Relationship between 7T MR-angiography features of vascular injury and cognitive decline in young brain tumor patients treated with radiation therapy
| Autor: | Melanie A. Morrison, Erin Felton, Steve Braunstein, Christopher P. Hess, Sivakami Avadiappan, Annette M. Molinaro, Janine M. Lupo, Sabine Mueller, Schuyler Stoller, Angela Jakary |
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| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty Neurology medicine.medical_treatment Brain tumor Article 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Cognitive Dysfunction Cognitive decline Young adult Cerebral Hemorrhage business.industry Brain Neoplasms Angiography Brain Vascular System Injuries medicine.disease Magnetic Resonance Imaging Radiation therapy Oncology 030220 oncology & carcinogenesis Brain size Susceptibility weighted imaging Cardiology Neurology (clinical) Verbal memory business 030217 neurology & neurosurgery |
| Zdroj: | J Neurooncol |
| ISSN: | 1573-7373 |
| Popis: | PURPOSE: Although radiation therapy (RT) is a common treatment for pediatric brain tumors, it is associated with detrimental long-term effects such as impaired cognition, vascular injury, and increased stroke risk. This study aimed to develop metrics that describe vascular injury and relate them to the presence of cerebral microbleeds (CMBs) and cognitive performance scores. METHODS: Twenty-five young adult survivors of pediatric brain tumors treated with either whole-brain (n = 12), whole-ventricular (n = 7), or no RT (n = 6) underwent 7T MRI and neurocognitive testing. Simultaneously acquired MR angiography and susceptibility-weighted images were used to segment CMBs and vessels and quantify their radii and volume. RESULTS: Patients treated with whole-brain RT had significantly lower arterial volumes (p = 0.003) and a higher proportion of smaller vessels (p = 0.003) compared to the whole-ventricular RT and non-irradiated control patients. Normalized arterial volume decreased with increasing CMB count (R = − 0.66, p = 0.003), and decreasing trends were observed with time since RT and at longitudinal follow-up. Global cognition and verbal memory significantly decreased with smaller normalized arterial volume (p ≤ 0.05). CONCLUSIONS: Arterial volume is reduced with increasing CMB presence and is influenced by the total brain volume exposed to radiation. This work highlights the potential use of vascular-derived metrics as non-invasive markers of treatment-induced injury and cognitive impairment in pediatric brain tumor patients. |
| Databáze: | OpenAIRE |
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