Calcified carotid artery atheromas on panoramic radiographs of head and neck cancer patients before and after radiotherapy

Abstract

BackgroundThe aims of this study were to verify if head and neck radiotherapy (RT) is able to induce calcified carotid artery atheroma (CCAA) in a large head and neck cancer (HNC) population and also to compare the socio-demographic and clinical findings of patients with and without CCAA detected on panoramic radiographs.Material and MethodsPanoramic radiographs taken before and after head and neck radiotherapy (RT) of 180 HNC patients were selected and analyzed in order to identify the presence of CCAA. In addition, CCAA presence or absence on panoramic radiographs were compared and correlated with clinicopathological findings.ResultsA high overall prevalence of CCAA was found on panoramic radiographs (63 out of 180 = 35%) of HNC patients. No significant difference of CCAA before and after RT was observed. There were also no differences between groups (with and without CCAA) regarding age, gender, tobacco and alcohol use, arterial hypertension, diabetes mellitus, acute myocardial infarction, hypercholesterolemia, tumor location, clinical stage of disease and RT dose. However, there was a greater prevalence of strokes in patients with CCAA (p<0.05).ConclusionsAlthough CCAA were frequently found in panoramic radiographs of patients with HNC, RT seems not to alter the prevalence of these calcifications. Key words:Head and neck cancer, radiotherapy, carotid artery diseases, panoramic radiography.

Head and neck radiotherapy-induced changes in dentomaxillofacial structures detected on panoramic radiographs: A systematic review

“…A total of 13,261 research articles were initially found in the databases after searching for all keywords. After applying the eligibility criteria and removing overlapping studies, 13,228 investigations were excluded, and a total of 33 studies 5 , 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 on the oral and maxillofacial effects of radiotherapy, as assessed by panoramic radiographs, were included. Table 1 summarizes the details of the selected studies.…”

“…Regarding the objectives of investigations pertaining to head and neck radiotherapy, 4 studies focused on determining whether radiotherapy may induce calcified carotid artery atheroma in patients with head and neck cancer, 16 35 38 39 and 2 studies exclusively examined patients with osteoradionecrosis by imaging. 17 31 The effects on oral structures such as teeth in children survivors of head and neck rhabdomyosarcoma was the subject of 4 investigations.…”

“…The main results and conclusions pertaining to the effects of head and neck radiotherapy and the timing of panoramic assessments in each study are presented in Table 2 . In 11 studies, panoramic radiographs were performed before and after radiotherapy, 9 10 16 17 19 20 30 31 33 34 35 particularly when the primary objective of the study was to investigate the effects of radiotherapy that could be evaluated by panoramic radiographs. Distinct results and conclusions were obtained by the researchers, reflecting the aim of each investigation ( Table 2 ).…”

“… 12 18 23 27 33 40 Regarding studies where the type of radiotherapy was missing, we assumed that conventional radiotherapy had been used. 10 12 13 16 18 19 23 24 25 26 27 28 29 33 35 37 38 39 40 Nevertheless, the radiation dose was essential information that could not be deduced. The assessment results of the risk of bias are presented in Table 3 .…”

Detection of calcified atheromas on panoramic radiographs of cirrhotic patients

“…Atheromatous plaques can accumulate at the carotid artery bifurcation and can be viewed on panoramic radiographs when they are calcified 9 . This type of imaging examination proved to be capable of detecting calcified atheromas in other systemic diseases, such as HIV infection, 10 chronic renal failure (CRF), 11,12 metabolic syndrome, dilated cardiomyopathy, 13 obstructive sleep apnea 14 and type‐2 diabetes, 15 including post‐menopausal women 14 .…”