Evaluating growth failure with diffusion tensor imaging in pediatric survivors of high-risk neuroblastoma treated with high-dose cis-retinoic acid

Delgado, Jorge; Jaramillo, Diego; Chauvin, Nancy A.; Guo, Michelle; Stratton, Mackenzie S.; Sweeney, Hannah E.; Barrera, Christian A.; Mostoufi‐Moab, Sogol

doi:10.1007/s00247-019-04409-1

Cited by 16 publications

(19 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Participant characteristics did not differ between enrolled and eligible patients who declined study participation. The group characteristics are summarized in Table 1, as previously described by our group 5 . HR‐NBL survivors and control participants were matched for age (HR‐NBL participant mean age: 12.45 years, range: 9.46–16.03; control participant mean age: 12.18 years, range: 10.36–14.11).…”

Section: Resultsmentioning

confidence: 99%

“…As previously described, 5 survivors with growth hormone deficiency were diagnosed using conventional assessments, which included growth failure, abnormal growth velocity for age, laboratory testing and formal stimulation testing of the growth axis.…”

Section: Methodsmentioning

confidence: 99%

“…The cumulative dose of cis ‐RA for each participant was calculated as the sum of total milligram dose (mg/m 2 body surface area, multiplied by the participant's body surface area) for all cycles of therapy, as previously described. 5 …”

Section: Methodsmentioning

confidence: 99%

“…The combination of young age at diagnosis and aggressive multimodal treatment, even in the absence of total body irradiation (TBI), leads to marked growth failure and short stature 4 . We recently reported differences in physeal structure between HR‐NBL survivors and healthy controls, suggesting poor growth plate architecture as the underlying cause for abnormal growth 5 . However, body composition abnormalities have not been well characterized in HR‐NBL survivors.…”

Section: Introductionmentioning

confidence: 99%

“… 4 We recently reported differences in physeal structure between HR‐NBL survivors and healthy controls, suggesting poor growth plate architecture as the underlying cause for abnormal growth. 5 However, body composition abnormalities have not been well characterized in HR‐NBL survivors. Metabolic syndrome at rates higher than healthy controls has been identified in survivors of neuroblastoma, but not specifically HR‐NBL, who received abdominal radiation.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Sarcopenia and preserved bone mineral density in paediatric survivors of high‐risk neuroblastoma with growth failure

Guo

Zemel

Hawkes

et al. 2021

J cachexia sarcopenia muscle

Self Cite

View full text Add to dashboard Cite

Background Survival from paediatric high‐risk neuroblastoma (HR‐NBL) has increased, but cis‐retinoic acid (cis‐RA), the cornerstone of HR‐NBL therapy, can cause osteoporosis and premature physeal closure and is a potential threat to skeletal structure in HR‐NBL survivors. Sarcopenia is associated with increased morbidity in survivors of paediatric malignancies. Low muscle mass may be associated with poor prognosis in HR‐NBL patients but has not been studied in these survivors. The study objective was to assess bone density, body composition and muscle strength in HR‐NBL survivors compared with controls. Methods This prospective cross‐sectional study assessed areal bone mineral density (aBMD) of the whole body, lumbar spine, total hip, femoral neck, distal 1/3 and ultradistal radius and body composition (muscle and fat mass) using dual‐energy X‐ray absorptiometry (DXA) and lower leg muscle strength using a dynamometer. Measures expressed as sex‐specific standard deviation scores (Z‐scores) included aBMD (adjusted for height Z‐score), bone mineral apparent density (BMAD), leg lean mass (adjusted for leg length), whole‐body fat mass index (FMI) and ankle dorsiflexion peak torque adjusted for leg length (strength‐Z). Muscle‐specific force was assessed as strength relative to leg lean mass. Outcomes were compared between HR‐NBL survivors and controls using Student's t‐test or Mann–Whitney U test. Linear regression models examined correlations between DXA and dynamometer outcomes. Results We enrolled 20 survivors of HR‐NBL treated with cis‐RA [13 male; mean age: 12.4 ± 1.6 years; median (range) age at therapy initiation: 2.6 (0.3–9.1) years] and 20 age‐, sex‐ and race‐matched controls. Height‐Z was significantly lower in HR‐NBL survivors compared with controls (−1.73 ± 1.38 vs. 0.34 ± 1.12, P < 0.001). Areal BMD‐Z, BMAD‐Z, FMI‐Z, visceral adipose tissue and subcutaneous adipose tissue were not significantly different in HR‐NBL survivors compared with controls. Compared with controls, HR‐NBL survivors had lower leg lean mass‐Z (−1.46 ± 1.35 vs. − 0.17 ± 0.84, P < 0.001) and strength‐Z (−1.13 ± 0.86 vs. − 0.15 ± 0.71, P < 0.001). Muscle‐specific force was lower in HR‐NBL survivors compared with controls (P < 0.05). Conclusions Bone mineral density and adiposity are not severely impacted in HR‐NBL survivors with growth failure, but significant sarcopenia persists years after treatment. Future studies are needed to determine if sarcopenia improves with muscle‐specific interventions in this population of cancer survivors.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Sarcopenia and preserved bone mineral density in paediatric survivors of high‐risk neuroblastoma with growth failure

Guo

Zemel

Hawkes

et al. 2021

J cachexia sarcopenia muscle

Self Cite

View full text Add to dashboard Cite

show abstract

Imaging Biomarkers of the Physis: Cartilage Volume on MRI vs. Tract Volume and Length on Diffusion Tensor Imaging

Duong

Mostoufi‐Moab

Raya

et al. 2020

Magnetic Resonance Imaging

View full text Add to dashboard Cite

BackgroundCurrent methods to predict height and growth failure are imprecise. MRI measures of physeal cartilage are promising biomarkers for growth.PurposeIn the physis, to assess how 3D MRI volume measurements, and diffusion tensor imaging (DTI) measurements (tract volume and length) correlate with growth parameters and detect differences in growth. We compared patients exposed to cis‐retinoic acid, which causes physeal damage and growth failure, with normal subjects.Study TypeCase–control.PopulationTwenty pediatric neuroblastoma survivors treated with cis‐retinoic acid and 20 age‐ and sex‐matched controls.Field Strength/Sequence3T; DTI and 3D double‐echo steady‐state (DESS) sequences.AssessmentOn distal femoral MR studies, physeal 3D volume and DTI tract measurements were calculated and compared to height.Statistical TestsWe used partial Spearman correlation, analysis of covariance, logistic regression, Wald test, and the intraclass correlation coefficient (ICC).ResultsThe height percentile correlated most strongly with DTI tract volumes (r = 0.74), followed by mean tract length (r = 0.53) and 3D volume (r = 0.40) (all P < 0.02). Only tract volumes and lengths correlated with annualized growth velocity. Relative to controls, patients showed smaller tract volumes (8.00 cc vs. 13.71 cc, P < 0.01), shorter tract lengths (5.92 mm vs 6.99 mm, P = 0.03), and smaller ratios of 3D cartilage volume to tract length; but no difference (4.51 cc vs 4.85 cc) in 3D MRI volumes. The 10 patients with the lowest height percentiles had smaller tract volumes (5.07 cc vs. 10.93 cc, P < 0.01), but not significantly different 3D MRI volumes. Tract volume is associated with abnormal growth, with an accuracy of 75%.Data ConclusionDTI tract volume of the physis/metaphysis predicts abnormal growth better than physeal cartilage volumetric measurement and correlates best with height percentile and growth velocity.Evidence Level2Technical EfficacyStage 2 J. Magn. Reson. Imaging 2020;52:544–551.

show abstract

Applications of Diffusion‐Weighted MRI to the Musculoskeletal System

Raya

Duarte

Wang

et al. 2023

Magnetic Resonance Imaging

Self Cite

View full text Add to dashboard Cite

Diffusion‐weighted imaging (DWI) is an established MRI technique that can investigate tissue microstructure at the scale of a few micrometers. Musculoskeletal tissues typically have a highly ordered structure to fulfill their functions and therefore represent an optimal application of DWI. Even more since disruption of tissue organization affects its biomechanical properties and may indicate irreversible damage. The application of DWI to the musculoskeletal system faces application‐specific challenges on data acquisition including susceptibility effects, the low T2 relaxation time of most musculoskeletal tissues (2–70 msec) and the need for sub‐millimetric resolution. Thus, musculoskeletal applications have been an area of development of new DWI methods. In this review, we provide an overview of the technical aspects of DWI acquisition including diffusion‐weighting, MRI pulse sequences and different diffusion regimes to study tissue microstructure. For each tissue type (growth plate, articular cartilage, muscle, bone marrow, intervertebral discs, ligaments, tendons, menisci, and synovium), the rationale for the use of DWI and clinical studies in support of its use as a biomarker are presented. The review describes studies showing that DTI of the growth plate has predictive value for child growth and that DTI of articular cartilage has potential to predict the radiographic progression of joint damage in early stages of osteoarthritis. DTI has been used extensively in skeletal muscle where it has shown potential to detect microstructural and functional changes in a wide range of muscle pathologies. DWI of bone marrow showed to be a valuable tool for the diagnosis of benign and malignant acute vertebral fractures and bone metastases. DTI and diffusion kurtosis have been investigated as markers of early intervertebral disc degeneration and lower back pain. Finally, promising new applications of DTI to anterior cruciate ligament grafts and synovium are presented. The review ends with an overview of the use of DWI in clinical routine.Evidence Level5Technical EfficacyStage 3

show abstract

Evaluating growth failure with diffusion tensor imaging in pediatric survivors of high-risk neuroblastoma treated with high-dose cis-retinoic acid

Cited by 16 publications

References 26 publications

Sarcopenia and preserved bone mineral density in paediatric survivors of high‐risk neuroblastoma with growth failure

Sarcopenia and preserved bone mineral density in paediatric survivors of high‐risk neuroblastoma with growth failure

Imaging Biomarkers of the Physis: Cartilage Volume on MRI vs. Tract Volume and Length on Diffusion Tensor Imaging

Applications of Diffusion‐Weighted MRI to the Musculoskeletal System

Contact Info

Product

Resources

About