Dose-dependent volume loss in subcortical deep grey matter structures after cranial radiotherapy
| Autor: | Nagtegaal, Steven H.J, David, Szabolcs, Philippens, Marielle E.P., Snijders, Tom J., Leemans, Alexander, Verhoeff, Joost J.C. |
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| Rok vydání: | 2021 |
| Předmět: |
Pathology
medicine.medical_specialty Population R895-920 Globus pallidus Caudate nucleus RT radiotherapy Grey matter Hippocampus Article 030218 nuclear medicine & medical imaging White matter Medical physics. Medical radiology. Nuclear medicine 03 medical and health sciences 0302 clinical medicine Thalamus Medicine Radiology Nuclear Medicine and imaging Cognitive decline Gray matter education RC254-282 education.field_of_study Radiotherapy business.industry Putamen PALM permutation analysis of linear models TFE turbo fast echo Neoplasms. Tumors. Oncology. Including cancer and carcinogens CAT12 computational anatomy toolbox 12 WBRT whole-brain radiotherapy GM grey matter Amygdala CT computed tomography SPM statistical parametric mapping FWER family-wise error rate Brain neoplasms medicine.anatomical_structure Oncology Cerebral cortex 030220 oncology & carcinogenesis Nucleus accumbens business MRI magnetic resonance imaging PTV planning target volume |
| Zdroj: | Clinical and Translational Radiation Oncology Clinical and Translational Radiation Oncology, Vol 26, Iss, Pp 35-41 (2021) |
| ISSN: | 2405-6308 |
| Popis: | Highlights • Subcortical grey matter is susceptible to dose-dependent volume loss after RT. • Hippocampal age increases 1 year after radiotherapy, by a median of 11 years. • We may need to reconsider current sparing strategies in RT for brain tumours. • Future studies should examine the impact of deep GM volume loss on cognition. Background and purpose The relation between radiotherapy (RT) dose to the brain and morphological changes in healthy tissue has seen recent increased interest. There already is evidence for changes in the cerebral cortex and white matter, as well as selected subcortical grey matter (GM) structures. We studied this relation in all deep GM structures, to help understand the aetiology of post-RT neurocognitive symptoms. Materials and methods We selected 31 patients treated with RT for grade II-IV glioma. Pre-RT and 1 year post-RT 3D T1-weighted MRIs were automatically segmented, and the changes in volume of the following structures were assessed: amygdala, nucleus accumbens, caudate nucleus, hippocampus, globus pallidus, putamen, and thalamus. The volumetric changes were related to the mean RT dose received by each structure. Hippocampal volumes were entered into a population-based nomogram to estimate hippocampal age. Results A significant relation between RT dose and volume loss was seen in all examined structures, except the caudate nucleus. The volume loss rates ranged from 0.16 to 1.37%/Gy, corresponding to 4.9–41.2% per 30 Gy. Hippocampal age, as derived from the nomogram, was seen to increase by a median of 11 years. Conclusion Almost all subcortical GM structures are susceptible to radiation-induced volume loss, with higher volume loss being observed with increasing dose. Volume loss of these structures is associated with neurological deterioration, including cognitive decline, in neurodegenerative diseases. To support a causal relationship between radiation-induced deep GM loss and neurocognitive functioning in glioma patients, future studies are needed that directly correlate volumetrics to clinical outcomes. |
| Databáze: | OpenAIRE |
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