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Correlation of Mucositis During Head and Neck Radiotherapy With Computed Tomography Perfusion Imaging of the Oropharyngeal Mucosa

Saito, Naoko MD, PhD; Truong, Minh Tam MD; Qureshi, Muhammad M. MB, BS; Lee, Richard J. MD; Wang, Jimmy W. MD; Ozonoff, Al PhD; Sakai, Osamu MD, PhD

Journal of Computer Assisted Tomography: July/August 2013 - Volume 37 - Issue 4 - p 499–504
doi: 10.1097/RCT.0b013e31828aed3f

Objective The objective of this study was to correlate changes in computed tomography perfusion (CTP) parameters in the oropharyngeal mucosa following start of radiotherapy (RT) with acute mucositis in head and neck cancer patients.

Methods Fifteen patients were prospectively evaluated with serial CTP imaging. Computed tomography perfusion studies were obtained before RT; at weeks 2, 4, and 6 during RT; and 6 weeks after completion of RT.

Results At week 2 during RT, mean transition time increased to 13.9% and 261.8% in patients with and without mucositis, respectively (P = 0.024). At week 6 of RT, patients with grade 3 mucositis had a 325.4% increase in blood flow compared with a 58.3% increase in patients with grade 0–2 mucositis (P = 0.039). Mean transition time decreased by 29.9% and increased by 187.4% in patients with grade 3 and grade 0–2 mucositis, respectively (P = 0.025).

Conclusions Mean transition time and blood flow changes in the oropharyngeal mucosa correlated with the incidence and severity of RT-related mucositis.

From the Departments of *Radiology and †Radiation Oncology, Boston Medical Center and Boston University School of Medicine; and ‡Department of Biostatistics, Boston University School of Public Health, Boston, MA.

Received for publication September 14, 2012; accepted January 31, 2013.

Dr Saito is now with the Department of Radiology, Saitama International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan. Dr Ozonoff is now with the Children’s Hospital Boston, Clinical Research Program, Boston, MA.

Reprints: Minh Tam Truong, MD, Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, 830 Harrison Ave, Moakley Bldg LL 238, Boston, MA 02118 (e-mail:

This study was supported by an American Cancer Society institutional grant (IRG-72-001-32-IRG; principal investigator: Dr Truong).

None of the authors have conflict of interest to disclose.

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