Noninvasive diffuse optical monitoring of head and neck tumor blood flow and oxygenation during radiation delivery.
Noninvasive diffuse optical monitoring of head and neck tumor blood flow and oxygenation during radiation delivery.
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DOI：
10.1364/boe.3.000259
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发表时间：
2012-02-01
影响因子：
3.4
通讯作者：
Yu G
中科院分区：
文献类型：
--
作者：
Dong L;Kudrimoti M;Cheng R;Shang Y;Johnson EL;Stevens SD;Shelton BJ;Yu G
本研究探索使用新型扩散相关光谱（DCS）血氧计来无创监测放射治疗过程中头颈部肿瘤的血流和氧合变化。将连接至 DCS 血氧计的光纤探针放置在放射学/临床涉及的颈部淋巴结的表面上。治疗室的 DCS 血氧仪由控制室的计算机远程操作。从早期的测量来看，当光学装置靠近辐射束放置时，观察到异常信号。通过模型测试，这些伪影被证明是由散射的 X 射线引起的，因此可以通过将光学设备移离 X 射线束来避免这些伪影。在七周的治疗期内，对 11 名头颈部肿瘤患者进行了每周一次的持续测量，尽管由于患者相关事件导致一些数据缺失。在放射治疗期间观察到肿瘤血流动力学反应的患者间存在较大差异。治疗第一周观察到肿瘤血流量显着增加，这可能是对辐射耗氧造成的缺氧的生理反应。在肿瘤血氧中只发现了微小且不显着的变化，这表明在短期的分段放射治疗期间，肿瘤中的氧气利用率要么很小，要么被血流调节等其他效应所平衡。需要对大量患者进行进一步研究，将个体血流动力学反应与临床结果关联起来，以确定光学测量的预后价值。
This study explored using a novel diffuse correlation spectroscopy (DCS) flow-oximeter to noninvasively monitor blood flow and oxygenation changes in head and neck tumors during radiation delivery. A fiber-optic probe connected to the DCS flow-oximeter was placed on the surface of the radiologically/clinically involved cervical lymph node. The DCS flow-oximeter in the treatment room was remotely operated by a computer in the control room. From the early measurements, abnormal signals were observed when the optical device was placed in close proximity to the radiation beams. Through phantom tests, the artifacts were shown to be caused by scattered x rays and consequentially avoided by moving the optical device away from the x-ray beams. Eleven patients with head and neck tumors were continually measured once a week over a treatment period of seven weeks, although there were some missing data due to the patient related events. Large inter-patient variations in tumor hemodynamic responses were observed during radiation delivery. A significant increase in tumor blood flow was observed at the first week of treatment, which may be a physiologic response to hypoxia created by radiation oxygen consumption. Only small and insignificant changes were found in tumor blood oxygenation, suggesting that oxygen utilizations in tumors during the short period of fractional radiation deliveries were either minimal or balanced by other effects such as blood flow regulation. Further investigations in a large patient population are needed to correlate the individual hemodynamic responses with the clinical outcomes for determining the prognostic value of optical measurements.