Longitudinal assessment of carotid atherosclerosis after Radiation Therapy using Computed Tomography: A case control Study

Objectives To study the carotid artery plaque composition and its volume changes in a group of patients at baseline and 2 years after head and neck radiation therapy treatment (HNXRT). Methods In this retrospective study, 62 patients (41 males; mean age 63 years; range 52–81) who underwent HNXRT and 40 patients (24 males; mean age 65) who underwent surgical resection of neoplasm and did not undergo HNXRT were assessed, with 2-year follow-up. The carotid artery plaque volumes, as well as the volume of the sub-components (fatty-mixed-calcified), were semiautomatically quantified. Mann-Whitney and Wilcoxon tests were used to test the hypothesis. Results In the HNXRT group, there was a statistically significant increase in the total volume of the carotid artery plaques (from 533 to 746 mm 3 ; p = 0.001), in the fatty plaques (103 vs. 202 mm 3 ; p = 0.001) and mixed plaque component volume (328 vs. 419 mm 3 ; p = 0.034). A statistically significant variation (from 21.8 % to 27.6 %) in the percentage of the fatty tissue was found. Conclusions Results of this preliminary study suggest that HNXRT promotes increased carotid artery plaque volume, particularly the fatty plaque component. Key Points • HNXRT increases carotid plaque volume . • Plaque volume increase is mainly due to increase.in fatty plaque component • Patients who undergo HNXRT have a progression of carotid artery disease .