Computed tomography perfusion assessment of radiation therapy effects on spinal cord hemodynamics

Int J Radiat Oncol Biol Phys. 2010 Jul 1;77(3):851-7. doi: 10.1016/j.ijrobp.2009.05.060. Epub 2009 Dec 16.

Abstract

Purpose: We used computed tomography (CT) perfusion to evaluate the acute and late effect of radiation therapy (RT) on spinal cord (SC) hemodynamics in patients without symptoms of myelopathy. We hypothesized that SC perfusion could be acutely altered during RT.

Methods and materials: We analyzed neck CT perfusion studies of 36 head-and-neck cancer patients (N1), 16 of whom had previously undergone RT. In a separate group of 6 patients (N2), CT perfusion studies were obtained before RT, after 40 Gy, and after treatment completion.

Results: In the N1 group, SC blood flow (BF), blood volume (BV), mean transit time (MTT), and capillary permeability (CP) maps were not significantly different between RT-treated and RT-naive patients. In the N2 group, BF and CP were significantly increased during treatment compared with the baseline and post-RT studies.

Conclusions: Radiation therapy of the head and neck may cause transient perturbations of SC perfusion that seem to reverse after treatment. There are no definite chronic effects of RT on SC perfusion observeable at the typical doses administered during treatment of head and neck malignancies.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Flow Velocity / physiology
  • Blood Flow Velocity / radiation effects
  • Blood Volume / physiology
  • Blood Volume / radiation effects
  • Capillary Permeability / physiology
  • Capillary Permeability / radiation effects
  • Female
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Regional Blood Flow / physiology
  • Regional Blood Flow / radiation effects
  • Spinal Cord / blood supply*
  • Spinal Cord / radiation effects*
  • Tomography, X-Ray Computed / methods*