Perfusion characteristics of late radiation injury of parotid glands: quantitative evaluation with dynamic contrast-enhanced MRI

Eur Radiol. 2009 Jan;19(1):94-102. doi: 10.1007/s00330-008-1104-9. Epub 2008 Jul 26.

Abstract

We aimed to quantitatively investigate the alteration of parotid perfusion after irradiation using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) based on a two-compartment tracer kinetic model. This study enrolled 19 patients (53.2 +/- 14.9 years) treated by head and neck radiotherapy and 19 age-relevant and sex-matched subjects as a control group. Perfusion parameters (K ( el ), k (21) and A) of parotid glands were analyzed based on the Brix model from T1-weighted DCE-MRI. Suitability of the Brix model was evaluated via Monte Carlo simulation for the goodness-of-fit. Analysis of nonlinear goodness-of-fit showed that the Brix model is appropriate in evaluating the parotid perfusion (R(2) = 0.938 +/- 0.050). The irradiated parotid glands showed significantly lower K ( el ) (P < 0.0005) and k (21) (P < 0.05) and consequently significantly higher value of peak enhancement (P < 0.0005) and time-to-peak (P < 0.0005) compared with non-irradiated ones, suggestive of gradual and prolonged accumulation and delayed wash-out of contrast agent due to increased extracellular extravascular space and decreased vascular permeability in the irradiated glands. Linear regression analysis showed dose-dependent perfusion changes of the irradiated parotid glands. We conclude that quantitative DCE-MRI is a potential tool in investigating parotid gland perfusion changes after radiotherapy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Contrast Media
  • Female
  • Gadolinium DTPA*
  • Head and Neck Neoplasms / diagnostic imaging*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Parotid Gland / blood supply
  • Parotid Gland / injuries*
  • Parotid Gland / pathology*
  • Radiation Injuries / diagnosis*
  • Radiation Injuries / etiology*
  • Radiography
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Xerostomia / diagnosis*
  • Xerostomia / etiology*
  • Young Adult

Substances

  • Contrast Media
  • Gadolinium DTPA