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Serial diffusion tensor imaging for early detection of radiation‐induced injuries to normal‐appearing white matter in high‐grade glioma patients
Author(s) -
Hope Tuva R.,
Vardal Jonas,
Bjørnerud Atle,
Larsson Christopher,
Arnesen Marius R.,
Salo Raimo A.,
Groote Inge R.
Publication year - 2015
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.24533
Subject(s) - diffusion mri , fractional anisotropy , white matter , nuclear medicine , medicine , glioma , kurtosis , radiation therapy , magnetic resonance imaging , radiology , mathematics , statistics , cancer research
Purpose To study the potential of diffusion tensor imaging (DTI) to serve as a biomarker for radiation‐induced brain injury during chemo‐radiotherapy (RT) treatment. Materials and Methods Serial DTI data were collected from 18 high‐grade glioma (HGG) patients undergoing RT and 7 healthy controls. Changes across time in mean, standard deviation (SD), skewness, and kurtosis of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ a ), and transversal diffusivity (λ t ) within the normal‐appearing white matter (NAWM) were modeled using a linear mixed‐effects model to assess dose dependent changes of five dose bins (0–60 Gy), and global changes compared with a control group. Results Mean MD, λ a and λ t were all significantly increasing in >41 Gy dose regions (0.14%, 0.10%, and 0.18% per week) compared with <12 Gy regions. SD λ t had significant dose dependent time evolution of 0.019*dose per week. Mean and SD MD, λ a and λ t in the global NAWM of the patient group significantly increased (mean; 0.06%, 0.03%, 0.09%, and SD; 0.57%, 0.34%, 0.51 per week) compared with the control group. The changes were significant at week 6 of, or immediately after RT. Conclusion DTI is not sensitive to acute global NAWM changes during the treatment of HGG, but sensitive to early posttreatment changes. J. Magn. Reson. Imaging 2015;41:414–423. © 2013 Wiley Periodicals, Inc .