Quantitative Ultrasonic Nakagami Imaging Of Neck Fibrosis After Head and Neck Radiation Therapy

Overview

Journal Int J Radiat Oncol Biol Phys

Specialties Oncology
Radiology

Date 2015 Mar 31

PMID 25817529

Citations 2

Authors

Xiaofeng Yang

Emi Yoshida

Richard J Cassidy

Jonathan J Beitler

David S Yu

Walter J Curran

Tian Liu

Affiliations

Soon will be listed here.

Abstract

Purpose: To investigate the feasibility of ultrasound Nakagami imaging to quantitatively assess radiation-induced neck fibrosis, a common sequela of radiation therapy (RT) to the head and neck.

Methods And Materials: In a pilot study, 40 study participants were enrolled and classified into 3 subgroups: (1) a control group of 12 healthy volunteers; (2) an asymptomatic group of 11 patients who had received intensity modulated RT for head and neck cancer and had experienced no neck fibrosis; and (3) a symptomatic group of 17 post-RT patients with neck fibrosis. Each study participant underwent 1 ultrasound study in which scans were performed in the longitudinal orientation of the bilateral neck. Three Nakagami parameters were calculated to quantify radiation-induced tissue injury: Nakagami probability distribution function, shape, and scaling parameters. Physician-based assessments of the neck fibrosis were performed according to the Radiation Therapy Oncology Group late morbidity scoring scheme, and patient-based fibrosis assessments were rated based on symptoms such as pain and stiffness.

Results: Major discrepancies existed between physician-based and patient-based assessments of radiation-induced fibrosis. Significant differences in all Nakagami parameters were observed between the control group and 2 post-RT groups. Moreover, significant differences in Nakagami shape and scaling parameters were observed among asymptomatic and symptomatic groups. Compared with the control group, the average Nakagami shape parameter value increased by 32.1% (P<.001), and the average Nakagami scaling parameter increased by 55.7% (P<.001) for the asymptomatic group, whereas the Nakagami shape parameter increased by 74.1% (P<.001) and the Nakagami scaling parameter increased by 83.5% (P<.001) for the symptomatic group.

Conclusions: Ultrasonic Nakagami imaging is a potential quantitative tool to characterize radiation-induced asymptomatic and symptomatic neck fibrosis.

Citing Articles

Quantitative clinical outcomes of therapy for head and neck lymphedema.

Doke K, Bowman L, Shnayder Y, Shen X, TenNapel M, Thomas S Adv Radiat Oncol. 2018; 3(3):366-371.

PMID: 30202804 PMC: 6128036. DOI: 10.1016/j.adro.2018.04.007.

Small-window parametric imaging based on information entropy for ultrasound tissue characterization.

Tsui P, Chen C, Kuo W, Chang K, Fang J, Ma H Sci Rep. 2017; 7:41004.

PMID: 28106118 PMC: 5247684. DOI: 10.1038/srep41004.

References

Leung S, Zheng Y, Choi C, Mak S, Chiu S, Zee B . Quantitative measurement of post-irradiation neck fibrosis based on the young modulus: description of a new method and clinical results. Cancer. 2002; 95(3):656-62. DOI: 10.1002/cncr.10700. View

Hojris I, Andersen J, Overgaard M, Overgaard J . Late treatment-related morbidity in breast cancer patients randomized to postmastectomy radiotherapy and systemic treatment versus systemic treatment alone. Acta Oncol. 2000; 39(3):355-72. DOI: 10.1080/028418600750013131. View

Balbir-Gurman A, Denton C, Nichols B, Knight C, Nahir A, Martin G . Non-invasive measurement of biomechanical skin properties in systemic sclerosis. Ann Rheum Dis. 2002; 61(3):237-41. PMC: 1754026. DOI: 10.1136/ard.61.3.237. View

Bentzen S, Dische S . Morbidity related to axillary irradiation in the treatment of breast cancer. Acta Oncol. 2000; 39(3):337-47. DOI: 10.1080/028418600750013113. View

Small Jr W, Woloschak G . Radiation toxicity: a practical guide. Introduction. Cancer Treat Res. 2005; 128:3-5. View

Jeraj R, Cao Y, Ten Haken R, Hahn C, Marks L . Imaging for assessment of radiation-induced normal tissue effects. Int J Radiat Oncol Biol Phys. 2010; 76(3 Suppl):S140-4. PMC: 2843154. DOI: 10.1016/j.ijrobp.2009.08.077. View

Zheng Y, Leung S, Mak A . Assessment of neck tissue fibrosis using an ultrasound palpation system: a feasibility study. Med Biol Eng Comput. 2000; 38(5):497-502. DOI: 10.1007/BF02345743. View

Dische S, Saunders M, Barrett A, Harvey A, Gibson D, Parmar M . A randomised multicentre trial of CHART versus conventional radiotherapy in head and neck cancer. Radiother Oncol. 1997; 44(2):123-36. DOI: 10.1016/s0167-8140(97)00094-7. View

Liao Y, Li C, Tsui P, Chang C, Kuo W, Chang K . Strain-compounding technique with ultrasound Nakagami imaging for distinguishing between benign and malignant breast tumors. Med Phys. 2012; 39(5):2325-33. DOI: 10.1118/1.3700167. View

10.

Bentzen S . Preventing or reducing late side effects of radiation therapy: radiobiology meets molecular pathology. Nat Rev Cancer. 2006; 6(9):702-13. DOI: 10.1038/nrc1950. View

11.

Bentzen S, Thames H, Overgaard M . Latent-time estimation for late cutaneous and subcutaneous radiation reactions in a single-follow-up clinical study. Radiother Oncol. 1989; 15(3):267-74. DOI: 10.1016/0167-8140(89)90095-9. View

12.

Bentzen S, Overgaard M, Thames H . Fractionation sensitivity of a functional endpoint: impaired shoulder movement after post-mastectomy radiotherapy. Int J Radiat Oncol Biol Phys. 1989; 17(3):531-7. DOI: 10.1016/0360-3016(89)90103-x. View

13.

Cox J, Stetz J, Pajak T . Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995; 31(5):1341-6. DOI: 10.1016/0360-3016(95)00060-C. View

14.

Johansson S, Svensson H, Denekamp J . Dose response and latency for radiation-induced fibrosis, edema, and neuropathy in breast cancer patients. Int J Radiat Oncol Biol Phys. 2002; 52(5):1207-19. DOI: 10.1016/s0360-3016(01)02743-2. View

15.

Delanian S, Lefaix J . Current management for late normal tissue injury: radiation-induced fibrosis and necrosis. Semin Radiat Oncol. 2007; 17(2):99-107. DOI: 10.1016/j.semradonc.2006.11.006. View

16.

Zhou Z, Wu S, Chang K, Chen W, Chen Y, Kuo W . Classification of Benign and Malignant Breast Tumors in Ultrasound Images with Posterior Acoustic Shadowing Using Half-Contour Features. J Med Biol Eng. 2015; 35(2):178-187. PMC: 4414937. DOI: 10.1007/s40846-015-0031-x. View

17.

Tsui P, Yeh C, Liao Y, Chang C, Kuo W, Chang K . Ultrasonic Nakagami imaging: a strategy to visualize the scatterer properties of benign and malignant breast tumors. Ultrasound Med Biol. 2009; 36(2):209-17. DOI: 10.1016/j.ultrasmedbio.2009.10.006. View

18.

Davis A, Dische S, Gerber L, Saunders M, Leung S, OSullivan B . Measuring postirradiation subcutaneous soft-tissue fibrosis: state-of-the-art and future directions. Semin Radiat Oncol. 2003; 13(3):203-13. DOI: 10.1016/S1053-4296(03)00022-5. View

19.

Wagner R, Insana M, Brown D . Statistical properties of radio-frequency and envelope-detected signals with applications to medical ultrasound. J Opt Soc Am A. 1987; 4(5):910-22. PMC: 5657192. DOI: 10.1364/josaa.4.000910. View

20.

Shankar P . Ultrasonic tissue characterization using a generalized Nakagami model. IEEE Trans Ultrason Ferroelectr Freq Control. 2002; 48(6):1716-20. DOI: 10.1109/58.971725. View