Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Oncology Letters
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-1074 Online ISSN: 1792-1082
Journal Cover
April-2024 Volume 27 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
April-2024 Volume 27 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML

  • Supplementary Files
    • Supplementary_Data.pdf
Article Open Access

Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy

  • Authors:
    • Xianhai Zhang
    • Zhifeng Xu
    • Yabin Jin
    • Linwen Huang
    • Wenxiu Wu
    • Mingyong Gao
  • View Affiliations / Copyright

    Affiliations: Department of Radiology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China, Clinical Research Center, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China
    Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 180
    |
    Published online on: February 28, 2024
       https://doi.org/10.3892/ol.2024.14313
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

The present study aimed to investigate the value of intravoxel incoherent motion imaging (IVIM) and three‑dimensional pulsed continuous arterial spin labeling (ASL) in assessing dynamic changes of the parotid gland in patients with nasopharyngeal carcinoma (NPC) following radiotherapy (RT). A total of 18 patients with NPC who underwent intensity‑modulated RT were enrolled in the present study. All patients underwent conventional magnetic resonance imaging, plus IVIM and ASL imaging of the bilateral parotid glands within 2 weeks prior to RT, and 1 week (1W) and 3 months (3M) following RT. Pure diffusion coefficient (D), pseudo‑diffusion coefficient (D*), perfusion fraction (F) and blood flow (BF) were analyzed. D and BF values were significantly increased from pre‑RT to 1W post‑RT [change rate: Median (IQR), ΔD1W%: 39.28% (38.23%) and ΔBF1W%: 60.84% (54.88%)] and continued to increase from 1W post‑RT to 3M post‑RT [55.44% (40.56%) and ΔBF%: 120.39% (128.74%)]. In addition, the F value was significantly increased from pre‑RT to 1W post‑RT, [change rate: Median (IQR), ΔF1W%: 28.13% (44.66%)], and this decreased significantly from 1W post‑RT to 3M post‑RT. However, no significant differences were observed between pre‑RT and 3M post‑RT. Results of the present study also demonstrated that the D* value was significantly decreased from pre‑RT to 1W post‑RT and 3M post‑RT [change rate: Median (IQR), ΔD*1w%: ‑41.86% (51.71%) and ΔD*3M: ‑29.11% (42.67%)]. No significant difference was observed between the different time intervals post‑RT. There was a significant positive correlation between percentage change in ΔBF1W and radiation dose (ρ=0.548, P=0.001). Thus, IVIM‑diffusion‑weighted imaging and ASL may aid in the detection and prediction of radiation‑induced parotid damage in the early stages following RT. They may contribute to further understanding the potential association between damage to the parotid glands and patient‑/treatment‑related variables, through the assessment of individual microcapillary perfusion and tissue diffusivity.
View Figures

Figure 1

Figure 2

Figure 3

View References

1 

Guo Y, Jiang W, Lakshminarayanan P, Han P, Cheng Z, Bowers M, Hui X, Shpitser I, Siddiqui S, Taylor RH, et al: Spatial radiation dose influence on xerostomia recovery and its comparison to acute incidence in patients with head and neck cancer. Adv Radiat Oncol. 5:221–230. 2019. View Article : Google Scholar : PubMed/NCBI

2 

Wang K, Pearlstein KA, Moon DH, Mahbooba ZM, Deal AM, Wang Y, Sutton SR, Motley BB, Judy GD, Holmes JA, et al: Assessment of risk of xerostomia after whole-brain radiation therapy and association with parotid dose. JAMA Oncol. 5:221–228. 2019. View Article : Google Scholar : PubMed/NCBI

3 

Zhang T, Liu C, Ma S, Gao Y and Wang R: Protective effect and mechanism of action of rosmarinic acid on radiation-induced parotid gland injury in rats. Dose Response. 18:15593258209077822020. View Article : Google Scholar : PubMed/NCBI

4 

Feng X, Wu Z, Xu J, Xu Y, Zhao B, Pang B, Qu X, Hu L, Hu L, Fan Z, et al: Dietary nitrate supplementation prevents radiotherapy-induced xerostomia. Elife. 10:e707102021. View Article : Google Scholar : PubMed/NCBI

5 

Xu J, Yan X, Gao R, Mao L, Cotrim AP, Zheng C, Zhang C, Baum BJ and Wang S: Effect of irradiation on microvascular endothelial cells of parotid glands in the miniature pig. Int J Radiat Oncol Biol Phys. 78:897–903. 2010. View Article : Google Scholar : PubMed/NCBI

6 

Fan WJ, Teng F, Luo YR, Yu W, Zhang Q, Lu YP and Ma L: Diffusion-weighted imaging as a follow-up modality for evaluation of major salivary gland function in nasopharyngeal carcinoma patients: A preliminary study. Strahlenther Onkol. 196:530–541. 2020. View Article : Google Scholar : PubMed/NCBI

7 

Juan CJ, Chen CY, Jen YM, Liu HS, Liu YJ, Hsueh CJ, Wang CY, Chou YC, Chai YT, Huang GS and Chung HW: Perfusion characteristics of late radiation injury of parotid glands: Quantitative evaluation with dynamic contrast-enhanced MRI. Eur Radiol. 19:94–102. 2009. View Article : Google Scholar : PubMed/NCBI

8 

Xu Z, Zheng S, Pan A, Cheng X and Gao M: A multiparametric analysis based on DCE-MRI to improve the accuracy of parotid tumor discrimination. Eur J Nucl Med Mol Imaging. 46:2228–2234. 2019. View Article : Google Scholar : PubMed/NCBI

9 

Wu W, Jiang G, Xu Z, Wang R, Pan A, Gao M, Yu T, Huang L, Quan Q and Li J: Three-dimensional pulsed continuous arterial spin labeling and intravoxel incoherent motion imaging of nasopharyngeal carcinoma: Correlations with Ki-67 proliferation status. Quant Imaging Med Surg. 11:1394–1405. 2021. View Article : Google Scholar : PubMed/NCBI

10 

Li Y, Lin CY, Qi YF, Wang X, Chen B, Zhou HL, Ren J, Yang JJ, Xiang Y, He YL, et al: Three-dimensional turbo-spin-echo amide proton transfer-weighted and intravoxel incoherent motion MR imaging for type I endometrial carcinoma: Correlation with Ki-67 proliferation status. Magn Reson Imaging. 78:18–24. 2021. View Article : Google Scholar : PubMed/NCBI

11 

Yu YM, Wang W, Wen J, Zhang Y, Lu GM and Zhang LJ: Detection of renal allograft fibrosis with MRI: Arterial spin labeling outperforms reduced field-of-view IVIM. Eur Radiol. 31:6696–6707. 2021. View Article : Google Scholar : PubMed/NCBI

12 

Poynton CB, Lee MM, Li Y, Laszik Z, Worters PW, Mackenzie JD and Courtier J: Intravoxel incoherent motion analysis of renal allograft diffusion with clinical and histopathological correlation in pediatric kidney transplant patients: A preliminary cross-sectional observational study. Pediatr Transplant. 21:e129962017. View Article : Google Scholar : PubMed/NCBI

13 

Jia QJ, Zhang SX, Chen WB, Liang L, Zhou ZG, Qiu QH, Liu ZY, Zeng QX and Liang CH: Initial experience of correlating parameters of intravoxel incoherent motion and dynamic contrast-enhanced magnetic resonance imaging at 3.0 T in nasopharyngeal carcinoma. Eur Radiol. 24:3076–3087. 2014. View Article : Google Scholar : PubMed/NCBI

14 

Kang M, Zhou P, Li G, Yan H and Wang R: Validation of the 8th edition of the UICC/AJCC staging system for nasopharyngeal carcinoma treated with intensity-modulated radiotherapy. Oncotarget. 8:70586–70594. 2017. View Article : Google Scholar : PubMed/NCBI

15 

Chinese Committee for Staging of Nasopharyngeal Carcinoma, . The 2017 edition for staging of nasopharyngeal carcinoma in China (The Chinese 2008 expert consensus on staging revision of nasopharyngeal carcinoma). Chinese J Radiation Oncology. 26:1119–1124. 2017.(In Chinese).

16 

Westgaard KL, Hynne H, Amdal CD, Young A, Singh PB, Chen X, Rykke M, Hove LH, Aqrawi LA, Utheim TP, et al: Oral and ocular late effects in head and neck cancer patients treated with radiotherapy. Sci Rep. 11:40262021. View Article : Google Scholar : PubMed/NCBI

17 

Acauan MD, Figueiredo MA, Cherubini K, Gomes AP and Salum FG: Radiotherapy-induced salivary dysfunction: Structural changes, pathogenetic mechanisms and therapies. Arch Oral Biol. 60:1802–1810. 2015. View Article : Google Scholar : PubMed/NCBI

18 

Wu VWC, Ying MT, Kwong DL, Khong PL, Wong GK and Tam SY: A longitudinal study on parotid and submandibular gland changes assessed by magnetic resonance imaging and ultrasonography in post-radiotherapy nasopharyngeal cancer patients. BJR Open. 2:202000032020.PubMed/NCBI

19 

Hu S, Gao Y, Zhou H, Kong F, Xiao F, Zhou P and Chen Y: New insight into mitochondrial changes in vascular endothelial cells irradiated by gamma ray. Int J Radiat Biol. 93:470–476. 2017. View Article : Google Scholar : PubMed/NCBI

20 

Fajardo LF: The pathology of ionizing radiation as defined by morphologic patterns. Acta Oncol. 44:13–22. 2005. View Article : Google Scholar : PubMed/NCBI

21 

Boström M, Kalm M, Eriksson Y, Bull C, Ståhlberg A, Björk-Eriksson T, Hellström Erkenstam N and Blomgren K: A role for endothelial cells in radiation-induced inflammation. Int J Radiat Biol. 94:259–271. 2018. View Article : Google Scholar : PubMed/NCBI

22 

Lee FK, King AD, Kam MK, Ma BB and Yeung DK: Radiation injury of the parotid glands during treatment for head and neck cancer: Assessment using dynamic contrast-enhanced MR imaging. Radiat Res. 175:291–296. 2011. View Article : Google Scholar : PubMed/NCBI

23 

Bisdas S, Koh TS, Roder C, Braun C, Schittenhelm J, Ernemann U and Klose U: Intravoxel incoherent motion diffusion-weighted MR imaging of gliomas: Feasibility of the method and initial results. Neuroradiology. 55:1189–1196. 2013. View Article : Google Scholar : PubMed/NCBI

24 

Marzi S, Forina C, Marucci L, Giovinazzo G, Giordano C, Piludu F, Landoni V, Spriano G and Vidiri A: Early radiation-induced changes evaluated by intravoxel incoherent motion in the major salivary glands. J Magn Reson Imaging. 41:974–982. 2015. View Article : Google Scholar : PubMed/NCBI

25 

Shen N, Zhao L, Jiang J, Jiang R, Su C, Zhang S, Tang X and Zhu W: Intravoxel incoherent motion diffusion-weighted imaging analysis of diffusion and microperfusion in grading gliomas and comparison with arterial spin labeling for evaluation of tumor perfusion. J Magn Reson Imaging. 44:620–632. 2016. View Article : Google Scholar : PubMed/NCBI

26 

Dolgorsuren EA, Harada M, Kanazawa Y, Abe T, Otomo M, Matsumoto Y, Mizobuchi Y and Nakajima K: Correlation and characteristics of intravoxel incoherent motion and arterial spin labeling techniques versus multiple parameters obtained on dynamic susceptibility contrast perfusion MRI for brain tumors. J Med Invest. 66:308–313. 2019. View Article : Google Scholar : PubMed/NCBI

27 

van Dijk LV, Thor M, Steenbakkers RJHM, Apte A, Zhai TT, Borra R, Noordzij W, Estilo C, Lee N, Langendijk JA, et al: Parotid gland fat related Magnetic Resonance image biomarkers improve prediction of late radiation-induced xerostomia. Radiother Oncol. 128:459–466. 2018. View Article : Google Scholar : PubMed/NCBI

28 

Zhang L, Murata Y, Ishida R, Ohashi I, Yoshimura R and Shibuya H: Functional evaluation with intravoxel incoherent motion echo-planar MRI in irradiated salivary glands: A correlative study with salivary gland scintigraphy. J Magn Reson Imaging. 14:223–229. 2001. View Article : Google Scholar : PubMed/NCBI

29 

Hey J, Setz J, Gerlach R, Janich M, Hildebrandt G, Vordermark D, Gernhardt CR and Kuhnt T: Parotid gland-recovery after radiotherapy in the head and neck region-36 months follow-up of a prospective clinical study. Radiat Oncol. 6:1252011. View Article : Google Scholar : PubMed/NCBI

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Zhang X, Xu Z, Jin Y, Huang L, Wu W and Gao M: Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy. Oncol Lett 27: 180, 2024.
APA
Zhang, X., Xu, Z., Jin, Y., Huang, L., Wu, W., & Gao, M. (2024). Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy. Oncology Letters, 27, 180. https://doi.org/10.3892/ol.2024.14313
MLA
Zhang, X., Xu, Z., Jin, Y., Huang, L., Wu, W., Gao, M."Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy". Oncology Letters 27.4 (2024): 180.
Chicago
Zhang, X., Xu, Z., Jin, Y., Huang, L., Wu, W., Gao, M."Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy". Oncology Letters 27, no. 4 (2024): 180. https://doi.org/10.3892/ol.2024.14313
Copy and paste a formatted citation
x
Spandidos Publications style
Zhang X, Xu Z, Jin Y, Huang L, Wu W and Gao M: Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy. Oncol Lett 27: 180, 2024.
APA
Zhang, X., Xu, Z., Jin, Y., Huang, L., Wu, W., & Gao, M. (2024). Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy. Oncology Letters, 27, 180. https://doi.org/10.3892/ol.2024.14313
MLA
Zhang, X., Xu, Z., Jin, Y., Huang, L., Wu, W., Gao, M."Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy". Oncology Letters 27.4 (2024): 180.
Chicago
Zhang, X., Xu, Z., Jin, Y., Huang, L., Wu, W., Gao, M."Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy". Oncology Letters 27, no. 4 (2024): 180. https://doi.org/10.3892/ol.2024.14313
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team