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Texture analysis as a predictor of radiation-induced xerostomia in head and neck patients undergoing IMRT

Authors :
Roberta Grassi
Luigi Pirtoli
Pierpaolo Pastina
Paolo Tini
Lucio Sebaste
Maria Antonietta Mazzei
Giuseppe Battaglia
Tommaso Carfagno
Christophe Nioche
Valerio Nardone
Nardone, Valerio
Tini, Paolo
Nioche, Christophe
Mazzei, Maria Antonietta
Carfagno, Tommaso
Battaglia, Giuseppe
Pastina, Pierpaolo
Grassi, Roberta
Sebaste, Lucio
Pirtoli, Luigi
Publication Year :
2018

Abstract

Purpose: Image texture analysis (TA) is a heterogeneity quantifying approach that cannot be appreciated by the naked eye, and early evidence suggests that TA has great potential in the field of oncology. The aim of this study is to evaluate parotid gland texture analysis (TA) combined with formal dosimetry as a factor for predicting severe late xerostomia in patients undergoing radiation therapy for head and neck cancers. Methods: We performed a retrospective analysis of patients treated at our Radiation Oncology Unit between January 2010 and December 2015, and selected the patients whose normal dose constraints for the parotid gland (mean dose < 26 Gy for the bilateral gland) could not be satisfied due to the presence of positive nodes close to the parotid glands. The parotid gland that showed the higher V30 was contoured on CT simulation and analysed with LifeX Software©. TA parameters included features of grey-level co-occurrence matrix (GLCM), neighbourhood grey-level dependence matrix (NGLDM), grey-level run length matrix (GLRLM), grey-level zone length matrix (GLZLM), sphericity, and indices from the grey-level histogram. We performed a univariate and multivariate analysis between all the texture parameters, the volume of the gland, the normal dose parameters (V30 and Mean Dose), and the development of severe chronic xerostomia. Results: Seventy-eight patients were included and 25 (31%) developed chronic xerostomia. The TA parameters correlated with severe chronic xerostomia included V30 (OR 5.63), Dmean (OR 5.71), Kurtosis (OR 0.78), GLCM Correlation (OR 1.34), and RLNU (OR 2.12). The multivariate logistic regression showed a significant correlation between V30 (0.001), GLCM correlation (p: 0.026), RLNU (p: 0.011), and chronic xerostomia (p < 0.001, R2:0.664). Conclusions: Xerostomia represents an important cause of morbidity for head and neck cancer survivors after radiation therapy, and in certain cases normal dose constraints cannot be satisfied. Our results seem promising as texture analysis could enhance the normal dose constraints for the prediction of xerostomia. © 2018 Italian Society of Medical Radiology

Details

Language :
English
Database :
OpenAIRE
Accession number :
edsair.doi.dedup.....83c4129feee0dcfc567150fca76660cc