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Radiation Injury to the Normal Brain Measured by 3D‐Echo‐Planar Spectroscopic Imaging and Diffusion Tensor Imaging: Initial Experience
Author(s) -
Chawla Sanjeev,
Wang Sumei,
Kim Sungheon,
Sheriff Sulaiman,
Lee Peter,
Rengan Ramesh,
Lin Alexander,
Melhem Elias,
Maudsley Andrew,
Poptani Harish
Publication year - 2013
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12070
Subject(s) - medicine , fractional anisotropy , diffusion mri , white matter , corpus callosum , nuclear medicine , creatine , radiology , pathology , magnetic resonance imaging
BACKGROUND AND PURPOSE Whole brain radiation therapy (WBRT) may cause cognitive and neuropsychological impairment and hence objective assessment of adverse effects of radiation may be valuable to plan therapy. The purpose of our study was to determine the potential of echo planar spectroscopic imaging (EPSI) and diffusion tensor imaging (DTI) in detecting subacute radiation induced injury to the normal brain. MATERIALS AND METHODS Four patients with brain metastases and three patients with lung cancer underwent cranial irradiation. These patients were subjected to 3D‐EPSI and DTI at two time points (pre‐radiation, and 1 month post‐irradiation). Parametric maps of N ‐acetyl aspartate (NAA), creatine (Cr), choline (Cho), mean diffusivity (MD), and fractional anisotropy (FA) were generated and co‐registered to post‐contrast T1‐weighted images. Normal appearing gray‐matter and white‐matter regions were compared between the two time points to assess sub‐acute effects of radiation using independent sample t‐tests. RESULTS Significantly increased MD ( P = .02), Cho/Cr ( P = .02) and a trend towards a decrease in NAA/Cr ( P = .06) was observed from the hippocampus. Significant decrease in FA ( P = .02) from the centrum‐semiovale and a significant increase in MD ( P = .04) and Cho/Cr ( P = .02) from genu of corpus‐callosum was also observed. CONCLUSIONS Our preliminary findings suggest that 3D‐EPSI and DTI may provide quantitative measures of radiation induced injury to the normal brain.