Radiation-induced cerebellar–cerebral functional connectivity alterations in nasopharyngeal carcinoma patients

Ma, Qingsong; Zeng, Ling‐Li; Qin, Jian; Luo, Zhiguo; Su, Jianpo; Wu, Donglin; Qiu, Shijun; Hu, Dewen

doi:10.1097/wnr.0000000000000813

Cited by 14 publications

(20 citation statements)

References 25 publications

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“…The method of PCA+SVM was quite helpful to improve the accuracy of the classification, and validly detected the abnormal brain regions, which widely contained the previous research achievement. As shown in Table 1, our results were consistent with previous studies, suggesting that the method was in favour of identifying the injury caused by RT [5][6][7]9]. The classification accuracy was 82.5 %, indicating that the method could well identify the abnormal changes induced by RT.…”

Section: Resultssupporting

confidence: 81%

“…The cerebellum was vital to the motor control, cognitive and affective regulation [7]. Shen et al [20] reported that the cerebral microbleeds (CMBs) observed in the cerebellum were related to cognitive dysfunction.…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies have found that radiation therapy for NPC resulted in multiple regions abnormalities, such as temporal lobe necrosis [3,4], precuneus, cuneus, lateral occipital cortex [5], the vermis, hippocampus, cerebellum lobule, middle occipital lobe, and insula [6,7]. However, it was difficult for doctors to identify the abnormal changes after radiotherapy (RT) based on original image features.…”

Section: Introductionmentioning

confidence: 99%

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Identify the radiotherapy-induced abnormal changes in the patients with nasopharyngeal carcinoma

Wang

Zhao

Zhang³

et al. 2017

ADMET DMPK

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<p class="ADMETabstracttext">Radiotherapy (RT) is the standard treatment for nasopharyngeal carcinoma, which often causes inevitable brain injury in the process of treatment. The majority of patients has no abnormal signal or density change of the conventional magnetic resonance imaging (MRI) and computed tomography (CT) examination in the long-term follow-up after radiation therapy. However, when there is a visible CT and conventional MR imaging changes, the damage often has been severe and lack of effective treatments, seriously influencing the prognosis of patients. Therefore, the present study aimed to investigate the abnormal changes in nasopharyngeal carcinoma (NPC) patients after RT. In the present study, we exploited the machine learning framework which contained two parts: feature extraction and classification to automatically detect the brain injury. Our results showed that the method could effectively identify the abnormal regions reduced by radiotherapy. The highest classification accuracy was 82.5 % in the abnormal brain regions. The parahippocampal gyrus was the highest accuracy region, which suggested that the parahippocampal gyrus could be most sensitive to radiotherapy and involved in the pathogenesis of radiotherapy-induced brain injury in NPC patients.</p>

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Section: Resultssupporting

confidence: 81%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Identify the radiotherapy-induced abnormal changes in the patients with nasopharyngeal carcinoma

Wang

Zhao

Zhang³

et al. 2017

ADMET DMPK

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“…Diffusion kurtosis imaging (DKI) can detect the early presence of relatively subtle radiation-induced changes before temporal lobe necrosis [25,26]. Altered brain functional connections were significantly correlated to the Montreal Cognitive Assessment scores in NPC patients, which may serve as a potential biomarker of the brain functional impairments [27,28]. Thus, structural and functional MRI were more sensitive than conventional MRI in determining radiation induced brain damage.…”

Section: Discussionmentioning

confidence: 99%

Machine-learning based MRI radiomics models for early detection of radiation-induced brain injury in nasopharyngeal carcinoma

et al. 2020

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Background: Early radiation-induced temporal lobe injury (RTLI) diagnosis in nasopharyngeal carcinoma (NPC) is clinically challenging, and prediction models of RTLI are lacking. Hence, we aimed to develop radiomic models for early detection of RTLI. Methods: We retrospectively included a total of 242 NPC patients who underwent regular follow-up magnetic resonance imaging (MRI) examinations, including contrast-enhanced T1-weighted and T2-weighted imaging. For each MRI sequence, four non-texture and 10,320 texture features were extracted from medial temporal lobe, gray matter, and white matter, respectively. The relief and 0.632 + bootstrap algorithms were applied for initial and subsequent feature selection, respectively. Random forest method was used to construct the prediction model. Three models, 1, 2 and 3, were developed for predicting the results of the last three follow-up MRI scans at different times before RTLI onset, respectively. The area under the curve (AUC) was used to evaluate the performance of models. Results: Of the 242 patients, 171 (70.7%) were men, and the mean age of all the patients was 48.5 ± 10.4 years. The median follow-up and latency from radiotherapy until RTLI were 46 and 41 months, respectively. In the testing cohort, models 1, 2, and 3, with 20 texture features derived from the medial temporal lobe, yielded mean AUCs of 0.830 (95% CI: 0.823-0.837), 0.773 (95% CI: 0.763-0.782), and 0.716 (95% CI: 0.699-0.733), respectively. Conclusion: The three developed radiomic models can dynamically predict RTLI in advance, enabling early detection and allowing clinicians to take preventive measures to stop or slow down the deterioration of RTLI.

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“…Recently, a research team has suggested that radiation can induce functional connectivity (FC) alterations using two independent samples (one group comprised untreated NPC patients and the other comprised NPC patients 6 months after receiving RT), but it is still difficult to directly and objectively demonstrate the functional changes because it is hard to avoid various confounders from two different samples in these studies. [14,15]…”

Section: Introductionmentioning

confidence: 99%

Cerebral functional abnormalities in patients with nasopharyngeal carcinoma after radiotherapy

Ren

Wang

et al. 2019

Chinese Medical Journal

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Background: Nasopharyngeal carcinoma (NPC) is sensitive to radiotherapy (RT). However, neurocognitive complications such as memory loss and learning and attention deficits emerge in the survivors of NPC who received RT. It remains unclear how radiation affects patient brain function. This pilot study aimed at finding cerebral functional alterations in NPC patients who have received RT. Methods: From September 2014 to December 2016, 42 individuals, including 22 NPC patients and 20 normal volunteer controls in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, were recruited in this study. All patients received resting-state functional magnetic resonance imaging scans and neurocognitive tests 1 day before the initiation of RT (baseline) and 1 day after the completion of RT; the 20 normal controls were also subjected to the same scans and tests. The amplitude of the low-frequency fluctuations (ALFF) in blood oxygen level-dependent signals and functional connectivity (FC) were used to characterize cerebral functional changes. Independent t test, paired t test, and analysis of variances were used to obtain statistical significance across groups. Results: After RT, NPC patients showed significantly decreased ALFF values in the calcarine sulcus, lingual gyrus, cuneus, and superior occipital gyrus and showed significantly reduced FC mainly in the default mode network ( P < 0.05, corrected by AlphaSim). Relative to the controls, ALFF was decreased in the lingual gyrus, calcarine sulcus, cingulate cortex, medial prefrontal gyrus ( P < 0.05, corrected by AlphaSim), and FC reduction was found in multiple cerebellar–cerebral regions, including the cerebellum, parahippocampus, hippocampus, fusiform gyrus, inferior frontal gyrus, inferior occipital gyrus, precuneus, and cingulate cortex ( P < 0.001, corrected by AlphaSim). Conclusions: Cerebral functional alterations occur immediately after RT. This study may provide an explanation for the cognitive deficits in the morphologically normal-appearing brains of NPC patients after RT and may contribute to the understanding of the complex mechanism of RT.

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Radiation-induced cerebellar–cerebral functional connectivity alterations in nasopharyngeal carcinoma patients

Cited by 14 publications

References 25 publications

Identify the radiotherapy-induced abnormal changes in the patients with nasopharyngeal carcinoma

Identify the radiotherapy-induced abnormal changes in the patients with nasopharyngeal carcinoma

Machine-learning based MRI radiomics models for early detection of radiation-induced brain injury in nasopharyngeal carcinoma

Cerebral functional abnormalities in patients with nasopharyngeal carcinoma after radiotherapy

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