Sonographic assessment of acute changes in plaque size and echogenicity and in intima‐media thickness of carotid arteries after neck radiation therapy

Toprak, Uğur; Aytaş, İLknur; Üstüner, Evren; Habiboğlu, Rahşan; Aslan, Nalan; Paşaoğlu, Lale; Karademir, Alp

doi:10.1002/jcu.21971

Cited by 23 publications

(33 citation statements)

References 21 publications

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“…The results are consistent with the study of Fokkema et al in which they used MRI and found that radiation-induced carotid lesions were less inflammatory with more fibrosis tissue (38,39). Toprak's groups found the soft and dense present plaques turned calcified after receiving radiotherapy in head and neck cancer patients (40). Similar studies also reported that microcalcifications(41), cardiovascular calcifications (42), calcification in basal ganglia 43 Values are mean ± SEM † N = total number of subject in the corresponding analysis; n = total number of carotid plaque in the corresponding analysis P T =Comparison between total post-RT NPC subjects and CVRF subjects.…”

Section: Evaluation Of Carotid Plaque Componentsmentioning

confidence: 74%

Computer-assisted Ultrasound Assessment of Plaque Characteristics in Radiation-induced and Non-radiation-induced Carotid Atherosclerosis

Kwong

et al. 2020

Preprint

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Background Carotid atherosclerosis is common in post-radiotherapy (post-RT) patients and subjects with cardiovascular risk factors (CVRFs). The associated development of carotid plaques (CPs), particularly unstable plaques, is a major cause of cerebrovascular disease. Therefore, accurate detection and evaluation of CP characteristics is of essence. This study investigated the feasibility of using a computer-assisted method to evaluate and differentiate the CP characteristics in radiation-induced and non-radiation-induced CA. Methods 107 post-RT NPC and 110 CVRF subjects were recruited. Each participant had a carotid ultrasound examination of CPs and carotid intima-media thickness (CIMT). The carotid plaque characteristics were evaluated for grey-scale median (GSM) and detailed plaque texture analysis (DPTA) using specific computer software. In DPTA, five different intra-plaque components were color-coded according to different grey scale ranges. Multivariate regression model was used to evaluate the correlation of risk factors and carotid plaque characteristics. Results Post-RT NPC patients have significantly higher CIMT (748±15.1µm, p=0.001), more incidence of plaque formation (80.4%, p<0.001) and larger number of plaques (2.3±0.2, p<0.001) than CVRF subjects (680.4±10.0µm, 38.2% and 0.5±0.1 respectively). Among the five intra-plaque components, radiation-induced carotid plaques had significantly larger area of calcification (4.8 ±7.7%, p=0.012), but lesser area of lipid (42.1%±16.9%, p=0.034) when compared to non-radiation-induced CPs (3.0%±5.7% and 46.3%±17.9% respectively). Age, radiation and number of CVRF were significantly associated with the CA burden (p<0.001). Besides, age was significantly associated with the amount of lipid and calcification within CPs (p<0.001). Conclusions Compared to CVRF subjects, post-RT NPC patients were more susceptible to carotid plaque formation with less lipid content. Considering both CA burden and plaque component, both post-RT NPC patients and individuals with CVRF have a high risk of cerebrovascular diseases.

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Section: Evaluation Of Carotid Plaque Componentsmentioning

confidence: 74%

Computer-assisted Ultrasound Assessment of Plaque Characteristics in Radiation-induced and Non-radiation-induced Carotid Atherosclerosis

Kwong

et al. 2020

Preprint

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“…Nevertheless, in their studied population the presence of hypertension was significantly greater in the group with atheromas (60% vs. 30.4%) and all patients were evaluated before undergoing RT. Toprak et al (2012) also found that the presence of risk factors did not influence significantly IMT of carotid arteries after RT (20). …”

Section: Discussionmentioning

confidence: 99%

“…Many studies have suggested that the direct effect of RT to the carotid arteries is able to induce/accelerate atherosclerosis (16,20-22). In the current research, most of the patients with CCAA in their panoramic radiograph after RT also presented this alteration before treatment.…”

Section: Discussionmentioning

confidence: 99%

Calcified carotid artery atheromas on panoramic radiographs of head and neck cancer patients before and after radiotherapy

Markman

Kg²,

Brandão³

et al. 2017

Med Oral

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BackgroundThe aims of this study were to verify if head and neck radiotherapy (RT) is able to induce calcified carotid artery atheroma (CCAA) in a large head and neck cancer (HNC) population and also to compare the socio-demographic and clinical findings of patients with and without CCAA detected on panoramic radiographs.Material and MethodsPanoramic radiographs taken before and after head and neck radiotherapy (RT) of 180 HNC patients were selected and analyzed in order to identify the presence of CCAA. In addition, CCAA presence or absence on panoramic radiographs were compared and correlated with clinicopathological findings.ResultsA high overall prevalence of CCAA was found on panoramic radiographs (63 out of 180 = 35%) of HNC patients. No significant difference of CCAA before and after RT was observed. There were also no differences between groups (with and without CCAA) regarding age, gender, tobacco and alcohol use, arterial hypertension, diabetes mellitus, acute myocardial infarction, hypercholesterolemia, tumor location, clinical stage of disease and RT dose. However, there was a greater prevalence of strokes in patients with CCAA (p<0.05).ConclusionsAlthough CCAA were frequently found in panoramic radiographs of patients with HNC, RT seems not to alter the prevalence of these calcifications. Key words:Head and neck cancer, radiotherapy, carotid artery diseases, panoramic radiography.

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“…Toprak et al performed 50 sonographic evaluations on patients pre-and postradiation therapy. 16 They concluded that radiation caused new plaque formation and increase in the size of pre-existing plaques. 16 Cheng et al performed a prospective study on the effects of radiation on carotid stenosis.…”

Section: Discussionmentioning

confidence: 99%

“…16 They concluded that radiation caused new plaque formation and increase in the size of pre-existing plaques. 16 Cheng et al performed a prospective study on the effects of radiation on carotid stenosis. 17 They found an annual progression rate from less than 50% to 50% or greater stenosis in 14.5% of irradiated arteries compared with only 4.8% on nonirradiated arteries.…”

Section: Discussionmentioning

confidence: 99%

Validating common carotid stenosis by duplex ultrasound with carotid angiogram or computed tomography scan

Matos

Barshes

McCoy

et al. 2014

Journal of Vascular Surgery

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Sonographic assessment of acute changes in plaque size and echogenicity and in intima‐media thickness of carotid arteries after neck radiation therapy

Abstract: Radiation in the acute phase not only increases the IMT but also causes new plaque formation and changes in plaque size and echogenicity.

Cited by 23 publications

References 21 publications

Computer-assisted Ultrasound Assessment of Plaque Characteristics in Radiation-induced and Non-radiation-induced Carotid Atherosclerosis

Computer-assisted Ultrasound Assessment of Plaque Characteristics in Radiation-induced and Non-radiation-induced Carotid Atherosclerosis

Calcified carotid artery atheromas on panoramic radiographs of head and neck cancer patients before and after radiotherapy

Validating common carotid stenosis by duplex ultrasound with carotid angiogram or computed tomography scan

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