Quantifying fibrosis in head and neck cancer treatment: An overview

Moloney, Emma; Brunner, Markus; Alexander, Ashlin J.; Clark, Jonathan

doi:10.1002/hed.23722

Cited by 34 publications

(38 citation statements)

References 69 publications

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“…Radiation therapy-induced fibrosis is associated with expression of inflammatory cytokines (transforming growth factor [TGF]-b), which stimulate fibroblast proliferation, differentiation into fibrocytes, and collagen production. Fibrosis due to radiation therapy is a dynamic process with an apparently uncontrolled remodeling phase and increased severity over time (49,50). The extent of radiation therapyinduced fibrosis and organ atrophy may differ from one patient to another, even if identical radiation therapy treatments are used (50), and it has been suggested that genetic factors, additional chemotherapy, corticosteroid administration, and fractionation schedule may contribute to variability in individual radiosensitivity (51).…”

Section: Key Findings At Mr Dw and Pet/mr Imagingmentioning

confidence: 99%

“…Fibrosis due to radiation therapy is a dynamic process with an apparently uncontrolled remodeling phase and increased severity over time (49,50). The extent of radiation therapyinduced fibrosis and organ atrophy may differ from one patient to another, even if identical radiation therapy treatments are used (50), and it has been suggested that genetic factors, additional chemotherapy, corticosteroid administration, and fractionation schedule may contribute to variability in individual radiosensitivity (51). Combined treatment modalities (ie, radiation therapy with surgery or chemotherapy) can further lead to increased severity of fibrosis (51,52).…”

Section: Key Findings At Mr Dw and Pet/mr Imagingmentioning

confidence: 99%

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Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors

Varoquaux¹,

Rager²,

Dulguerov³

et al. 2015

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Interpreting imaging studies of the irradiated neck constitutes a challenge because of radiation therapy-induced tissue alterations, the variable appearances of recurrent tumors, and functional and metabolic phenomena that mimic disease. Therefore, morphologic magnetic resonance (MR) imaging, diffusion-weighted (DW) imaging, positron emission tomography with computed tomography (PET/CT), and software fusion of PET and MR imaging data sets are increasingly used to facilitate diagnosis in clinical practice. Because MR imaging and PET often yield complementary information, PET/MR imaging holds promise to facilitate differentiation of tumor recurrence from radiation therapy-induced changes and complications. This review focuses on clinical applications of DW and PET/MR imaging in the irradiated neck and discusses the added value of multiparametric imaging to solve diagnostic dilemmas. Radiologists should understand key features of radiation therapy-induced tissue alterations and potential complications seen at DW and PET/MR imaging, including edema, fibrosis, scar tissue, soft-tissue necrosis, bone and cartilage necrosis, cranial nerve palsy, and radiation therapy-induced arteriosclerosis, brain necrosis, and thyroid disorders. DW and PET/MR imaging also play a complementary role in detection of residual and recurrent disease. Interpretation pitfalls due to technical, functional, and metabolic phenomena should be recognized and avoided. Familiarity with DW and PET/MR imaging features of expected findings, potential complications, and treatment failure after radiation therapy increases diagnostic confidence when interpreting images of the irradiated neck. Online supplemental material is available for this article.

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Section: Key Findings At Mr Dw and Pet/mr Imagingmentioning

confidence: 99%

Section: Key Findings At Mr Dw and Pet/mr Imagingmentioning

confidence: 99%

Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors

Varoquaux¹,

Rager²,

Dulguerov³

et al. 2015

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“…For HNC, MRE might provide an alternative or complementary option for tumor differentiation and treatment response evaluation. For instance, fibrosis is a common late complication of radiotherapy for HNCs and is difficult to quantify, MRE might be used for this purpose (108). A customized external driver suitable for MRE of the head and neck has been proposed and preliminarily tested on six healthy volunteers and three patients with HNC (109).…”

Section: Mr Elastography (Mre)mentioning

confidence: 99%

Functional magnetic resonance imaging techniques and their development for radiation therapy planning and monitoring in the head and neck cancers

Yuan¹,

Lo²,

King³

2016

Quant. Imaging Med. Surg.

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Radiation therapy (RT), in particular intensity-modulated radiation therapy (IMRT), is becoming a more important nonsurgical treatment strategy in head and neck cancer (HNC). The further development of IMRT imposes more critical requirements on clinical imaging, and these requirements cannot be fully fulfilled by the existing radiotherapeutic imaging workhorse of X-ray based imaging methods. Magnetic resonance imaging (MRI) has increasingly gained more interests from radiation oncology community and holds great potential for RT applications, mainly due to its non-ionizing radiation nature and superior soft tissue image contrast. Beyond anatomical imaging, MRI provides a variety of functional imaging techniques to investigate the functionality and metabolism of living tissue. The major purpose of this paper is to give a concise and timely review of some advanced functional MRI techniques that may potentially benefit conformal, tailored and adaptive RT in the HNC. The basic principle of each functional MRI technique is briefly introduced and their use in RT of HNC is described. Limitation and future development of these functional MRI techniques for HNC radiotherapeutic applications are discussed. More rigorous studies are warranted to translate the hypotheses into credible evidences in order to establish the role of functional MRI in the clinical practice of head and neck radiation oncology.

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“…2 This can be problematic for patients 3 and may additionally impede clinical examination during follow up. 4,5 Neck ultrasound may be useful to evaluate nodal status in these patients. 6,7 Wood is a natural composite of cellulose fibers, which are strong in tension, embedded in a matrix of lignin which resists compression.…”

Section: Introductionmentioning

confidence: 98%

Woody hardness – a novel classification for the radiotherapy-treated neck

Colbert

Mitchell

Brennan

2015

British Journal of Oral and Maxillofacial Surgery

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Quantifying fibrosis in head and neck cancer treatment: An overview

Abstract: Quantitative assessment of neck fibrosis is sought after in order to compare treatment regimens and improve quality of life outcomes in patients with head and neck cancer.

Cited by 34 publications

References 69 publications

Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors

Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors

Functional magnetic resonance imaging techniques and their development for radiation therapy planning and monitoring in the head and neck cancers

Woody hardness – a novel classification for the radiotherapy-treated neck

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