Quantitative Evaluation of Fibrotic Change in the Irradiated Muscle of Head and Neck Cancer Patients Using Ultrasonography

• Main Authors: Jhe-Yuan Guo, 郭哲源
• Other Authors: Win-Li Lin
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/33txak

碩士 === 國立臺灣大學 === 醫學工程學研究所 === 105 === Background： 　　The patients with head and neck cancers generally receive radiation treatment. Radiation-induced toxicity could lead to long-term progressive sequelae, such as trismus, dysphagia, muscle sclerosis, restriction of motion range and atrophy. These patients need long-term follow-ups routinely with palpation and/or ultrasonography, which are all subjective and qualitative diagnosis. Objective and quantitative analysis is helpful for doctors to study clinical manifestations, optimize treatment strategies, and predict the prognosis after radiation treatment. Ultrasound is used to demonstrate muscle structure owing to high spatial resolution. In recent years, shear wave elastography which generated by ultrasound impulse was applied in muscle structure analysis. Material and methods： 　　In this study, 19 males and 8 females of age between 25 to 65 years old were involved, and they received 66 to 70 Gy radiation dose during treatment. We acquired B-mode ultrasonography and measured the velocities of shear wave during one year follow-ups. Frangi filter and Fuzzy c-means clustering algorithm were applied to segment fibrotic tissue from the B-mode images of sternocleidomastoid muscle (SCM). The ratio of fiber to muscle was calculated to quantify fibrosis of muscle. Results： 　　The methods in this study extracted fibrotic tissue from low-contrast region. Fiber increment of SCM increased significantly at 3 months after radiotherapy (RT). Correlation between the fiber increment at 3 months after RT and the area decrement of SCM at one year after RT is positive(r = 0.3571, p-value<0.05), and there is a significant trend (r = 0.6024, p-value <0.05) for the patients older than 50 years. The results showed that radiation-induced muscle fibrosis increased at 3 months after RT, but it declined at one year after RT. Conclusion： 　　The proposed methods quantified the radiation-induced fibrosis of SCM. There was a correlation between the fiber increment of SCM at 3 months after RT and the area decrement of SCM at one year after RT. They may support clinical doctors to analyze the radiation fibrosis syndrome and may be used to evaluate the treatment plan for rehabilitation.