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  • ISSN: 2333-7095
    Early Online
    Volume 7, Issue 1
    Research Article
    Jiwoong Jason Jeong, Tian Liu, Xiaofeng Yang, Mylin Torres, Jolinta Lin, Wilson Schreiber, Ann Barry Flood, Periannan Kuppusamy, Harold M. Swartz, Benjamin B. Williams, Philip E. Schaner, and Arif Ali
    Purpose/Objectives: During radiation therapy (RT), patients often develop radiation-induced toxicities. EPR oximetry is an effective method for measuring oxygen levels. We present first-in-clinic data with sequential and repeated measurements of oxygen in normal breast tissue during and after whole breast radiotherapy.
    Materials/Methods: Nine patients undergoing RT for breast cancer were enrolled in a pilot study for EPR oximetry. Normal breast tissue of patients were injected with the EPR reporter material prior to whole breast RT. Tissue oxygenation was assessed using a clinical EPR oximeter. Patients were measured every week during RT and every 2-3 month follow-ups using EPR oximetry.
    Results: All patients, an average of 8-9 measurements was taken for a total of 73 measurements across patients. During their RT, the average baseline pO2 value across patients was 7 ± 3mmHg. When hyperoxygenation was applied, there was a statistically significant rise of 27mmHg (p = 0.005). Following completion of RT, the baseline and hyperoxygenation values were 11 ± 2mmHg and 25 ± 6 mmHg, respectively (p = 0.01). For both baseline and hyperoxygenation, no significant difference was observed between measurements taken during and after radiation therapy (p>0.1).
    Conclusions: Our preliminary data from nine patients have validated the feasibility and reproducibility of EPR oximetry to measure temporal changes in the oxygenation of normal breast tissue during and after an RT course. The results indicate that EPR oximetry may be used to in clinical trials to investigate oxygen levels and their response to potentially hyperoxygenation interventions, which could be very useful in determining the clinical efficacy of radiosensitization and the mechanism of fibrogenesis.
    Special Issue on Head and Neck Imaging
    Review Article
    Toru Chikui1*, Masahiro Ohga2, Erina Kitamoto1, Tomoko Shiraishi3, Shintaro Kawano4, Takashi Yoshiura5 and Kazunori Yoshiura1
    Abstract: Diffusion Weighted Image (DWI) has various roles such as tissue characterization, the prediction and monitoring of the response to treatment and differentiation of recurrent tumors from post-therapeutic changes. The malignant tumors have a lower ADC compared to benign lesions. Follow-up of early response to cancer treatment is reflected in an ADC increase in the primary tumor and nodal metastases; whereas nonresponding lesions tend to reveal only a slight increase or even a decrease in ADC during follow-up. However, there are many limitations regarding the performance of DWI in the head and neck region, therefore, many attempts has been performed to overcome the flaws of the diffusion-weighted single-shot-echo planar imaging.
    The pharmacokinetic analyses of dynamic contrast enhanced MRI (DCE-MRI) can provide physiological condition of the tissue, and Tofts and Kermode Model has been applied to the head and neck region. Some researchers have used it for the prediction and monitoring of the tumor response to cancer therapy. The general consensus is that the early changes of these parameters during the early phase after the treatment are useful for the interpretation of the response to the treatment. However, the parameters reported in the literature vary considerably; therefore, it is difficult to compare the values of the parameters among research groups.
    Both DWI and the pharmacokinetic analysis of the DCE-MRI have shown a wide range of potential benefits in this region, but more comparative studies with established scan techniques and the quantification of the data are required.
    Tanaka R* and Hayashi T
    Abstract: Dual Energy or dual source Computed Tomography (DECT) is advantageous for clinical CT interpretation. Compared to conventional imaging, this technique enables tissue differentiation of tissues, such as kidney stones, with higher precision and has additional features such as automatic bone-, bone marrow-, and plaque removal and virtual non-contrast image generation. Moreover, DECT can potentially remove beam hardening artifacts and generate images as good as those acquired using monoenergetic high energy. This review includes studies on DECT dentomaxillofacial imaging and discusses potential applications of DECT in dentomaxillofacial imaging, focusing on monoenergetic imaging.
    Ariji Y*, Nakayama M, Nishiyama W and Ariji E
    Abstract: Sonographic elastography is a new technique for measurement of the tissue stiffness, and is currently under investigation for tissue characterization in several anatomic sites. This article introduces methodologies of sonographic elastography, and mentions the possibility of its application to oral and maxillofacial regions.
    Sonographic elastography seems to be suboptimal for salivary gland malignancies, because there are many pathological types, and overlap between pleomorphic adenoma and malignant tumors. As to cervical lymph nodes, most studies have documented promising results of high accuracy for malignancy, although further larger studies are required to validate these findings. Therefore, sonographic elastography may become a useful ancillary technique in the routine diagnostic work-up for lymph nodes in the near future. For the masseter muscle, sonographic elastography has a possibility for exploring the causes of muscle pain, understanding the state of the muscle, selecting therapeutic methods, and evaluating therapeutic effect.s
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