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

Chapman, Christopher H.; Nagesh, Vijaya; Sundgren, Pia LU ; Buchtel, Henry; Chenevert, Thomas L.; Junck, Larry; Lawrence, Theodore S.; Tsien, Christina I. and Cao, Yue (2012) In International Journal of Radiation Oncology, Biology, Physics 82(5). p.2033-2040
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Diffusion tensor imaging, Neurocognitive function, Late-delayed effects, Biomarker, Quality of life
in
International Journal of Radiation Oncology, Biology, Physics
volume
82
issue
5
pages
2033 - 2040
publisher
Elsevier
external identifiers
  • wos:000301891300083
  • scopus:84858708942
ISSN
0360-3016
DOI
10.1016/j.ijrobp.2011.01.068
language
English
LU publication?
yes
id
7e15e2a2-c181-45f9-9af5-6bf0c73491e2 (old id 2587640)
date added to LUP
2012-06-01 09:37:29
date last changed
2017-11-19 03:21:22
@article{7e15e2a2-c181-45f9-9af5-6bf0c73491e2,
  abstract     = {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 &lt; .05). The radiation dose correlated with an increase in cingulum lambda(perpendicular to) at 3 weeks, and patients with &gt;50% of cingula volume receiving &gt;12 Gy had a greater increase in lambda(perpendicular to) at 3 and 6 weeks (p &lt; .05). The post-RT changes in verbal recall scores correlated linearly with the late changes in cingulum lambda(parallel to) (30 weeks, p &lt; .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 &lt; .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.},
  author       = {Chapman, Christopher H. and Nagesh, Vijaya and Sundgren, Pia and Buchtel, Henry and Chenevert, Thomas L. and Junck, Larry and Lawrence, Theodore S. and Tsien, Christina I. and Cao, Yue},
  issn         = {0360-3016},
  keyword      = {Diffusion tensor imaging,Neurocognitive function,Late-delayed effects,Biomarker,Quality of life},
  language     = {eng},
  number       = {5},
  pages        = {2033--2040},
  publisher    = {Elsevier},
  series       = {International Journal of Radiation Oncology, Biology, Physics},
  title        = {Diffusion Tensor Imaging of Normal-Appearing White Matter as Biomarker for Radiation-Induced Late Delayed Cognitive Decline},
  url          = {http://dx.doi.org/10.1016/j.ijrobp.2011.01.068},
  volume       = {82},
  year         = {2012},
}