Diagnostic Accuracy of ultrasonic histogram features to evaluate radiation toxicity of the parotid glands: A clinical study of xerostomia following head-and-neck cancer radiotherapy

Academic Article


  • Rationale and Objectives: To investigate the diagnostic accuracy of ultrasound histogram features in the quantitative assessment of radiation-induced parotid gland injury and to identify potential imaging biomarkers for radiation-induced xerostomia (dry mouth)-the most common and debilitating side effect after head-and-neck radiotherapy (RT). Materials and Methods: Thirty-four patients, who have developed xerostomia after RT for head-and-neck cancer, were enrolled. Radiation-induced xerostomia was defined by the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer morbidity scale. Ultrasound scans were performed on each patient's parotids bilaterally. The 34 patients were stratified into the acute-toxicity groups (16 patients, ≤3months after treatment) and the late-toxicity group (18 patients, >3months after treatment). A separate control group of 13 healthy volunteers underwent similar ultrasound scans of their parotid glands. Six sonographic features were derived from the echo-intensity histograms to assess acute and late toxicity of the parotid glands. The quantitative assessments were compared to a radiologist's clinical evaluations. The diagnostic accuracy of these ultrasonic histogram features was evaluated with the receiver operating characteristic (ROC) curve. Results: With an area under the ROC curve greater than 0.90, several histogram features demonstrated excellent diagnostic accuracy for evaluation of acute and late toxicity of parotid glands. Significant differences (P<.05) in all six sonographic features were demonstrated between the control, acute-toxicity, and late-toxicity groups. However, subjective radiologic evaluation cannot distinguish between acute and late toxicity of parotid glands. Conclusions: We demonstrated that ultrasound histogram features could be used to measure acute and late toxicity of the parotid glands after head-and-neck cancer RT, which may be developed into a low-cost imaging method for xerostomia monitoring and assessment.
  • Published In

  • Academic Radiology  Journal
  • Digital Object Identifier (doi)

    Pubmed Id

  • 11127441
  • Author List

  • Yang X; Tridandapani S; Beitler JJ; Yu DS; Chen Z; Kim S; Bruner DW; Curran WJ; Liu T
  • Start Page

  • 1304
  • End Page

  • 1313
  • Volume

  • 21
  • Issue

  • 10