Effect of radiation therapy on cerebral cortical thickness in glioma patients: Treatment-induced thinning of the healthy cortex.

cerebral cortex cortical thickness glioma radiation therapy

Journal

Neuro-oncology advances
ISSN: 2632-2498
Titre abrégé: Neurooncol Adv
Pays: England
ID NLM: 101755003

Informations de publication

Date de publication:
Historique:
entrez: 10 7 2020
pubmed: 10 7 2020
medline: 10 7 2020
Statut: epublish

Résumé

With overall survival of brain tumors improving, radiation induced brain injury is becoming an increasing issue. One of the effects of radiation therapy (RT) is thinning of the cerebral cortex, which could be one of the factors contributing to cognitive impairments after treatment. In healthy brain, cortex thickness varies between 1 and 4.5 mm. In this study, we assess the effect of RT on the thickness of the cerebral cortex and relate the changes to the local dose. We identified 28 glioma patients with optimal scan quality. Clinical CTs and MRIs at baseline and 1 year post-RT were collected and coregistered. The scans were processed via an automated image processing pipeline, which enabled measuring changes of the cortical thickness, which were related to local dose. Three areas were identified where significant dose-dependent thinning occurred, with thinning rates of 5, 6, and 26 μm/Gy after 1 year, which corresponds to losses of 5.4%, 7.2%, and 21.6% per 30 Gy per year. The first area was largely located in the right inferior parietal, supramarginal, and superior parietal regions, the second in the right posterior cingulate and paracentral regions, and the third almost completely in the right lateral orbital frontal region. We have identified three areas susceptible to dose-dependent cortical thinning after radiation therapy. Should future prospective studies conclude that irradiation of these areas lead to cognitive decline, they need to be spared in order to prevent this debilitating consequence of treatment.

Sections du résumé

BACKGROUND BACKGROUND
With overall survival of brain tumors improving, radiation induced brain injury is becoming an increasing issue. One of the effects of radiation therapy (RT) is thinning of the cerebral cortex, which could be one of the factors contributing to cognitive impairments after treatment. In healthy brain, cortex thickness varies between 1 and 4.5 mm. In this study, we assess the effect of RT on the thickness of the cerebral cortex and relate the changes to the local dose.
METHODS METHODS
We identified 28 glioma patients with optimal scan quality. Clinical CTs and MRIs at baseline and 1 year post-RT were collected and coregistered. The scans were processed via an automated image processing pipeline, which enabled measuring changes of the cortical thickness, which were related to local dose.
RESULTS RESULTS
Three areas were identified where significant dose-dependent thinning occurred, with thinning rates of 5, 6, and 26 μm/Gy after 1 year, which corresponds to losses of 5.4%, 7.2%, and 21.6% per 30 Gy per year. The first area was largely located in the right inferior parietal, supramarginal, and superior parietal regions, the second in the right posterior cingulate and paracentral regions, and the third almost completely in the right lateral orbital frontal region.
CONCLUSIONS CONCLUSIONS
We have identified three areas susceptible to dose-dependent cortical thinning after radiation therapy. Should future prospective studies conclude that irradiation of these areas lead to cognitive decline, they need to be spared in order to prevent this debilitating consequence of treatment.

Identifiants

pubmed: 32642712
doi: 10.1093/noajnl/vdaa060
pii: vdaa060
pmc: PMC7284116
doi:

Types de publication

Journal Article

Langues

eng

Pagination

vdaa060

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.

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Auteurs

Steven H J Nagtegaal (SHJ)

Department of Radiation Oncology, University Medical Center, Utrecht, The Netherlands.

Szabolcs David (S)

Image Sciences Institute, University Medical Center, Utrecht, The Netherlands.

Tom J Snijders (TJ)

Department of Neurology, University Medical Center, Utrecht, The Netherlands.

Marielle E P Philippens (MEP)

Department of Radiation Oncology, University Medical Center, Utrecht, The Netherlands.

Alexander Leemans (A)

Image Sciences Institute, University Medical Center, Utrecht, The Netherlands.

Joost J C Verhoeff (JJC)

Department of Radiation Oncology, University Medical Center, Utrecht, The Netherlands.

Classifications MeSH