimulation (ADCI, ADCIR) of the submandibular and parotid glands were calculated. The differences in the variables' values between 2 weeks after the beginning of RT and baseline (ΔADCR, ΔADCI, and ΔADCIR) were compared to the degree of xerostomia at 6 months after RT.
RESULTS
The ADCR of the submandibular and parotid glands were both significantly higher at 2 weeks after the beginning of RT than found at baseline (both p < 0.01). The ADCI and ADCIR for the parotid glands were both significantly lower at 2 weeks after the beginning of RT than found at baseline (both p < 0.01). ΔADCI and ΔADCIR of the parotid glands were associated with the degree of xerostomia at 6 months after RT (r = −0.61 and −0.72, both p < 0.01).
CONCLUSION
The ADCs of the salivary glands change early during RT. The differences in the ADC increase and increase rate of the parotid glands between 2 weeks after the beginning of RT and baseline were associated with the degree of xerostomia at 6 months after RT.

Keyword

Diffusion-weighted imaging; MR imaging; Parotid gland; Dry mouth; Nasopharyngeal carcinoma; Head and neck; Radiation-induced complication; Quality of life

MeSH Terms

Diffusion*
Humans
Magnetic Resonance Imaging
Parotid Gland
Quality of Life
Radiotherapy*
Salivary Glands*
Xerostomia*

Figure

• 

  Fig. 1 Measurement of ADC of salivary glands.T2WI image (A) and corresponding ADC map (B) for 60-year-old male patient with nasopharyngeal carcinoma before radiotherapy. After placing ROI in manner that enclosed as much of gland parenchyma as possible in reference to T2WI, ROI was automatically copied to corresponding ADC map for further analysis. ADC = apparent diffusion coefficient, ROI = region of interest, T2WI = T2-weighted imaging

• 

  Fig. 2 ADC maps of parotid glands of 53-year-old male patient with nasopharyngeal carcinoma before (A) and during (B) RT.Mean ADC of parotid glands at rest was 0.89 × 10−3 mm2/s before RT and increased to 1.24 × 10−3 mm2/s during RT. RT = radiotherapy

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