TY - JOUR
T1 - Diffusion tensor imaging predicts cognitive function change following partial brain radiotherapy for low-grade and benign tumors
AU - Chapman, Christopher H.
AU - Zhu, Tong
AU - Nazem-Zadeh, Mohamad
AU - Tao, Yebin
AU - Buchtel, Henry A.
AU - Tsien, Christina I.
AU - Lawrence, Theodore S.
AU - Cao, Yue
N1 - Funding Information:
This study was funded by USA National Institutes of Health grant R01 NS064973 (Cao).
Publisher Copyright:
© 2016 Elsevier Ireland Ltd
PY - 2016/8/1
Y1 - 2016/8/1
N2 - 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 low-grade tumors received partial brain radiation therapy (RT) to a median dose of 54 Gy. Patients underwent DTI before RT, during RT, and at the end of RT. Cognitive testing was performed before RT, and 6 and 18 months after RT. Parahippocampal cingulum white matter was contoured to obtain mean values of AD and RD. Results By univariate analysis, decreasing AD and increasing RD during RT predicted declines in verbal memory and verbal fluency. By multivariate analysis, baseline neurocognitive score was the only clinical variable predicting verbal memory change; no clinical variables predicted verbal fluency change. In a multivariate model, increased RD at the end of RT significantly predicted decline in verbal fluency 18 months after RT. Conclusions Imaging biomarkers of white matter injury contributed to predictive models of cognitive function change after RT.
AB - 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 low-grade tumors received partial brain radiation therapy (RT) to a median dose of 54 Gy. Patients underwent DTI before RT, during RT, and at the end of RT. Cognitive testing was performed before RT, and 6 and 18 months after RT. Parahippocampal cingulum white matter was contoured to obtain mean values of AD and RD. Results By univariate analysis, decreasing AD and increasing RD during RT predicted declines in verbal memory and verbal fluency. By multivariate analysis, baseline neurocognitive score was the only clinical variable predicting verbal memory change; no clinical variables predicted verbal fluency change. In a multivariate model, increased RD at the end of RT significantly predicted decline in verbal fluency 18 months after RT. Conclusions Imaging biomarkers of white matter injury contributed to predictive models of cognitive function change after RT.
KW - Cognitive function
KW - Glioma
KW - Late effects
KW - Magnetic resonance imaging
UR - http://www.scopus.com/inward/record.url?scp=84991051886&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84991051886&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2016.06.021
DO - 10.1016/j.radonc.2016.06.021
M3 - Article
C2 - 27418525
AN - SCOPUS:84991051886
SN - 0167-8140
VL - 120
SP - 234
EP - 240
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 2
ER -