title: Magnetic resonance imaging of the carotid artery in long-term head and neck cancer survivors treated with radiotherapy.
abstract: BACKGROUND
  In head and neck cancer (HNC) patients, long-term treatment-related complications include radiotherapy (RT)-induced carotid vasculopathy and stroke. The current study investigated the magnetic resonance imaging (MRI) characteristics of the carotid wall in long-term HNC survivors treated with RT.
  
  
  METHODS
  MRI of the carotid arteries was performed within a prospective cohort of 42 HNC patients on average 7 years after RT. Two independent radiologists assessed maximal vessel wall thickness of common and internal carotid arteries. In case of wall thickening (≥ 2 mm) the MRI signals as well as length of the thickened segment were assessed.
  
  
  RESULTS
  Mean (SD) age of the 42 patients at baseline was 53 (13) years and mean (SD) follow-up time after RT was 6.8 (1.3) years. In total 62% were men and 60% had one or more cerebrovascular risk factors. Mean (SD) dose of RT on the common carotid arteries and internal carotid arteries was 57 Gy (11) and 61 Gy (10), respectively. Wall thickening was observed in 58% of irradiated versus 27% of non-irradiated common carotid arteries and 24% of irradiated versus 6% of non-irradiated internal carotid arteries (p < 0.05). Mean (SD) thickness of the irradiated and non-irradiated common carotid arteries was 2.5 (0.9) and 2 (0.7) mm (p = 0.02). Mean thickness of the irradiated and non-irradiated internal carotid arteries was 1.8 (0.8) and 1.5 mm (0.3) (n.s.). Mean length of the thickened vessel wall was 48 mm versus 36 mm in the irradiated versus non-irradiated common carotid arteries (p = 0.03) and 20 mm versus 15 mm in the irradiated versus non-irradiated internal carotid arteries (n.s.). No significant differences were observed for signal intensities of the vessel walls.
  
  
  CONCLUSIONS
  Our study showed significantly more vessel wall thickening in irradiated versus non-irradiated carotid arteries years after RT for HNC, while no differences in signal intensities were observed.
authors.affiliation: a Department of Neurology , Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behaviour Centre for Neuroscience , Nijmegen , The Netherlands.
authors.forename: Joyce
authors.initials: J
authors.lastname: Wilbers
authors.forename: Frederick J A
authors.initials: FJ
authors.lastname: Meijer
authors.forename: Arnoud C
authors.initials: AC
authors.lastname: Kappelle
authors.forename: Johannes H
authors.initials: JH
authors.lastname: Kaanders
authors.forename: Willem
authors.initials: W
authors.lastname: Boogerd
authors.forename: Lucille D
authors.initials: LD
authors.lastname: Dorresteijn
authors.forename: Ewoud J
authors.initials: EJ
authors.lastname: van Dijk
authors.forename: Stefan C A
authors.initials: SC
authors.lastname: Steens
mesh_terms: D002339:Carotid Arteries / Q000473:pathology* / Q000528:radiation effects*; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000473:pathology*; D017741:Survivors