Faculty Collaboration Database

Early Prediction of Acute Xerostomia During Radiation Therapy for Head and Neck Cancer Based on Texture Analysis of Daily CT. Int J Radiat Oncol Biol Phys 2018 Nov 15;102(4):1308-1318

Date

06/13/2018

Pubmed ID

29891201

DOI

10.1016/j.ijrobp.2018.04.059

Scopus ID

2-s2.0-85048541509 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

PURPOSE: To investigate radiation-induced changes of computed tomography (CT) textures in parotid glands (PG) to predict acute xerostomia during radiotherapy (RT) for head and neck cancer (HNC).

METHODS AND MATERIALS: Daily or fraction kilovoltage CTs acquired using diagnostic CT scanners (eg, in-room CTs) during intensity-modulated RT for 59 HNC patients at 3 institutions were analyzed. The PG contours were generated on selected daily/fraction CTs. A series of histogram-based texture features, including the mean CT number (MCTN) in Hounsfield units, volume, standard deviation, skewness, kurtosis, and entropy for PGs were calculated for each fraction. Correlations between the changes of the texture features, radiation dose, and observed acute xerostomia were analyzed. A classifier model and the incurred CT-based xerostomia score (CTXS) were introduced to predict xerostomia based on combined changes of MCTN and volume of PGs. The t test and Spearman and Pearson correlation tests were used in the analyses.

RESULTS: Substantial changes in various CT texture features of PGs were observed during RT delivery. The changes of PG MCTN or volume are not strongly correlated with the observed xerostomia grades if they are considered separately. The CTXS showed a significant correlation to the observed xerostomia grades (r = 0.71, P < .00001). The CTXS-based classifier can predict the xerostomia severity with a success rate ranging from 79% to 98%. The xerostomia severity at the end of treatment can be predicted based on the CTXS determined at the fifth week with a precision and sensitivity of 100%.

CONCLUSION: Significant changes in the CT histogram features of the parotid glands were observed during RT of HNC. A practical method of using the changes of MCTN and volume of PGs is proposed to predict radiation-induced acute xerostomia, which may be used to help design adaptive treatment.

Author List

Wu H, Chen X, Yang X, Tao Y, Xia Y, Deng X, Zheng C, Robbins J, Schultz C, Li XA

Authors

Xiaojian Chen PhD Assistant Professor in the Radiation Oncology department at Medical College of Wisconsin
Christopher J. Schultz MD Chair, Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adult
Aged
Aged, 80 and over
Female
Head and Neck Neoplasms
Humans
Male
Middle Aged
Parotid Gland
Radiation Injuries
Radiotherapy Dosage
Radiotherapy, Intensity-Modulated
Tomography, X-Ray Computed
Xerostomia