Impact of nasopharyngeal irradiation and gadolinium administration on changes in T1 signal intensity of the dentate nucleus in nasopharyngeal malignancy patients without intracranial abnormalities. Issue 1 (24th May 2019)

• Record Type: Journal Article
• Authors: Tang, Rongbiao; Haacke, E. Mark; Zhang, Yibin; Wang, Qingrou; He, Naying; Chen, Ke‐min; Yan, Fuhua
• Is Part Of: Journal of magnetic resonance imaging. Volume 51:Issue 1(2020)
• Page Start: 250
• Page End: 259
• Publication Date: 2019-05-24
• Subjects: gadolinium deposition -- irradiation -- dentate nucleus -- nasopharyngeal malignancy; Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.26800
• Languages: English
• ISSNs: 1053-1807

Abstract

Abstract : Background: Irradiation has been found to increase T1 signal intensity (SI) of the dentate nucleus (DN) by accelerating the gadolinium deposition in patients after multiple gadolinium‐based contrast agent (GBCA) administrations. Several reports have focused on this phenomenon in patients with brain tumors; however, data in patients receiving irradiation with no intracranial abnormalities (NIAs) are lacking. Purpose: To explore how nasopharyngeal irradiation affected SI changes on unenhanced T1 ‐weighted imaging (T1 WI) in the DN in nasopharyngeal malignancy (NPM) patients who presented with NIAs and who had multiple injection doses (IDs) of linear GBCAs. Study Type: Single‐center, retrospective, case–control study. Population: In all, 132 subjects: 66 NPM patients, 66 matched controls. Field Strength/Sequence: 1.5T and 3T/T1 WI, T2 WI, and fluid‐attenuated inversion recovery (FLAIR). Assessment: Radiation doses (RDs) were calculated by a radiotherapy technician. SIs were measured by a radiologist. The DN‐to‐cerebellar white matter (CWM) SI ratios and their relative percentage change (Rchange ) were compared. Statistical Tests: Shapiro–Wilk test, paired t ‐test, independent t ‐test, Mann–Whitney U ‐test, Pearson and Spearman correlation. Results: DN/CWM b ratios or R change from the NPM group were significantly higher than those from the control group ( P < 0.001). No significant difference of DN/CWM a ratios was found between the two groups ( P > 0.05). Positive correlations between R change, DN/CWM b ratio, and the number of IDs were found in both the NPM and control groups ( P < 0.01). The overall changes of DN/CWM b ratio or R change between NPM and control groups were higher for the higher‐IDs subgroup (≥10) than for the lower‐IDs subgroup (<10). Data Conclusion: Nasopharyngeal irradiation appeared to increase SI in T1 WI in NPM patients with NIAs and repeated GBCA administrations relative to control patients who also underwent GBCA administrations, especially when IDs ≥10. However, no significant association between R change and RDs to the DNs was found. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:250–259.