Retrospective study of late radiation-induced damages after focal radiotherapy for childhood brain tumors.
Abnormalities, Radiation-Induced
/ diagnostic imaging
Brain Neoplasms
/ radiotherapy
Child
Diffusion Tensor Imaging
/ methods
Female
Follow-Up Studies
Gray Matter
/ diagnostic imaging
Humans
Male
Mental Status and Dementia Tests
Neurocognitive Disorders
Retrospective Studies
White Matter
/ diagnostic imaging
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
19
02
2020
accepted:
15
02
2021
entrez:
26
2
2021
pubmed:
27
2
2021
medline:
28
8
2021
Statut:
epublish
Résumé
To study a robust and reproducible procedure to investigate a relation between focal brain radiotherapy (RT) low doses, neurocognitive impairment and late White Matter and Gray Matter alterations, as shown by Diffusion Tensor Imaging (DTI), in children. Forty-five patients (23 males and 22 females, median age at RT 6.2 years, median age at evaluations 11.1 years) who had received focal RT for brain tumors were recruited for DTI exams and neurocognitive tests. Patients' brains were parceled in 116 regions of interest (ROIs) using an available segmented atlas. After the development of an ad hoc, home-made, multimodal and highly deformable registration framework, we collected mean RT doses and DTI metrics values for each ROI. The pattern of association between cognitive scores or domains and dose or DTI values was assessed in each ROI through both considering and excluding ROIs with mean doses higher than 75% of the prescription. Subsequently, a preliminary threshold value of dose discriminating patients with and without neurocognitive impairment was selected for the most relevant associations. The workflow allowed us to identify 10 ROIs where RT dose and DTI metrics were significantly associated with cognitive tests results (p<0.05). In 5/10 ROIs, RT dose and cognitive tests were associated with p<0.01 and preliminary RT threshold dose values, implying a possible cognitive or neuropsychological damage, were calculated. The analysis of domains showed that the most involved one was the "school-related activities". This analysis, despite being conducted on a retrospective cohort of children, shows that the identification of critical brain structures and respective radiation dose thresholds is achievable by combining, with appropriate methodological tools, the large amount of data arising from different sources. This supported the design of a prospective study to gain stronger evidence.
Identifiants
pubmed: 33635906
doi: 10.1371/journal.pone.0247748
pii: PONE-D-20-04740
pmc: PMC7909688
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0247748Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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