The irradiated human mandible: A quantitative study on bone vascularity
•Irradiation decreases mandibular vascular density and vascular number.•In local dosages exceeding 50 Gy, the proportion of smaller vessels decreases.•With increased time after radiotherapy, the proportion of smaller vessels decreases. Hypovascularisation is thought to play an important role in the...
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| Veröffentlicht in: | Oral oncology 2018-12, Vol.87, p.126-130 |
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| creator | Dekker, H. Bravenboer, N. van Dijk, D. Bloemena, E. Rietveld, D.H.F. ten Bruggenkate, Chr.M. Schulten, E.A.J.M. |
| description | •Irradiation decreases mandibular vascular density and vascular number.•In local dosages exceeding 50 Gy, the proportion of smaller vessels decreases.•With increased time after radiotherapy, the proportion of smaller vessels decreases.
Hypovascularisation is thought to play an important role in the pathogenesis of osteoradionecrosis. The objective of this study was to assess the microvascular system in the irradiated mandibular bone marrow.
Mandibular bone biopsies were taken from 20 irradiated patients and 24 controls. Blood vessels were visualized using CD34 antibody stain to detect endothelial cells. The vascular density (VD) and vascular area fraction (VAF) were measured. Mean vessel lumen area, perimeter and diameter of the vessels were calculated for each vessel. A distinction was made between large and small vessels (cut-off point |
| doi_str_mv | 10.1016/j.oraloncology.2018.10.030 |
| format | Article |
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Hypovascularisation is thought to play an important role in the pathogenesis of osteoradionecrosis. The objective of this study was to assess the microvascular system in the irradiated mandibular bone marrow.
Mandibular bone biopsies were taken from 20 irradiated patients and 24 controls. Blood vessels were visualized using CD34 antibody stain to detect endothelial cells. The vascular density (VD) and vascular area fraction (VAF) were measured. Mean vessel lumen area, perimeter and diameter of the vessels were calculated for each vessel. A distinction was made between large and small vessels (cut-off point <400 µm2).
Vascular density and vascular area fraction were lower in the irradiated group. The mean vascular perimeter and mean vascular diameter were higher in samples with a local radiation dose of ≥50 Gy, whereas the percentage of small vessels was lower. Larger vessel perimeter is associated with higher radiation dose. A longer interval between biopsy and radiotherapy is associated with a larger mean vessel perimeter and a lower percentage of small vessels.
Radiation dosages higher than 50 Gy mainly affect the smaller vessels. With increased time after irradiation, the share of smaller vessels in the mandibular bone marrow seems to decrease. In search of the exact mechanisms of irradiation damage and osteoradionecrosis of the mandible, the role of the microvascular system in the mandibular bone marrow should be further explored.</description><identifier>ISSN: 1368-8375</identifier><identifier>EISSN: 1879-0593</identifier><identifier>DOI: 10.1016/j.oraloncology.2018.10.030</identifier><identifier>PMID: 30527227</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Biopsy ; Bone Marrow - blood supply ; Bone Marrow - pathology ; Bone Marrow - radiation effects ; Case-Control Studies ; Dose-Response Relationship, Radiation ; Female ; Head and Neck Neoplasms - radiotherapy ; Humans ; Male ; Mandible ; Mandible - blood supply ; Mandible - pathology ; Mandible - radiation effects ; Mandibular Osteotomy ; Microvascular network ; Microvasculature ; Microvessel ; Middle Aged ; Oral cancer ; Osteoradionecrosis ; Osteoradionecrosis - etiology ; Osteoradionecrosis - pathology ; Osteoradionecrosis - surgery ; Radiation Dosage ; Radiotherapy ; Radiotherapy, Intensity-Modulated - adverse effects ; Time Factors</subject><ispartof>Oral oncology, 2018-12, Vol.87, p.126-130</ispartof><rights>2018 The Authors</rights><rights>Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c432t-2fc2a7c4f20a4cd191df0f420240e11c707f4e37d13db5af64bb50c492d9cc73</citedby><cites>FETCH-LOGICAL-c432t-2fc2a7c4f20a4cd191df0f420240e11c707f4e37d13db5af64bb50c492d9cc73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1368837518303981$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30527227$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dekker, H.</creatorcontrib><creatorcontrib>Bravenboer, N.</creatorcontrib><creatorcontrib>van Dijk, D.</creatorcontrib><creatorcontrib>Bloemena, E.</creatorcontrib><creatorcontrib>Rietveld, D.H.F.</creatorcontrib><creatorcontrib>ten Bruggenkate, Chr.M.</creatorcontrib><creatorcontrib>Schulten, E.A.J.M.</creatorcontrib><title>The irradiated human mandible: A quantitative study on bone vascularity</title><title>Oral oncology</title><addtitle>Oral Oncol</addtitle><description>•Irradiation decreases mandibular vascular density and vascular number.•In local dosages exceeding 50 Gy, the proportion of smaller vessels decreases.•With increased time after radiotherapy, the proportion of smaller vessels decreases.
Hypovascularisation is thought to play an important role in the pathogenesis of osteoradionecrosis. The objective of this study was to assess the microvascular system in the irradiated mandibular bone marrow.
Mandibular bone biopsies were taken from 20 irradiated patients and 24 controls. Blood vessels were visualized using CD34 antibody stain to detect endothelial cells. The vascular density (VD) and vascular area fraction (VAF) were measured. Mean vessel lumen area, perimeter and diameter of the vessels were calculated for each vessel. A distinction was made between large and small vessels (cut-off point <400 µm2).
Vascular density and vascular area fraction were lower in the irradiated group. The mean vascular perimeter and mean vascular diameter were higher in samples with a local radiation dose of ≥50 Gy, whereas the percentage of small vessels was lower. Larger vessel perimeter is associated with higher radiation dose. A longer interval between biopsy and radiotherapy is associated with a larger mean vessel perimeter and a lower percentage of small vessels.
Radiation dosages higher than 50 Gy mainly affect the smaller vessels. With increased time after irradiation, the share of smaller vessels in the mandibular bone marrow seems to decrease. In search of the exact mechanisms of irradiation damage and osteoradionecrosis of the mandible, the role of the microvascular system in the mandibular bone marrow should be further explored.</description><subject>Adult</subject><subject>Aged</subject><subject>Biopsy</subject><subject>Bone Marrow - blood supply</subject><subject>Bone Marrow - pathology</subject><subject>Bone Marrow - radiation effects</subject><subject>Case-Control Studies</subject><subject>Dose-Response Relationship, Radiation</subject><subject>Female</subject><subject>Head and Neck Neoplasms - radiotherapy</subject><subject>Humans</subject><subject>Male</subject><subject>Mandible</subject><subject>Mandible - blood supply</subject><subject>Mandible - pathology</subject><subject>Mandible - radiation effects</subject><subject>Mandibular Osteotomy</subject><subject>Microvascular network</subject><subject>Microvasculature</subject><subject>Microvessel</subject><subject>Middle Aged</subject><subject>Oral cancer</subject><subject>Osteoradionecrosis</subject><subject>Osteoradionecrosis - etiology</subject><subject>Osteoradionecrosis - pathology</subject><subject>Osteoradionecrosis - surgery</subject><subject>Radiation Dosage</subject><subject>Radiotherapy</subject><subject>Radiotherapy, Intensity-Modulated - adverse effects</subject><subject>Time Factors</subject><issn>1368-8375</issn><issn>1879-0593</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1LxDAQhoMofv8FCZ68dJ0kbdN6E79hwcveQ5pMNUu30SRd2H9vllXx6GGYgXnfeZmHkEsGMwasvl7OfNCDH40f_NtmxoE1eTEDAXvkmDWyLaBqxX6eRd0UjZDVETmJcQkAFavgkBwJqLjkXB6Tp8U7UheCtk4ntPR9WumR5rKuG_CG3tLPSY_JJZ3cGmlMk91QP9LOj0jXOppp0MGlzRk56PUQ8fy7n5LF48Pi7rmYvz693N3OC1MKngreG66lKXsOujSWtcz20JcceAnImJEg-xKFtEzYrtJ9XXZdBaZsuW2NkeKUXO3OfgT_OWFMauWiwWHQI_opKs6q_GJd8yZLb3ZSE3yMAXv1EdxKh41ioLYc1VL95ai2HLe7zDGbL75zpm6F9tf6Ay4L7ncCzM-uHQYVjcPRoHUBTVLWu__kfAH9RovA</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Dekker, H.</creator><creator>Bravenboer, N.</creator><creator>van Dijk, D.</creator><creator>Bloemena, E.</creator><creator>Rietveld, D.H.F.</creator><creator>ten Bruggenkate, Chr.M.</creator><creator>Schulten, E.A.J.M.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201812</creationdate><title>The irradiated human mandible: A quantitative study on bone vascularity</title><author>Dekker, H. ; Bravenboer, N. ; van Dijk, D. ; Bloemena, E. ; Rietveld, D.H.F. ; ten Bruggenkate, Chr.M. ; Schulten, E.A.J.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c432t-2fc2a7c4f20a4cd191df0f420240e11c707f4e37d13db5af64bb50c492d9cc73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biopsy</topic><topic>Bone Marrow - blood supply</topic><topic>Bone Marrow - pathology</topic><topic>Bone Marrow - radiation effects</topic><topic>Case-Control Studies</topic><topic>Dose-Response Relationship, Radiation</topic><topic>Female</topic><topic>Head and Neck Neoplasms - radiotherapy</topic><topic>Humans</topic><topic>Male</topic><topic>Mandible</topic><topic>Mandible - blood supply</topic><topic>Mandible - pathology</topic><topic>Mandible - radiation effects</topic><topic>Mandibular Osteotomy</topic><topic>Microvascular network</topic><topic>Microvasculature</topic><topic>Microvessel</topic><topic>Middle Aged</topic><topic>Oral cancer</topic><topic>Osteoradionecrosis</topic><topic>Osteoradionecrosis - etiology</topic><topic>Osteoradionecrosis - pathology</topic><topic>Osteoradionecrosis - surgery</topic><topic>Radiation Dosage</topic><topic>Radiotherapy</topic><topic>Radiotherapy, Intensity-Modulated - adverse effects</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dekker, H.</creatorcontrib><creatorcontrib>Bravenboer, N.</creatorcontrib><creatorcontrib>van Dijk, D.</creatorcontrib><creatorcontrib>Bloemena, E.</creatorcontrib><creatorcontrib>Rietveld, D.H.F.</creatorcontrib><creatorcontrib>ten Bruggenkate, Chr.M.</creatorcontrib><creatorcontrib>Schulten, E.A.J.M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Oral oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dekker, H.</au><au>Bravenboer, N.</au><au>van Dijk, D.</au><au>Bloemena, E.</au><au>Rietveld, D.H.F.</au><au>ten Bruggenkate, Chr.M.</au><au>Schulten, E.A.J.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The irradiated human mandible: A quantitative study on bone vascularity</atitle><jtitle>Oral oncology</jtitle><addtitle>Oral Oncol</addtitle><date>2018-12</date><risdate>2018</risdate><volume>87</volume><spage>126</spage><epage>130</epage><pages>126-130</pages><issn>1368-8375</issn><eissn>1879-0593</eissn><abstract>•Irradiation decreases mandibular vascular density and vascular number.•In local dosages exceeding 50 Gy, the proportion of smaller vessels decreases.•With increased time after radiotherapy, the proportion of smaller vessels decreases.
Hypovascularisation is thought to play an important role in the pathogenesis of osteoradionecrosis. The objective of this study was to assess the microvascular system in the irradiated mandibular bone marrow.
Mandibular bone biopsies were taken from 20 irradiated patients and 24 controls. Blood vessels were visualized using CD34 antibody stain to detect endothelial cells. The vascular density (VD) and vascular area fraction (VAF) were measured. Mean vessel lumen area, perimeter and diameter of the vessels were calculated for each vessel. A distinction was made between large and small vessels (cut-off point <400 µm2).
Vascular density and vascular area fraction were lower in the irradiated group. The mean vascular perimeter and mean vascular diameter were higher in samples with a local radiation dose of ≥50 Gy, whereas the percentage of small vessels was lower. Larger vessel perimeter is associated with higher radiation dose. A longer interval between biopsy and radiotherapy is associated with a larger mean vessel perimeter and a lower percentage of small vessels.
Radiation dosages higher than 50 Gy mainly affect the smaller vessels. With increased time after irradiation, the share of smaller vessels in the mandibular bone marrow seems to decrease. In search of the exact mechanisms of irradiation damage and osteoradionecrosis of the mandible, the role of the microvascular system in the mandibular bone marrow should be further explored.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30527227</pmid><doi>10.1016/j.oraloncology.2018.10.030</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Biopsy Bone Marrow - blood supply Bone Marrow - pathology Bone Marrow - radiation effects Case-Control Studies Dose-Response Relationship, Radiation Female Head and Neck Neoplasms - radiotherapy Humans Male Mandible Mandible - blood supply Mandible - pathology Mandible - radiation effects Mandibular Osteotomy Microvascular network Microvasculature Microvessel Middle Aged Oral cancer Osteoradionecrosis Osteoradionecrosis - etiology Osteoradionecrosis - pathology Osteoradionecrosis - surgery Radiation Dosage Radiotherapy Radiotherapy, Intensity-Modulated - adverse effects Time Factors |
| title | The irradiated human mandible: A quantitative study on bone vascularity |
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