Pilot study using technetium-99m pertechnetate sequential radionuclide-sialography to assess salivary gland function in nasopharyngeal cancer patients on radiation therapy

Nasopharyngeal carcinoma (NPC) is mainly treated by radiation therapy. A common complication of radiotherapy is xerostomia. Direct measurements of the amount of saliva produced using suction cups and volumetric assessments are cumbersome and time-consuming. Sequential radionuclide sialography is a r...

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Veröffentlicht in:Annals of the Academy of Medicine, Singapore Singapore, 2003-07, Vol.32 (4), p.455-460
Hauptverfasser: Ng, K S, Sundram, F X, Tan, H S, Somanesan, S, Chung, B, Gao, F, Machin, D
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container_issue 4
container_start_page 455
container_title Annals of the Academy of Medicine, Singapore
container_volume 32
creator Ng, K S
Sundram, F X
Tan, H S
Somanesan, S
Chung, B
Gao, F
Machin, D
description Nasopharyngeal carcinoma (NPC) is mainly treated by radiation therapy. A common complication of radiotherapy is xerostomia. Direct measurements of the amount of saliva produced using suction cups and volumetric assessments are cumbersome and time-consuming. Sequential radionuclide sialography is a reproducible and convenient method of measuring salivary function. Patients with newly diagnosed NPC underwent a pilot study using technetium-99m pertechnetate sequential radionuclide sialography to assess their salivary function before and at 3 months post radiation therapy. From the sialography, time activity curves were obtained for analysis of salivary function. The shape of the time activity curve with citric acid stimulation was classified into 4 types according to the degree of radiation-induced dysfunction. All 14 patients had worse (P < 0.005) time activity curves for both parotids and submandibular glands after radiation therapy. All patients with abnormal curves before radiation therapy presented type IV (non-functioning) curve after radiation therapy. A ratio of pre- and post-stimulation counts allowed for quantification of the degree of stimulatory response. We found a significant decrease in Rc before and after radiation therapy for all salivary glands (P < 0.001). The salivary gland to background ratio, which is a reflection of the degree of salivary gland functional uptake, also had a significant reduction after radiation. It is feasible to use technetium-99m pertechnetate in the measurement of salivary gland function in nasopharyngeal cancer patients treated with radiation therapy.
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All patients with abnormal curves before radiation therapy presented type IV (non-functioning) curve after radiation therapy. A ratio of pre- and post-stimulation counts allowed for quantification of the degree of stimulatory response. We found a significant decrease in Rc before and after radiation therapy for all salivary glands (P &lt; 0.001). The salivary gland to background ratio, which is a reflection of the degree of salivary gland functional uptake, also had a significant reduction after radiation. 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A common complication of radiotherapy is xerostomia. Direct measurements of the amount of saliva produced using suction cups and volumetric assessments are cumbersome and time-consuming. Sequential radionuclide sialography is a reproducible and convenient method of measuring salivary function. Patients with newly diagnosed NPC underwent a pilot study using technetium-99m pertechnetate sequential radionuclide sialography to assess their salivary function before and at 3 months post radiation therapy. From the sialography, time activity curves were obtained for analysis of salivary function. The shape of the time activity curve with citric acid stimulation was classified into 4 types according to the degree of radiation-induced dysfunction. All 14 patients had worse (P &lt; 0.005) time activity curves for both parotids and submandibular glands after radiation therapy. 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subjects Adult
Aged
Feasibility Studies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Monitoring, Physiologic - methods
Nasopharyngeal Neoplasms - diagnosis
Nasopharyngeal Neoplasms - radiotherapy
Pilot Projects
Probability
Radionuclide Imaging
Radiotherapy Dosage
Risk Assessment
Salivary Glands - diagnostic imaging
Salivary Glands - physiology
Sensitivity and Specificity
Sialography - methods
Sodium Pertechnetate Tc 99m
Treatment Outcome
Xerostomia - diagnostic imaging
Xerostomia - prevention & control
title Pilot study using technetium-99m pertechnetate sequential radionuclide-sialography to assess salivary gland function in nasopharyngeal cancer patients on radiation therapy
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