Work

Quantitative evaluation of salivary gland structural and microvascular alterations after chemoradiotherapy in nasopharyngeal carcinoma using SWE and UMAI

Year: 2026

Type: article

Abstract: Background: This study examines the structural and microvascular effects of chemoradiotherapy (CRT) on salivary glands in patients with nasopharyngeal carcinoma using two-dimensional shear-wave elastography (2D-SWE) and subtracted ultra-microangiographic imaging vascular index (sUMAI-VI). Materials and methods: The study compared 31 patients with nasopharyngeal carcinoma (NPC) who had xerostomia after CRT with 32 healthy volunteers without a history of head and neck malignancy or CRT. The Xerostomia Questionnaire (XQ) was used to assess symptoms, and the Radiation Therapy Oncology Group (RTOG) side effect assessment was performed. Volumetric data from salivary glands were compared. Tissue stiffness and vascularity of parotid glands (PG) and submandibular glands (SMG) were assessed using new-generation ultrasonographic imaging techniques. Structural and microvascular changes in the glands were analysed using objective numerical data. Results: According to the XQ, 100% of patients had xerostomia, 83.8% had difficulty swallowing and feeding, and 41.9% had lifestyle changes in the post-CRT group. Post-CRT volumes were significantly lower in all PG and SMG regions (p < 0.001). 2D-SWE values for PG and SMG were significantly higher in patients than in controls (p < 0.001). Regarding the vascularity of PG and SMG, a significant decrease in sUMAI-VI values was observed (p ≤ 0.002). Strong positive correlations were found between the right and left PGs for both 2D-SWE and sUMAI-VI values (p < 0.001). Additionally, strong positive correlations were observed between the right and left SMGs for both 2D-SWE and sUMAI-VI values (p < 0.001). These findings support the symmetrical nature of glandular stiffness and bilateral similarity of vascular involvement. Conclusions: Structural changes and the severity of CRT-induced injury in PG and SMG in patients with NPC can be quantitatively assessed using 2D-SWE and sUMAI-VI with objective numerical data.

Source: Reports of Practical Oncology & Radiotherapy

DOI: 10.5603/rpor.113330