Gözde Mütevelizade, Bilal Çağrı Bozdemir, Nazım Aydın, Ahmet Furkan Süner, Ömür Karakoyun Çelik, Yasemin Parlak, Ecem Çorlu, Özgür Yıldırım, Mustafa Kahya, Gizem Bakıcıerler, Gül Gümüşer, Elvan Sayıt
{"title":"Radiation-induced Xerostomia: Evaluation with <sup>18</sup>F-FDG PET/CT.","authors":"Gözde Mütevelizade, Bilal Çağrı Bozdemir, Nazım Aydın, Ahmet Furkan Süner, Ömür Karakoyun Çelik, Yasemin Parlak, Ecem Çorlu, Özgür Yıldırım, Mustafa Kahya, Gizem Bakıcıerler, Gül Gümüşer, Elvan Sayıt","doi":"10.4274/mirt.galenos.2025.04696","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relationship between radiation dose, metabolic changes in the salivary glands assessed by <sup>18</sup>F-fluorodeoxyglucose positron emission tomography/computed tomography (<sup>18</sup>F-FDG PET/CT), and xerostomia severity in patients with head and neck cancer following radiotherapy (RT).</p><p><strong>Methods: </strong>We retrospectively analyzed 107 patients treated with intensity-modulated RT or volumetric modulated arc therapy for head and neck malignancies. Clinical xerostomia severity was evaluated at the time of post-treatment PET/CT. Mean gland doses and dose-volume parameters (V10-V50) were extracted from treatment plans. Metabolic changes were evaluated by <sup>Δ</sup>maximum standardized uptake value and <sup>Δ</sup>mean standardized uptake value between pre and post treatment PET/CT scans. The relationships between clinical, dosimetric, and metabolic variables were examined.</p><p><strong>Results: </strong>Moderate-to-severe xerostomia occurred in 63.6% of patients. Both higher T and N stage were significantly associated with greater xerostomia severity (p<0.05). Patients with nodal metastases on pretreatment PET/CT demonstrated a higher prevalence of xerostomia. Dose-volume parameters (V10-V30 for parotids, V50 for submandibular glands) were significantly correlated with symptom severity. <sup>Δ</sup>SUV values were significantly associated with both mean dose and dose-volume parameters, particularly in the left parotid gland, where patients receiving >30 Gy showed markedly greater metabolic decline. Parotid glands demonstrated stronger dose-dependent metabolic changes compared with submandibular glands, consistent with their higher radiosensitivity.</p><p><strong>Conclusion: </strong>Despite the use of advanced RT techniques, xerostomia remains a frequent toxicity. <sup>18</sup>F-FDG PET/CT reliably captured dose-dependent salivary gland impairment and reflected the impact of tumor burden on toxicity risk. These findings underscore the complementary role of PET-derived biomarkers as integrative tools for predicting salivary dysfunction beyond conventional dosimetric parameters.</p>","PeriodicalId":44681,"journal":{"name":"Molecular Imaging and Radionuclide Therapy","volume":"34 3","pages":"213-220"},"PeriodicalIF":1.1000,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505182/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Molecular Imaging and Radionuclide Therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4274/mirt.galenos.2025.04696","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: To investigate the relationship between radiation dose, metabolic changes in the salivary glands assessed by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), and xerostomia severity in patients with head and neck cancer following radiotherapy (RT).
Methods: We retrospectively analyzed 107 patients treated with intensity-modulated RT or volumetric modulated arc therapy for head and neck malignancies. Clinical xerostomia severity was evaluated at the time of post-treatment PET/CT. Mean gland doses and dose-volume parameters (V10-V50) were extracted from treatment plans. Metabolic changes were evaluated by Δmaximum standardized uptake value and Δmean standardized uptake value between pre and post treatment PET/CT scans. The relationships between clinical, dosimetric, and metabolic variables were examined.
Results: Moderate-to-severe xerostomia occurred in 63.6% of patients. Both higher T and N stage were significantly associated with greater xerostomia severity (p<0.05). Patients with nodal metastases on pretreatment PET/CT demonstrated a higher prevalence of xerostomia. Dose-volume parameters (V10-V30 for parotids, V50 for submandibular glands) were significantly correlated with symptom severity. ΔSUV values were significantly associated with both mean dose and dose-volume parameters, particularly in the left parotid gland, where patients receiving >30 Gy showed markedly greater metabolic decline. Parotid glands demonstrated stronger dose-dependent metabolic changes compared with submandibular glands, consistent with their higher radiosensitivity.
Conclusion: Despite the use of advanced RT techniques, xerostomia remains a frequent toxicity. 18F-FDG PET/CT reliably captured dose-dependent salivary gland impairment and reflected the impact of tumor burden on toxicity risk. These findings underscore the complementary role of PET-derived biomarkers as integrative tools for predicting salivary dysfunction beyond conventional dosimetric parameters.
期刊介绍：
Molecular Imaging and Radionuclide Therapy (Mol Imaging Radionucl Ther, MIRT) is publishes original research articles, invited reviews, editorials, short communications, letters, consensus statements, guidelines and case reports with a literature review on the topic, in the field of molecular imaging, multimodality imaging, nuclear medicine, radionuclide therapy, radiopharmacy, medical physics, dosimetry and radiobiology.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
