Projects / Programmes
Effects of hyperbaric oxygenation on tissue with radiation injury
| Code |
Science |
Field |
Subfield |
| 3.02.00 |
Medical sciences |
Stomatology |
|
| Code |
Science |
Field |
| B725 |
Biomedical sciences |
Diagnostics |
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
postradiation injury; head and neck tumors; salivary glands; hyperbaric oxygen therapy; magnetic resonance imaging;
Researchers (15)
Organisations (2)
Abstract
Proposal abstract - summary
Radiotherapy represents a frequently applied modality for the treatment of malignant diseases in the craniocervical area. The use of radiotherapy, despite the safety issues, causes radiation injuries, which are mostly manifested by disorders in tissue microcirculation and usually result in clinically relevant hypo perfusion of tissues in the oral cavity and reduced activity of the salivary glands. Patients are prone to rapid progression of caries, bacterial or fungal infections, and tissue necrosis in the oral cavity or adjacent tissues, which all profoundly affect their quality of life.
Hyperbaric oxygenation (HBO) is one of the most promising therapies, since it is known that HBO stimulates angiogenesis of capillary network, thus resulting in an improved vascularisation of tissues injured by radiotherapy. However, its use is still not uniformly accepted. The first reason is that there is a lack of studies using highly specific and sensitive methods that could objectively evaluate the therapeutic effect during and after HBO treatment, especially in humans. Another problem is the fact that some patients do not respond favourably to HBO treatment. Currently we simply do not have enough knowledge to predict the effect of HBO treatment. Therefore, we treat patients with HBO without prior selection, which brings possible side effects without any (or too small) benefit for some patients, and poses a financial problem to the health care system.
Aim:
1) To evaluate the effectiveness of the HBO therapy in patients with craniocervical radiation injuries, by means of advanced non-invasive methods for microcirculation assessment, in particular by MRI, before, during and after HBO treatment. We wish to prepare a suitable protocol investigations and measurements, which will enable us to predict the efficacy of HBO treatment.
2) We intend to prepare specific MR imaging sequences for detection of tissue response to HBO. We are particularly interested in imaging sequences that allow monitoring of tissue responses at the soft and hard tissue interface. Sequences will be based mainly on different combinations of existing and advanced MR imaging. This will be followed by optimization of imaging parameters for monitoring patients in a clinical setting. In test experiments, we will choose MRI diagnostic indicators that are most appropriate for the qualitative and quantitative evaluation of tissue responses to HBO in radiation areas of the head and neck (salivary glands, oral cavity hard and soft tissues).
3) To compare other methods and techniques (salivary gland function monitoring, ultrasound investigation, oral and dental status, caries risk assessment, questionnaires assessing the quality of life), which are simpler and less expensive than MRI, with the developed MR techniques.
Significance for science
Relevance to the development of science or a scientific field
1. Testing of different advanced magnetic resonance imaging methods and analysis of their sensitivity and specificity will at the end result in discovery of optimal method/technique (or a combination of methods/techniques), suitable for detection of changes in tissues injured by radiotherapy.
2. Discovered new methods/techniques of MR imaging will allow quantitative assessment of structural tissue responses in radiation injuries before and after completion of HBO therapy. Detailed analysis will elucidate the possible link between the structural responses in soft and hard injured tissues in comparison to intact tissues.
3. The use of advanced MR imaging (diffusion imaging with diffusion coefficient mapping,
mapping of the relaxation times T2) will provide insight into dynamics of vascular events
and regeneration of radiation injuries during HBO therapy. Detailed analysis of the tissue regeneration dynamics will allow us to obtain a model of tissue viability.
4. We expect that such a model could have an important prognostic value for the assessment of therapeutic tissue response prior to HBO treatments. This would allow us to significantly better choose patients to be treated in a hyperbaric chamber.
Significance for the country
1. Development of diagnostic methods for non-invasive evaluation of tissue perfusion
2. Introduction and improvement of guidelines for postradiation injures treatment with hyperbaric oxigenation
Most important scientific results
Interim report,
final report
Most important socioeconomically and culturally relevant results
Interim report,
final report
