Rate of radiation-induced microbleed formation on 7T MRI relates to cognitive impairment in young patients treated with radiation therapy for a brain tumor

Autor: Sivakami Avadiappan, Janine M. Lupo, Anu Banerjee, Sabine Mueller, Schuyler Stoller, Annette M. Molinaro, Melanie A. Morrison, Erin Felton, Christopher P. Hess, Justin Yuan, Steve Braunstein, Angela Jakary
Rok vydání: 2020
Předmět:
Oncology
medicine.medical_treatment
030218 nuclear medicine & medical imaging
0302 clinical medicine
Cognitive decline
Young adult
Child
Cancer
education.field_of_study
Brain Neoplasms
Brain
Hematology
Magnetic Resonance Imaging
Radiation therapy
Other Physical Sciences
030220 oncology & carcinogenesis
Neurological
Biomedical Imaging
Mental health
Cerebral microbleeds
medicine.medical_specialty
Adolescent
Oncology and Carcinogenesis
Population
Brain tumor
Brain tumors
Cognitive outcome
Article
03 medical and health sciences
Young Adult
Rare Diseases
Clinical Research
Internal medicine
Acquired Cognitive Impairment
medicine
Memory impairment
Humans
Radiology
Nuclear Medicine and imaging
Cognitive Dysfunction
Oncology & Carcinogenesis
Effects of sleep deprivation on cognitive performance
education
Cerebral Hemorrhage
business.industry
Prevention
Neurosciences
Ultra-high field magnetic resonance imaging
medicine.disease
Brain Disorders
Brain Cancer
Dementia
Verbal memory
business
Zdroj: Radiother Oncol
ISSN: 1879-0887
Popis: BackgroundRadiation therapy (RT) is essential to the management of many brain tumors, but has been known to lead to cognitive decline and vascular injury in the form of cerebral microbleeds (CMBs).PurposeIn a subset of children, adolescents, and young adults recruited from a larger trial investigating arteriopathy and stroke risk after RT, we evaluated the prevalence of CMBs after RT, examined risk factors for CMBs and cognitive impairment, and related their longitudinal development to cognitive performance changes.MethodsTwenty-five patients (mean 17years, range: 10-25years) underwent 7-Tesla MRI and cognitive assessment. Nineteen patients were treated with whole-brain or focal RT 1-month to 20-years prior, while 6 non-irradiated patients with posterior-fossa tumors served as controls. CMBs were detected on 7T susceptibility-weighted imaging (SWI) using semi-automated software, a first use in this population.ResultsCMB detection sensitivity with 7T SWI was higher than previously reported at lower field strengths, with one or more CMBs detected in 100% of patients treated with RT at least 1-year prior. CMBs were localized to dose-targeted brain volumes with risk factors including whole-brain RT (p=0.05), a higher RT dose (p=0.01), increasing time since RT (p=0.03), and younger age during RT (p=0.01). Apart from RT dose, these factors were associated with impaired memory performance. Follow-up data in a subset of patients revealed a proportional increase in CMB count with worsening verbal memory performance (r=-0.85, p=0.03).ConclusionsTreatment with RT during youth is associated with the chronic development of CMBs that evolve with memory impairment over time.
Databáze: OpenAIRE
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