Serial diffusion tensor imaging to characterize radiation-induced changes in normal-appearing white matter following radiotherapy in patients with adult low-grade gliomas

Haris, Mohammad; Kumar, Shaleen; Raj, Mani Karthick; Das, K.J. Maria; Sapru, S.; Behari, Sanjay; Rathore, Ram K.S.; Narayana, Ponnada A.; Gupta, Rakesh K.

doi:10.1007/s11604-007-0209-4

Cited by 49 publications

(54 citation statements)

References 33 publications

(37 reference statements)

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“…Earlier it has been reported that the CS truly reflect isotropic behavior of water molecule while MD does not [45]. Further, it has been shown that the increased BBB permeability results in increase CS value [45]. Strong direct correlation between MMP-9 and CS in the current study also suggests that the CS is more sensitive than MD in measuring the increased water concentration due to the MMP-9 induced BBB damage as well as ECM degradation.…”

Section: Discussionsupporting

confidence: 61%

“…In the current study, increased MD and CS values in cellular fraction of BT compared to normal brain parenchyma suggests increased interstitial fluid due to the degradation of the ECM by high MMP-9 expression in cellular fraction of the BT. Earlier it has been reported that the CS truly reflect isotropic behavior of water molecule while MD does not [45]. Further, it has been shown that the increased BBB permeability results in increase CS value [45].…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

DTI derived indices correlate with immunohistochemistry obtained matrix metalloproteinase (MMP-9) expression in cellular fraction of brain tuberculoma

Gupta¹,

Haris²,

Husain³

et al. 2008

Journal of the Neurological Sciences

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 96%

DTI derived indices correlate with immunohistochemistry obtained matrix metalloproteinase (MMP-9) expression in cellular fraction of brain tuberculoma

Gupta¹,

Haris²,

Husain³

et al. 2008

Journal of the Neurological Sciences

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“…A possible cause of the discrepancy is the effect of concomitant chemotherapy (which our patients did not receive) in those studies because chemotherapy alone can alter normal white matter structures (26). This postulation is supported by a longitudinal study on patients not receiving chemotherapy (27), which showed a recovery or no further progression at 8 or 14 months after therapy and no change when the average dose was less than 45 Gy. Other possible causes of the discrepancy could be whole brain irradiation (15) as opposed to focal irradiation by proton therapy, higher dose to the target volume (range, 50-81 Gy) (9) than that in the present study (54 CGE), and differences in adult and pediatric patients.…”

Section: Comparison To Previous Dti Studies Of Photon Therapymentioning

confidence: 74%

Effects of Surgery and Proton Therapy on Cerebral White Matter of Craniopharyngioma Patients

Hua

Ogg

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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Purpose-To determine the radiation dose-effect on the structural integrity of cerebral white matter in craniopharyngioma patients receiving surgery and proton therapy.Methods and Materials-Fifty-one patients (aged 2.1-19.3 years) with craniopharyngioma underwent surgery and proton therapy in a prospective therapeutic trial. Anatomical magnetic resonance images acquired after surgery but before proton therapy were inspected to identify white matter structures intersected by surgical corridors and catheter tracks. Longitudinal diffusion tensor imaging (DTI) was performed to measure microstructural integrity changes in cerebral white matter. Fractional anisotropy (FA) derived from DTI was statistically analyzed for 51 atlasbased white matter structures of the brain to determine radiation dose-effect. FA in surgeryaffected regions in the corpus callosum was compared to that in its intact counterpart to determine whether surgical defects affect radiation dose-effect.Results-Surgical defects were seen most frequently in the corpus callosum because of transcallosal resection of tumors and insertion of ventricular or cyst catheters. The longitudinal DTI data indicated reductions in FA 3 months after therapy, which was followed by a recovery in most white matter structures. A greater FA reduction was correlated with a higher radiation dose in 20 white matter structures, indicating a radiation dose-effect. The average FA in the surgery- Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript affected regions before proton therapy was smaller (P =0.0001) than that in their non-surgery affected counterparts with more intensified subsequent reduction of FA (P=0.0083) after therapy, suggesting that surgery accentuated the radiation dose-effect.Conclusions-DTI data suggest that mild radiation dose-effects occur in patients with craniopharyngioma receiving surgery and proton therapy. Surgical defects present at the time of proton therapy appear to accentuate the radiation dose-effect longitudinally. This study supports consideration of pre-existing surgical defects and their locations in proton therapy planning and studies of treatment effect.

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“…Early works have demonstrated the capabilities of DTI for 3D tracking of axonal projections (8,18). Recent studies have found DTI a potential biomarker of WM damage (15)(16)(17)19). In 2004, Huisman et al (17) reported that changes in the WM detected by DTI could be correlated with diffuse axonal injury.…”

Section: Introductionmentioning

confidence: 99%

“…Lately, Chapman et al (19) reported a potential correlation between early diffusion changes and radiation-induced late delayed neurocognitive decline and suggested DTI as a potentially useful biomarker for predicting late delayed cognitive decline. Although radiation-induced WM damage has been investiagted in conventional fractionated radiation therapy (15)(16)(17)19), few studies have been carried out to investigate radiation-induced changes in WM following stereotactic radiosurgery (SRS).…”

Section: Introductionmentioning

confidence: 99%

Evaluating Radiation-induced White Matter Changes in Patients Treated with Stereotactic Radiosurgery Using Diffusion Tensor Imaging: A Pilot Study

Chang

Kirkpatrick

Wang

et al. 2014

Technol Cancer Res Treat

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Abbreviations: SRS: Stereotactic Radiosurgery; DTI: Diffusion Tensor Imaging; WM: White Matter.Stereotactic radiosurgery (SRS) has been an effective treatment method for brain tumors; however, few data are available regarding radiation-induced white matter (WM) damage by SRS. In this work, diffusion tensor imaging (DTI) was used to investigate WM changes following SRS. Fifteen patients with gliomas were enrolled, with prescription doses ranging 18-25 Gy. Patients were scanned with magnetic resonance imaging (MRI) including DTI before and after SRS. Diffusion tensors were calculated and fiber tracking was performed. Non-irradiated WM volumes and irradiated WM volumes receiving 12 Gy and 5 Gy were contoured as volumes of interest (VOI). Apparent diffusion coefficient (D), fractional anisotropy (FA) and number of fibers (NF) were calculated and assessed using the Wilcoxon signed-rank test. Compared with those of non-irradiated VOIs, FA and NF decreased considerably after two months of SRS in the irradiated WM VOIs. The variation in D was however small and was not statistically significant. The preliminary results suggested that FA and NF might potentially be more sensitive indicators than D in measuring radiation-induced WM changes and DTI could be a valuable tool to assess radiation-induced WM changes in SRS. Although it is still preliminary, this pilot study may be useful to provide insights for future studies.

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Serial diffusion tensor imaging to characterize radiation-induced changes in normal-appearing white matter following radiotherapy in patients with adult low-grade gliomas

Cited by 49 publications

References 33 publications

DTI derived indices correlate with immunohistochemistry obtained matrix metalloproteinase (MMP-9) expression in cellular fraction of brain tuberculoma

DTI derived indices correlate with immunohistochemistry obtained matrix metalloproteinase (MMP-9) expression in cellular fraction of brain tuberculoma

Effects of Surgery and Proton Therapy on Cerebral White Matter of Craniopharyngioma Patients

Evaluating Radiation-induced White Matter Changes in Patients Treated with Stereotactic Radiosurgery Using Diffusion Tensor Imaging: A Pilot Study

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