DIFFUSION TENSOR IMAGING OF NORMAL-APPEARING WHITE MATTER AS BIOMARKER FOR RADIATION-INDUCED LATE DELAYED COGNITIVE DECLINE

被引:111
作者
Chapman, Christopher H. [1 ]
Nagesh, Vijaya [1 ]
Sundgren, Pia C. [2 ,5 ]
Buchtel, Henry [3 ,6 ]
Chenevert, Thomas L. [2 ]
Junck, Larry [4 ]
Lawrence, Theodore S. [1 ]
Tsien, Christina I. [1 ]
Cao, Yue [1 ,2 ]
机构
[1] Univ Michigan, Sch Med, Dept Radiat Oncol, Ann Arbor, MI 48103 USA
[2] Univ Michigan, Sch Med, Dept Radiol, Ann Arbor, MI 48103 USA
[3] Univ Michigan, Sch Med, Dept Psychiat, Ann Arbor, MI 48103 USA
[4] Univ Michigan, Sch Med, Dept Neurol, Ann Arbor, MI 48103 USA
[5] Skane Univ Hosp, Dept Radiol, Lund, Sweden
[6] Vet Affairs Ann Arbor Healthcare Syst, Ann Arbor, MI USA
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2012年 / 82卷 / 05期
基金
美国国家卫生研究院;
关键词
Diffusion tensor imaging; Neurocognitive function; Late-delayed effects; Biomarker; Quality of life; CENTRAL-NERVOUS-SYSTEM; QUALITY-OF-LIFE; CLINICAL-TRIALS; CHILDHOOD-CANCER; BRAIN-TUMOR; ANISOTROPY; RADIOTHERAPY; ASSOCIATION; RELIABILITY; IRRADIATION;
D O I
10.1016/j.ijrobp.2011.01.068
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To determine whether early assessment of cerebral white matter degradation can predict late delayed cognitive decline after radiotherapy (RT). Methods and Materials: Ten patients undergoing conformal fractionated brain RT participated in a prospective diffusion tensor magnetic resonance imaging study. Magnetic resonance imaging studies were acquired before RT, at 3 and 6 weeks during RT, and 10, 30, and 78 weeks after starting RT. The diffusivity variables in the parahippocampal cingulum bundle and temporal lobe white matter were computed. A quality-of-life survey and neuro-cognitive function tests were administered before and after RT at the magnetic resonance imaging follow-up visits. Results: In both structures, longitudinal diffusivity (lambda(parallel to)) decreased and perpendicular diffusivity (lambda(perpendicular to)) increased after RT, with early changes correlating to later changes (p < .05). The radiation dose correlated with an increase in cingulum lambda(perpendicular to) at 3 weeks, and patients with >50% of cingula volume receiving >12 Gy had a greater increase in lambda(perpendicular to) at 3 and 6 weeks (p < .05). The post-RT changes in verbal recall scores correlated linearly with the late changes in cingulum lambda(parallel to) (30 weeks, p < .02). Using receiver operating characteristic curves, early cingulum lambda(parallel to) changes predicted for post-RT changes in verbal recall scores (3 and 6 weeks, p < .05). The neurocognitive test scores correlated significantly with the quality-of-life survey results. Conclusions: The correlation between early diffusivity changes in the parahippocampal cingulum and the late decline in verbal recall suggests that diffusion tensor imaging might be useful as a biomarker for predicting late delayed cognitive decline. (C) 2012 Elsevier Inc.
引用
收藏
页码:2033 / 2040
页数:8
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