Abstract Archives of the RSNA, 2009
The Effect of Whole Brain Radiation on the Integrity of Brain White and Grey Matter as Well as Cognitive Performance Measured by MR-diffusion Tensor (DTI) Imaging: A Longitudinal Study
Presented on November 30, 2009
Presented as part of SSC12: ISP: Neuroradiology (Brain: Effects of Treatment)
Juergen Lutz MD, Presenter: Nothing to Disclose
Brigitte Walther, Abstract Co-Author: Nothing to Disclose
Axel Axel Siefert MD, PhD, Abstract Co-Author: Nothing to Disclose
Olaf Dietrich, Abstract Co-Author: Nothing to Disclose
Holger Frank Boehm MD, Abstract Co-Author: Nothing to Disclose
Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose
Stefan Oswald Schoenberg MD, PhD, Abstract Co-Author: Nothing to Disclose
Robert Stahl, Abstract Co-Author: Nothing to Disclose
00030490-DMT et al, Abstract Co-Author: Nothing to Disclose
The objective of this prospective study was to investigate the microstructural changes of grey and white matter regions in patients undergoing whole brain radiation due to metastatic disease with DTI. Radiation therapy is knowing to cause damage to peritumoral normal appearing grey and white matter, which result in altered diffusion properties.
15 patients (mean age 51.8 years) with confirmed diagnosis of cerebral metastatic disease were examined over a time course of 12 months after a six week radiation therapy using an 1.5 T MR System (AVANTO, Siemens) with a DTI Epi-sequence (TE 71 ms, TR 6000 ms, 36 Slices, 1.8x1.8x3.6 mm spatial resolution) along 12 different diffusion directions with a b-value of 1000s/mm2. After post processing, standardized regions of interests (ROI) were placed bilaterally (outside the masses) within 15 dedicated brain regions. Fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) were calculated. The cognitive performance was evaluated using the standardized MMSE (minimal mental state examination).
FA and ADC showed no significant changes (p>0.05) over the investigation period of 12 months. Initially, there was a uniformly significant (p<0.05) decrease of FA and an increase of ADC within the first three months after start of radiation and recovery in the subsequent months. The most severely affected regions were the white matter of the frontal and temporal lobes, and the corpus callosum. The grey matter showed equal results in time course. A concomitant evaluated longitudinal cognitive testing demonstrated no significant decline in memory skills.
This study demonstrates no significant differences of FA and ADC in the time course of white matter changes in patients undergoing whole brain radiation during an investigation period of 12 months. The effects of radiation therapy on the microstructural architecture can be visualized and monitored over time.
DTI may serve as a follow up tool during radiation therapy to show radiation induced microstrural changes and control treatment response and guidance.
et al, 0,
The Effect of Whole Brain Radiation on the Integrity of Brain White and Grey Matter as Well as Cognitive Performance Measured by MR-diffusion Tensor (DTI) Imaging: A Longitudinal Study. Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8014277.html