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Open Access 01-12-2019 | Magnetic Resonance Imaging | Research

Evaluation of acute esophageal radiation-induced damage using magnetic resonance imaging: a feasibility study in mice

Authors: Pouya Jelvehgaran, Jeffrey D. Steinberg, Artem Khmelinskii, Gerben Borst, Ji-Ying Song, Niels de Wit, Daniel M. de Bruin, Marcel van Herk

Published in: Radiation Oncology | Issue 1/2019

Abstract

Background

Thoracic and head and neck cancer radiation therapy (RT) can cause damage to nearby healthy organs such as the esophagus, causing acute radiation-induced esophageal damage (ARIED). A non-invasive method to detect and monitor ARIED can facilitate optimizing RT to avoid ARIED while improving local tumor control. Current clinical guidelines are limited to scoring the esophageal damage based on the symptoms of patients. Magnetic resonance imaging (MRI) is a non-invasive imaging modality that may potentially visualize radiation-induced organ damage. We investigated the feasibility of using T2-weighted MRI to detect and monitor ARIED using a two-phased study in mice.

Methods

The first phase aimed to establish the optimal dose level at which ARIED is inducible and to determine the time points where ARIED is detectable. Twenty four mice received a single dose delivery of 20 and 40 Gy at proximal and distal spots of 10.0 mm (in diameter) on the esophagus. Mice underwent MRI and histopathology analysis with esophageal resection at two, three, and 4 weeks post-irradiation, or earlier in case mice had to be euthanized due to humane endpoints. In the second phase, 32 mice received a 40 Gy single dose and were studied at two, three, and 7 days post-irradiation. We detected ARIED as a change in signal intensity of the MRI images. We measured the width of the hyperintense area around the esophagus in all mice that underwent MRI prior to and after irradiation. We conducted a blind qualitative comparison between MRI findings and histopathology as the gold standard.

Results/conclusions

A dose of 40 Gy was needed to induce substantial ARIED. MRI detected ARIED as high signal intensity, visible from 2 days post-irradiation. Quantitative MRI analysis showed that the hyperintense area around the esophagus with severe ARIED was 1.41 mm wider than with no damage and MRI-only mice. The overall sensitivity and specificity were 56 and 43% respectively to detect any form of ARIED. However, in this study MRI correctly detected 100% of severe ARIED cases. Our two-phased preclinical study showed that MRI has the potential to detect ARIED as a change in signal intensity and width of enhancement around the esophagus.

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Title: Evaluation of acute esophageal radiation-induced damage using magnetic resonance imaging: a feasibility study in mice
Authors: Pouya Jelvehgaran
Jeffrey D. Steinberg
Artem Khmelinskii
Gerben Borst
Ji-Ying Song
Niels de Wit
Daniel M. de Bruin
Marcel van Herk
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: Radiation Oncology / Issue 1/2019
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-019-1396-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Evaluation of acute esophageal radiation-induced damage using magnetic resonance imaging: a feasibility study in mice

Abstract

Background

Methods

Results/conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results/conclusions

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