Dose-Dependent Cortical Thinning After Partial Brain Irradiation in High-Grade Glioma.

Published on Feb 1, 2016in International Journal of Radiation Oncology Biology Physics7.038
· DOI :10.1016/J.IJROBP.2015.10.026
Roshan Karunamuni17
Estimated H-index: 17
 (UCSD: University of California, San Diego), Hauke Bartsch28
Estimated H-index: 28
 (UCSD: University of California, San Diego)+ 12 AuthorsJona A. Hattangadi-Gluth23
Estimated H-index: 23
 (UCSD: University of California, San Diego)
Sources
Abstract
Purpose Radiation-induced cognitive deficits may be mediated by tissue damage to cortical regions. Volumetric changes in cortex can be reliably measured using high-resolution magnetic resonance imaging (MRI). We used these methods to study the association between radiation therapy (RT) dose and change in cortical thickness in high-grade glioma (HGG) patients. Methods and Materials We performed a voxel-wise analysis of MRI from 15 HGG patients who underwent fractionated partial brain RT. Three-dimensional MRI was acquired pre- and 1 year post RT. Cortex was parceled with well-validated segmentation software. Surgical cavities were censored. Each cortical voxel was assigned a change in cortical thickness between time points, RT dose value, and neuroanatomic label by lobe. Effects of dose, neuroanatomic location, age, and chemotherapy on cortical thickness were tested using linear mixed effects (LME) modeling. Results Cortical atrophy was seen after 1 year post RT with greater effects at higher doses. Estimates from LME modeling showed that cortical thickness decreased by −0.0033 mm ( P P Conclusions We found dose-dependent thinning of the cerebral cortex, with varying neuroanatomical regional sensitivity, 1 year after fractionated partial brain RT. The magnitude of thinning parallels 1-year atrophy rates seen in neurodegenerative diseases and may contribute to cognitive decline following high-dose RT.
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