Dose-dependent white matter damage after brain radiotherapy.

Published on Nov 1, 2016in Radiotherapy and Oncology6.28
· DOI :10.1016/J.RADONC.2016.10.003
Michael Connor9
Estimated H-index: 9
(UCSD: University of California, San Diego),
Roshan Karunamuni17
Estimated H-index: 17
(UCSD: University of California, San Diego)
+ 13 AuthorsJona A. Hattangadi-Gluth23
Estimated H-index: 23
(UCSD: University of California, San Diego)
Sources
Abstract
Abstract Background and purpose Brain radiotherapy is limited in part by damage to white matter, contributing to neurocognitive decline. We utilized diffusion tensor imaging (DTI) with multiple b -values (diffusion weightings) to model the dose-dependency and time course of radiation effects on white matter. Materials and methods Fifteen patients with high-grade gliomas treated with radiotherapy and chemotherapy underwent MRI with DTI prior to radiotherapy, and after months 1, 4–6, and 9–11. Diffusion tensors were calculated using three weightings (high, standard, and low b -values) and maps of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity \( λ \∥ \) , and radial diffusivity ( λ ⊥ ) were generated. The region of interest was all white matter. Results MD, λ \∥ , and λ ⊥ increased significantly with time and dose, with corresponding decrease in FA. Greater changes were seen at lower b -values, except for FA. Time–dose interactions were highly significant at 4–6months and beyond ( p b -values reached statistical significance at 9–11months for MD, λ \∥ , and λ ⊥ ( p p p =.005 respectively) as well as at 4–6months for λ \∥ ( p =.04). Conclusions We detected dose-dependent changes across all doses, even b -values, suggesting prominent extracellular changes possibly due to vascular permeability and neuroinflammation.
Download
📖 Papers frequently viewed together
References49
Newest
#1G. Smyth (The Royal Marsden NHS Foundation Trust)H-Index: 7
#2Philip M. Evans (University of Surrey)H-Index: 54
Last. James L. Bedford (The Royal Marsden NHS Foundation Trust)H-Index: 32
view all 7 authors...
Abstract Background and purpose To evaluate non-coplanar volumetric modulated arc radiotherapy (VMAT) trajectories for organ at risk (OAR) sparing in primary brain tumor radiotherapy. Materials and methods Fifteen patients were planned using coplanar VMAT and compared against non-coplanar VMAT plans for three trajectory optimization techniques. A geometric heuristic technique (GH) combined beam scoring and Dijkstra's algorithm to minimize the importance-weighted sum of OAR volumes irradiated. Fl...
Source
#1Christopher H. Chapman (UM: University of Michigan)H-Index: 15
#2Tong Zhu (UM: University of Michigan)H-Index: 19
Last. Yue Cao (UM: University of Michigan)H-Index: 45
view all 8 authors...
Abstract Purpose/objectives Radiation injury to parahippocampal cingulum white matter is associated with cognitive decline. Diffusion tensor imaging (DTI) detects micropathologic changes in white matter. Increased radial diffusion (RD) and decreased axial diffusion (AD) correspond to demyelination and axonal degeneration/gliosis respectively. We aimed to develop a predictive model for radiation-induced cognitive changes based upon DTI changes. Materials/methods Twenty-seven adults with benign or...
Source
#1Roshan Karunamuni (UCSD: University of California, San Diego)H-Index: 17
#2Hauke Bartsch (UCSD: University of California, San Diego)H-Index: 28
Last. Jona A. Hattangadi-Gluth (UCSD: University of California, San Diego)H-Index: 23
view all 15 authors...
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-di...
Source
#1Roshan Karunamuni (UCSD: University of California, San Diego)H-Index: 17
#2Kevin L. Moore (UCSD: University of California, San Diego)H-Index: 45
Last. Jona A. Hattangadi-Gluth (UCSD: University of California, San Diego)H-Index: 23
view all 17 authors...
Abstract Background and purpose Neurocognitive decline in brain tumor patients treated with radiotherapy (RT) may be linked to cortical atrophy. We developed models to determine radiation treatment-planning objectives for cortex, which were tested on a sample population to identify the dosimetric cost of cortical sparing. Material and methods The relationship between the probability of cortical atrophy in fifteen high-grade glioma patients at 1-year post-RT and radiation dose was fit using logis...
Source
#1Luiz Victor Maia Loureiro (UNIFESP: Federal University of São Paulo)H-Index: 5
#2Elivane da Silva Victor (USP: University of São Paulo)H-Index: 11
Last. Suzana F. Malheiros (USP: University of São Paulo)H-Index: 6
view all 8 authors...
Abstract Background and purpose Previous studies have provided no clear conclusions regarding the effects of delaying radiotherapy (RT) in GBM patients. We present a systematic review and meta-analysis to address the effect of delayed RT on the overall survival (OS) of GBM patients. Methods A systematic search retrieved 19 retrospective studies published between 1975 and 2014 reporting on the waiting time (WT) to RT for GBM patients. The meta-analysis was performed by converting WT to RT studies...
Source
#1Reza Farjam (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 10
#2Priyanka Pramanik (UM: University of Michigan)H-Index: 3
Last. Yue Cao (UM: University of Michigan)H-Index: 45
view all 8 authors...
Purpose We aimed to develop a hippocampal vascular injury surrogate marker for early prediction of late neurocognitive dysfunction in patients receiving brain radiation therapy (RT). Methods and Materials Twenty-seven patients (17 males and 10 females, 31-80 years of age) were enrolled in an institutional review board-approved prospective longitudinal study. Patients received diagnoses of low-grade glioma or benign tumor and were treated by (3D) conformal or intensity-modulated RT with a median ...
Source
#1Douglas M. BatesH-Index: 36
#2Martin MächlerH-Index: 13
Last. Steven C. WalkerH-Index: 17
view all 4 authors...
Maximum likelihood or restricted maximum likelihood (REML) estimates of the parameters in linear mixed-effects models can be determined using the lmer function in the lme4 package for R. As for most model-fitting functions in R, the model is described in an lmer call by a formula, in this case including both fixed- and random-effects terms. The formula and data together determine a numerical representation of the model from which the profiled deviance or the profiled REML criterion can be evalua...
Source
#1Edward Ofori (UF: University of Florida)H-Index: 18
#2Ofer Pasternak (Brigham and Women's Hospital)H-Index: 49
Last. David E. Vaillancourt (UF: University of Florida)H-Index: 63
view all 9 authors...
There is a clear need to develop non-invasive markers of substantia nigra progression in Parkinson’s disease. We previously found elevated free-water levels in the substantia nigra for patients with Parkinson’s disease compared with controls in single-site and multi-site cohorts. Here, we test the hypotheses that free-water levels in the substantia nigra of Parkinson’s disease increase following 1 year of progression, and that baseline free-water levels in the substantia nigra predict the change...
Source
#1Yasuhiko Tachibana (NIRS: National Institute of Radiological Sciences)H-Index: 10
#2Takayuki Obata (NIRS: National Institute of Radiological Sciences)H-Index: 31
Last. Shigeki Aoki (Juntendo University)H-Index: 96
view all 12 authors...
Objectives To compare the significance of the two-compartment model, considering diffusional anisotropy with conventional diffusion analyzing methods regarding the detection of occult changes in normal-appearing white matter (NAWM) of multiple sclerosis (MS).
Source
#1Ofer Pasternak (Brigham and Women's Hospital)H-Index: 49
#2Carl-Fredrik Westin (Brigham and Women's Hospital)H-Index: 81
Last. Marek Kubicki (Brigham and Women's Hospital)H-Index: 65
view all 5 authors...
Abstract In a previous study we have demonstrated, using a novel diffusion MRI analysis called free-water imaging, that the early stages of schizophrenia are more likely associated with a neuroinflammatory response and less so with a white matter deterioration or a demyelination process. What is not known is how neuroinflammation and white matter deterioration change along the progression of the disorder. In this study we apply the free-water measures on a population of 29 chronic schizophrenia ...
Source
Cited By58
Newest
#1Sofía Ramírez-Guerrero (Del Rosario University)H-Index: 1
#2María Paula Vargas-Cuellar (Del Rosario University)
Last. Claudia Talero-GutiérrezH-Index: 11
view all 4 authors...
Source
Abstract null null Advances in computational neuroimaging techniques have expanded the armamentarium of imaging tools available for clinical applications in clinical neuroscience. Non-invasive, in vivo brain MRI structural and functional network mapping has been used to identify therapeutic targets, define eloquent brain regions to preserve, and gain insight into pathological processes and treatments as well as prognostic biomarkers. These tools have the real potential to inform patient-specific...
Source
#1Guido FrosinaH-Index: 22
#2Vincenzo FontanaH-Index: 28
Last. Antonio DagaH-Index: 35
view all 9 authors...
High-grade gliomas (HGGs; WHO grades III and IV) are invariably lethal brain tumors. Low-dose hyper-radiosensitivity (HRS) of HGG is a well-established phenomenon in vitro. However, possibly linked to the unavailability of accurate animal models of the diseases, this therapeutic effect could not be consistently translated to the animal setting, thus impairing its subsequent clinical development. The purpose of this study was to develop radiotherapeutic (RT) schedules permitting to significantly ...
Source
#1L. Dünger (HZDR: Helmholtz-Zentrum Dresden-Rossendorf)
#2Annekatrin Seidlitz (HZDR: Helmholtz-Zentrum Dresden-Rossendorf)H-Index: 10
Last. F. Raschke (HZDR: Helmholtz-Zentrum Dresden-Rossendorf)
view all 10 authors...
Abstract null null Background and purpose null Radio(chemo)therapy is standard in the adjuvant treatment of glioblastoma. Inevitably, brain tissue surrounding the target volume is also irradiated, potentially causing acute and late side-effects. Diffusion imaging has been shown to be a sensitive method to detect early changes in the cerebral white matter (WM) after radiation. The aim of this work was to assess possible changes in the mean diffusivity (MD) of WM after radio(chemo)therapy using Di...
Source
#1Jin Woong Kim (Chosun University)H-Index: 4
#8Tae-Hoon Kim (Wonkwang University)H-Index: 5
Radiation-induced injury is damage to normal tissues caused by unintentional exposure to ionizing radiation. Image-based evaluation of tissue damage by irradiation has an advantage for the early assessment of therapeutic effects by providing sensitive information on minute tissue responses in situ. Recent magnetic resonance (MR)-based electrical conductivity imaging has shown potential as an effective early imaging biomarker for treatment response and radiation-induced injury. However, to be a t...
Source
#2Viola OldratiH-Index: 6
Last. Geraldina PoggiH-Index: 16
view all 8 authors...
(1) Background: Brain tumor (BT) survivors show difficulties in the acquisition of developmental milestones, related to academic achievement, vocational employment, social relationships, and autonomy. The skills underlying adaptive functioning (AF) are usually damaged in BT survivors due to the presence of the brain tumor, treatment-related factors, and other neurological sequelae. In this study, we aimed to explore the contribution of different cognitive factors in children with BT to AF, consi...
Source
#1D. Wagenaar (UMCG: University Medical Center Groningen)H-Index: 4
#2Ewoud Schuit (UU: Utrecht University)H-Index: 24
Last. Stefan Both (UMCG: University Medical Center Groningen)H-Index: 13
view all 5 authors...
Abstract null null Background and purpose null The relative biological effectiveness (RBE) of proton therapy is predicted to vary with the dose-weighted average linear energy transfer (LETd). However, RBE values may substantially vary for different clinical endpoints. Therefore, the aim of this study was to assess the feasibility of relating mean D⋅LETd parameters to patient toxicity for HNC patients treated with proton therapy. null null null Materials and methods null The delivered physical do...
Source
#1Michael Connor (UCSD: University of California, San Diego)H-Index: 9
#2Michelle M. Kim (UM: University of Michigan)H-Index: 19
Last. Jona A. Hattangadi-Gluth (UCSD: University of California, San Diego)H-Index: 23
view all 4 authors...
ABSTRACT Gliomas are the most common primary brain cancer, yet are extraordinarily challenging to treat because they can be aggressive and infiltrative, locally recurrent, and resistant to standard treatments. Furthermore, the treatments themselves, including radiation therapy, can affect patients' neurocognitive function and quality of life. Noninvasive imaging is the standard of care for primary brain tumors, including diagnosis, treatment planning, and monitoring for treatment response. This ...
Source
#1Mia A Salans (UCSD: University of California, San Diego)H-Index: 3
#2Michelle D. Tibbs (UCSD: University of California, San Diego)H-Index: 5
Last. Jona A. Hattangadi-Gluth (UCSD: University of California, San Diego)H-Index: 23
view all 10 authors...
BACKGROUND We explored fine motor skills (FMS) before and after brain radiotherapy (RT), analyzing associations between longitudinal FMS and imaging biomarkers of cortical and white matter (WM) integrity in motor regions of interest (ROIs). METHODS On a prospective trial, 52 primary brain tumor patients receiving fractionated brain RT underwent volumetric brain MRI, diffusion tensor imaging, and FMS assessments (Delis-Kaplan Executive Function System Trail Making Test Motor Speed [DKEFS-MS], Gro...
Source
#1Pietro BontempiH-Index: 9
#2Daniele ScartoniH-Index: 6
Last. Paolo FaraceH-Index: 21
view all 7 authors...
PURPOSE To investigate MRI myelin water imaging (MWI) by multicomponent T2 relaxometry as a quantitative imaging biomarker for brain radiation-induced changes and to compare it with DTI. METHODS Sixteen patients underwent fractionated proton therapy (PT) receiving dose to the healthy tissue because of direct or indirect (base skull tumors) irradiation. MWI was performed by a multi-echo sequence with 32 equally spaced echoes (10-320 ms). Decay data were processed to identify 3 T2 compartments: my...
Source
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.