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Metabolic alterations: A biomarker for radiation‐induced normal brain injury—an MR spectroscopy study
Author(s) -
Sundgren P.C.,
Nagesh V.,
Elias A.,
Tsien C.,
Junck L.,
Gomez Hassan D.M.,
Lawrence T.S.,
Chenevert T.L.,
Rogers L.,
McKeever P.,
Cao Y.
Publication year - 2009
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.21657
Subject(s) - creatine , choline , medicine , nuclear medicine , in vivo magnetic resonance spectroscopy , radiation therapy , endocrinology , magnetic resonance imaging , radiology
Purpose To assess if interval changes in metabolic status in normal cerebral tissue after radiation therapy (RT) can be detected by 2D CSI (chemical shift imaging) proton spectroscopy. Materials and Methods Eleven patients with primary brain tumors undergoing cranial radiation therapy (RT) were included. 2D‐CSI MRS was performed before, during, and after the course of RT with the following parameters: TE/TR 144/1500 ms, field of view (FOV) 24, thickness 10 mm, matrix 16 × 16. The metabolic ratios choline/creatine (Cho/Cr), N‐acetylaspartate (NAA)/Cr, and NAA/Cho in normal brain tissue were calculated. Results NAA/Cr and Cho/Cr were significantly decreased at week 3 during RT and at 1 month and 6 months after RT compared to values prior to RT ( P < 0.01). The NAA/Cr ratio decreased by −0.19 ± 0.05 (mean ± standard error [SE]) at week 3 of RT, −0.14 ± 0.06 at the last week of RT, −0.14 ± 0.05 at 1 month after RT, and −0.30 ± 0.08 at 6 months after RT compared to the pre‐RT value of 1.43 ± 0.04. The Cho/Cr ratio decreased by −0.27 ± 0.05 at week 3 of RT, −0.11 ± 0.05 at the last week of RT, −0.26 ± 0.05 at 1 month after RT and −0.25 ± 0.07 at 6 months after RT from the pre‐RT value of 1.29 ± 0.03. Changes in Cho/Cr were correlated with the interaction of the radiation dose and dose‐volume at week 3 of RT, during the last week of RT ( P < 0.005), and at 1 month after RT ( P = 0.017). Conclusion The results of this study suggest that MRS can detect early metabolic changes in normal irradiated brain tissue. J. Magn. Reson. Imaging 2009;29:291–297. © 2009 Wiley‐Liss, Inc.