Diffusion Tensor Imaging of Normal-Appearing White Matter as Biomarker for Radiation-Induced Late Delayed Cognitive Decline

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• 作者：Christopher H. Chapman ; B.A.^&lowast ; ; ^{chchap@umich.edu} ; Vijaya Nagesh ; Ph.D.^&lowast ; ; Pia C. Sundgren ; M.D. ; Ph.D.^&dagger ; ; ^&Dagger ; ; Henry Buchtel ; Ph.D.^§ ; ; ^&para ; ; Thomas L. Chenevert ; Ph.D.^&dagger ; ; Larry Junck ; M.D.^?/sup> ; Theodore S. Lawrence ; M.D. ; Ph.D.^&lowast ; ; Christina I. Tsien ; M.D.^&lowast ; ; Yue Cao ; Ph.D.^&lowast ; ; ^&dagger ;
• 关键词：Diffusion tensor imaging ; Neurocognitive function ; Late-delayed effects ; Biomarker ; Quality of life
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2012
• 出版时间：1 April, 2012
• 年：2012
• 卷：82
• 期：5
• 页码：2033-2040
• 全文大小：567 K

文摘

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ass=""h4"">Purpose

To determine whether early assessment of cerebral white matter degradation can predict late delayed cognitive decline after radiotherapy (RT).

ass=""h4"">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 neurocognitive function tests were administered before and after RT at the magnetic resonance imaging follow-up visits.

ass=""h4"">Results

In both structures, longitudinal diffusivity (¦Ë_{?/sub>) decreased and perpendicular diffusivity (¦Ë?/sub>) increased after RT, with early changes correlating to later changes (p < .05). The radiation dose correlated with an increase in cingulum ¦Ë?/sub> at 3 weeks, and patients with >50 % of cingula volume receiving >12 Gy had a greater increase in ¦Ë?/sub> at 3 and 6 weeks (p < .05). The post-RT changes in verbal recall scores correlated linearly with the late changes in cingulum ¦Ë?/sub> (30 weeks, p < .02). Using receiver operating characteristic curves, early cingulum ¦Ë?/sub> 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.}

ass=""h4"">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.