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Using ultrasound sequential images processing to predict radiotherapy-induced sternocleidomastoid muscle fibrosis

Int J Radiat Biol. 2025 Feb 3:1-11. doi: 10.1080/09553002.2025.2453995. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the thickness and biomechanical parameters of the sternocleidomastoid muscle (SCM) before, during, and after radiotherapy using ultrasound elastography to predict radiotherapy-induced muscle fibrosis.

MATERIALS AND METHODS: The mean daily absorbed doses of 20 SCMs were determined. To find out the Young and shear modulus, shear wave elastography (SWE) and the B-mode sequential images processing method were implemented. In the B-mode sequential images processing method, by administering dynamic stress, the Young and shear modulus were estimated utilizing the maximum gradient and the block-matching algorithms, respectively. The imaging was done before, during the third and sixth weeks of treatment, and 3 months after radiotherapy.

RESULTS: There was a statistically significant increase in the maximum thickness during the sixth week compared to before radiotherapy (p = .043). However, this parameter did not change significantly 3 months later (p = .095). The Young modulus (p = .611) derived from SWE did not differ significantly throughout any of the weeks of radiotherapy. But Young and shear modulus increased significantly in the B-mode sequential images processing method before and during the third and sixth weeks of treatment (p = .001). The outcomes observed 3 months after radiotherapy revealed a statistically significant increase in both Young modulus (p = .029) and shear modulus (p = .004) compared to pre-radiotherapy.

CONCLUSION: The Young modulus and shear modulus are introduced as biological markers used to detect the onset of the fibrosis process during the initial radiotherapy fractions.

PMID:39899279 | DOI:10.1080/09553002.2025.2453995

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