Morphological changes after cranial fractionated photon radiotherapy: Localized loss of white matter and grey matter volume with increasing dose
| Autor: | Jjc Verhoeff, Mje van Zandvoort, Tom J. Snijders, Shj Nagtegaal, M.E.P. Philippens, Enrica Seravalli, Szabolcs David, E.E. van Grinsven |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
MNI
Montreal Neurological Institute R895-920 Hippocampus RT radiotherapy Grey matter computer.software_genre CSF cerebrospinal fluid Article White matter VBM voxel-based morphometry Medical physics. Medical radiology. Nuclear medicine Cerebrospinal fluid Voxel Cortex (anatomy) TIV total intracranial volume medicine IMPT intensity modulated proton therapy Radiology Nuclear Medicine and imaging CAT12 Computational Anatomy Toolbox 12 Cognitive decline Gray matter RC254-282 Radiotherapy medicine.diagnostic_test business.industry SNR signal to noise ratio PALM permutation analysis of linear models TFE turbo fast echo Neoplasms. Tumors. Oncology. Including cancer and carcinogens Magnetic resonance imaging GM grey matter Voxel-based morphometry CT computed tomography DBM deformation based morphometry TFCE Threshold-Free Cluster Enhancement FWER family-wise error rate Brain neoplasms medicine.anatomical_structure Oncology Cerebral cortex VMAT volumetric modulated arc therapy business Nuclear medicine MRI magnetic resonance imaging PTV planning target volume computer |
| Zdroj: | Clinical and Translational Radiation Oncology, Vol 31, Iss, Pp 14-20 (2021) Clinical and Translational Radiation Oncology |
| ISSN: | 2405-6308 |
| Popis: | Highlights • The entire brain is susceptible to dose-dependent volume loss after RT. • Future studies should examine the impact of cerebral volume loss on cognition. • Current sparing strategies in RT for brain tumours may need to be reconsidered. Purpose Numerous brain MR imaging studies have been performed to understand radiation-induced cognitive decline. However, many of them focus on a single region of interest, e.g. cerebral cortex or hippocampus. In this study, we use deformation-based morphometry (DBM) and voxel-based morphometry (VBM) to measure the morphological changes in patients receiving fractionated photon RT, and relate these to the dose. Additionally, we study tissue specific volume changes in white matter (WM), grey matter (GM), cerebrospinal fluid and total intracranial volume (TIV). Methods and materials From our database, we selected 28 patients with MRI of high quality available at baseline and 1 year after RT. Scans were rigidly registered to each other, and to the planning CT and dose file. We used DBM to study non-tissue-specific volumetric changes, and VBM to study volume loss in grey matter. Observed changes were then related to the applied radiation dose (in EQD2). Additionally, brain tissue was segmented into WM, GM and cerebrospinal fluid, and changes in these volumes and TIV were tested. Results Performing DBM resulted in clusters of dose-dependent volume loss 1 year after RT seen throughout the brain. Both WM and GM were affected; within the latter both cerebral cortex and subcortical nuclei show volume loss. Volume loss rates ranging from 5.3 to 15.3%/30 Gy were seen in the cerebral cortical regions in which more than 40% of voxels were affected. In VBM, similar loss rates were seen in the cortex and nuclei. The total volume of WM and GM significantly decreased with rates of 5.8% and 2.1%, while TIV remained unchanged as expected. Conclusions Radiotherapy is associated with dose-dependent intracranial morphological changes throughout the entire brain. Therefore, we will consider to revise sparing of organs at risk based on future cognitive and neurofunctional data. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|