Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal Cancer
The aim of this single-center, observational, retrospective study was to investigate magnetic resonance imaging (MRI) biomarkers for the assessment of radiotherapy (RT)-induced xerostomia. Twenty-seven patients who underwent radiation therapy for oropharyngeal cancer were divided into three groups a...
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| Format: | Article |
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MDPI AG
2023-01-01
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| Online Access: | https://www.mdpi.com/2076-3417/13/2/810 |
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| author | Leonardo Calamandrei Luca Mariotti Eleonora Bicci Linda Calistri Eleonora Barcali Martina Orlandi Nicholas Landini Francesco Mungai Luigi Bonasera Pierluigi Bonomo Isacco Desideri Leonardo Bocchi Cosimo Nardi |
| author_facet | Leonardo Calamandrei Luca Mariotti Eleonora Bicci Linda Calistri Eleonora Barcali Martina Orlandi Nicholas Landini Francesco Mungai Luigi Bonasera Pierluigi Bonomo Isacco Desideri Leonardo Bocchi Cosimo Nardi |
| author_sort | Leonardo Calamandrei |
| collection | DOAJ |
| description | The aim of this single-center, observational, retrospective study was to investigate magnetic resonance imaging (MRI) biomarkers for the assessment of radiotherapy (RT)-induced xerostomia. Twenty-seven patients who underwent radiation therapy for oropharyngeal cancer were divided into three groups according to the severity of their xerostomia—mild, moderate, and severe—clinically confirmed with the Common Terminology Criteria for Adverse Events (CTCAE). No severe xerostomia was found. Conventional and functional MRI (perfusion- and diffusion- weighted imaging) performed both pre- and post-RT were studied for signal intensity, mean apparent diffusion coefficient (ADC) values, k-trans, and area under the perfusion curves. Contrast-enhanced T1 images and ADC maps were imported into 3D slicer software, and salivary gland volumes were segmented. A total of 107 texture features were derived. T-Student and Wilcoxon signed-rank tests were performed on functional MRI parameters and texture analysis features to identify the differences between pre- and post-RT populations. A <i>p</i>-value < 0.01 was defined as acceptable. Receiver operating characteristic (ROC) curves were plotted for significant parameters to discriminate the severity of xerostomia in the pre-RT population. Conventional and functional MRI did not yield statistically significant results; on the contrary, five texture features showed significant variation between pre- and post-RT on the ADC maps, of which only informational measure of correlation 1 (IMC 1) was able to discriminate the severity of RT-induced xerostomia in the pre-RT population (area under the curve (AUC) > 0.7). Values lower than the cut-off of −1.473 × 10<sup>−11</sup> were associated with moderate xerostomia, enabling the differentiation of mild xerostomia from moderate xerostomia with a 73% sensitivity, 75% specificity, and 75% diagnostic accuracy. Therefore, the texture feature IMC 1 on the ADC maps allowed the distinction between different degrees of severity of RT-induced xerostomia in the pre-RT population. Accordingly, texture analysis on ADC maps should be considered a useful tool to evaluate salivary gland radiosensitivity and help identify patients at risk of developing more serious xerostomia before radiation therapy is administered. |
| first_indexed | 2024-03-09T13:45:06Z |
| format | Article |
| id | doaj.art-4ceefafd00bb4bc5af35262201aa0712 |
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| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-09T13:45:06Z |
| publishDate | 2023-01-01 |
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| spelling | doaj.art-4ceefafd00bb4bc5af35262201aa07122023-11-30T21:01:47ZengMDPI AGApplied Sciences2076-34172023-01-0113281010.3390/app13020810Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal CancerLeonardo Calamandrei0Luca Mariotti1Eleonora Bicci2Linda Calistri3Eleonora Barcali4Martina Orlandi5Nicholas Landini6Francesco Mungai7Luigi Bonasera8Pierluigi Bonomo9Isacco Desideri10Leonardo Bocchi11Cosimo Nardi12Radiodiagnostic Unit n.2, Department of Experimental and Clinical Biomedical Sciences, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, ItalyRadiodiagnostic Unit n.2, Department of Experimental and Clinical Biomedical Sciences, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, ItalyRadiodiagnostic Unit n.2, Department of Experimental and Clinical Biomedical Sciences, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, ItalyRadiodiagnostic Unit n.2, Department of Experimental and Clinical Biomedical Sciences, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, ItalyDepartment of Information Engineering, University of Florence, Via S. Marta, 3, 50139 Florence, ItalyRheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, 50134 Florence, ItalyDepartment of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University, 00185 Rome, ItalyDepartment of Radiology, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, ItalyDepartment of Radiology, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, ItalyRadiation Oncology, University of Florence-Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, ItalyRadiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134 Florence, ItalyDepartment of Information Engineering, University of Florence, Via S. Marta, 3, 50139 Florence, ItalyRadiodiagnostic Unit n.2, Department of Experimental and Clinical Biomedical Sciences, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, ItalyThe aim of this single-center, observational, retrospective study was to investigate magnetic resonance imaging (MRI) biomarkers for the assessment of radiotherapy (RT)-induced xerostomia. Twenty-seven patients who underwent radiation therapy for oropharyngeal cancer were divided into three groups according to the severity of their xerostomia—mild, moderate, and severe—clinically confirmed with the Common Terminology Criteria for Adverse Events (CTCAE). No severe xerostomia was found. Conventional and functional MRI (perfusion- and diffusion- weighted imaging) performed both pre- and post-RT were studied for signal intensity, mean apparent diffusion coefficient (ADC) values, k-trans, and area under the perfusion curves. Contrast-enhanced T1 images and ADC maps were imported into 3D slicer software, and salivary gland volumes were segmented. A total of 107 texture features were derived. T-Student and Wilcoxon signed-rank tests were performed on functional MRI parameters and texture analysis features to identify the differences between pre- and post-RT populations. A <i>p</i>-value < 0.01 was defined as acceptable. Receiver operating characteristic (ROC) curves were plotted for significant parameters to discriminate the severity of xerostomia in the pre-RT population. Conventional and functional MRI did not yield statistically significant results; on the contrary, five texture features showed significant variation between pre- and post-RT on the ADC maps, of which only informational measure of correlation 1 (IMC 1) was able to discriminate the severity of RT-induced xerostomia in the pre-RT population (area under the curve (AUC) > 0.7). Values lower than the cut-off of −1.473 × 10<sup>−11</sup> were associated with moderate xerostomia, enabling the differentiation of mild xerostomia from moderate xerostomia with a 73% sensitivity, 75% specificity, and 75% diagnostic accuracy. Therefore, the texture feature IMC 1 on the ADC maps allowed the distinction between different degrees of severity of RT-induced xerostomia in the pre-RT population. Accordingly, texture analysis on ADC maps should be considered a useful tool to evaluate salivary gland radiosensitivity and help identify patients at risk of developing more serious xerostomia before radiation therapy is administered.https://www.mdpi.com/2076-3417/13/2/810xerostomiamagnetic resonance imagingtexture analysisradiomicshead and neck |
| spellingShingle | Leonardo Calamandrei Luca Mariotti Eleonora Bicci Linda Calistri Eleonora Barcali Martina Orlandi Nicholas Landini Francesco Mungai Luigi Bonasera Pierluigi Bonomo Isacco Desideri Leonardo Bocchi Cosimo Nardi Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal Cancer Applied Sciences xerostomia magnetic resonance imaging texture analysis radiomics head and neck |
| title | Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal Cancer |
| title_full | Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal Cancer |
| title_fullStr | Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal Cancer |
| title_full_unstemmed | Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal Cancer |
| title_short | Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal Cancer |
| title_sort | morphological functional and texture analysis magnetic resonance imaging features in the assessment of radiotherapy induced xerostomia in oropharyngeal cancer |
| topic | xerostomia magnetic resonance imaging texture analysis radiomics head and neck |
| url | https://www.mdpi.com/2076-3417/13/2/810 |
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