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Title: Radiation Dose–Dependent Hippocampal Atrophy Detected With Longitudinal Volumetric Magnetic Resonance Imaging

Abstract

Purpose: After radiation therapy (RT) to the brain, patients often experience memory impairment, which may be partially mediated by damage to the hippocampus. Hippocampal sparing in RT planning is the subject of recent and ongoing clinical trials. Calculating appropriate hippocampal dose constraints would be improved by efficient in vivo measurements of hippocampal damage. In this study we sought to determine whether brain RT was associated with dose-dependent hippocampal atrophy. Methods and Materials: Hippocampal volume was measured with magnetic resonance imaging (MRI) in 52 patients who underwent fractionated, partial brain RT for primary brain tumors. Study patients had high-resolution, 3-dimensional volumetric MRI before and 1 year after RT. Images were processed using software with clearance from the US Food and Drug Administration and Conformité Européene marking for automated measurement of hippocampal volume. Automated results were inspected visually for accuracy. Tumor and surgical changes were censored. Mean hippocampal dose was tested for correlation with hippocampal atrophy 1 year after RT. Average hippocampal volume change was also calculated for hippocampi receiving high (>40 Gy) or low (<10 Gy) mean RT dose. A multivariate analysis was conducted with linear mixed-effects modeling to evaluate other potential predictors of hippocampal volume change, including patient (random effect), age, hemisphere, sex, seizure history, andmore » baseline volume. Statistical significance was evaluated at α = 0.05. Results: Mean hippocampal dose was significantly correlated with hippocampal volume loss (r=−0.24, P=.03). Mean hippocampal volume was significantly reduced 1 year after high-dose RT (mean −6%, P=.009) but not after low-dose RT. In multivariate analysis, both RT dose and patient age were significant predictors of hippocampal atrophy (P<.01). Conclusions: The hippocampus demonstrates radiation dose–dependent atrophy after treatment for brain tumors. Quantitative MRI is a noninvasive imaging technique capable of measuring radiation effects on intracranial structures. This technique could be investigated as a potential biomarker for development of reliable dose constraints for improved cognitive outcomes.« less

Authors:
;  [1];  [2];  [1];  [2]; ; ; ;  [1]; ;  [2];  [2];  [3];  [2];  [4];  [1]
  1. Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California (United States)
  2. Department of Radiology, University of California, San Diego, La Jolla, California (United States)
  3. (United States)
  4. Department of Psychiatry, University of California, San Diego, La Jolla, California (United States)
Publication Date:
OSTI Identifier:
22645762
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 97; Journal Issue: 2; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ATROPHY; BIOLOGICAL MARKERS; BIOMEDICAL RADIOGRAPHY; CLINICAL TRIALS; COMPUTER CODES; GY RANGE 01-10; GY RANGE 10-100; HIPPOCAMPUS; IMAGES; IN VIVO; MULTIVARIATE ANALYSIS; NEOPLASMS; NMR IMAGING; PATIENTS; RADIATION DOSES; RADIATION EFFECTS; RADIOTHERAPY

Citation Formats

Seibert, Tyler M., Karunamuni, Roshan, Bartsch, Hauke, Kaifi, Samar, Krishnan, Anitha Priya, Dalia, Yoseph, Burkeen, Jeffrey, Murzin, Vyacheslav, Moiseenko, Vitali, Kuperman, Joshua, White, Nathan S., Brewer, James B., Department of Neurosciences, University of California, San Diego, La Jolla, California, Farid, Nikdokht, McDonald, Carrie R., and Hattangadi-Gluth, Jona A., E-mail: jhattangadi@ucsd.edu. Radiation Dose–Dependent Hippocampal Atrophy Detected With Longitudinal Volumetric Magnetic Resonance Imaging. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2016.10.035.
Seibert, Tyler M., Karunamuni, Roshan, Bartsch, Hauke, Kaifi, Samar, Krishnan, Anitha Priya, Dalia, Yoseph, Burkeen, Jeffrey, Murzin, Vyacheslav, Moiseenko, Vitali, Kuperman, Joshua, White, Nathan S., Brewer, James B., Department of Neurosciences, University of California, San Diego, La Jolla, California, Farid, Nikdokht, McDonald, Carrie R., & Hattangadi-Gluth, Jona A., E-mail: jhattangadi@ucsd.edu. Radiation Dose–Dependent Hippocampal Atrophy Detected With Longitudinal Volumetric Magnetic Resonance Imaging. United States. doi:10.1016/J.IJROBP.2016.10.035.
Seibert, Tyler M., Karunamuni, Roshan, Bartsch, Hauke, Kaifi, Samar, Krishnan, Anitha Priya, Dalia, Yoseph, Burkeen, Jeffrey, Murzin, Vyacheslav, Moiseenko, Vitali, Kuperman, Joshua, White, Nathan S., Brewer, James B., Department of Neurosciences, University of California, San Diego, La Jolla, California, Farid, Nikdokht, McDonald, Carrie R., and Hattangadi-Gluth, Jona A., E-mail: jhattangadi@ucsd.edu. Wed . "Radiation Dose–Dependent Hippocampal Atrophy Detected With Longitudinal Volumetric Magnetic Resonance Imaging". United States. doi:10.1016/J.IJROBP.2016.10.035.
@article{osti_22645762,
title = {Radiation Dose–Dependent Hippocampal Atrophy Detected With Longitudinal Volumetric Magnetic Resonance Imaging},
author = {Seibert, Tyler M. and Karunamuni, Roshan and Bartsch, Hauke and Kaifi, Samar and Krishnan, Anitha Priya and Dalia, Yoseph and Burkeen, Jeffrey and Murzin, Vyacheslav and Moiseenko, Vitali and Kuperman, Joshua and White, Nathan S. and Brewer, James B. and Department of Neurosciences, University of California, San Diego, La Jolla, California and Farid, Nikdokht and McDonald, Carrie R. and Hattangadi-Gluth, Jona A., E-mail: jhattangadi@ucsd.edu},
abstractNote = {Purpose: After radiation therapy (RT) to the brain, patients often experience memory impairment, which may be partially mediated by damage to the hippocampus. Hippocampal sparing in RT planning is the subject of recent and ongoing clinical trials. Calculating appropriate hippocampal dose constraints would be improved by efficient in vivo measurements of hippocampal damage. In this study we sought to determine whether brain RT was associated with dose-dependent hippocampal atrophy. Methods and Materials: Hippocampal volume was measured with magnetic resonance imaging (MRI) in 52 patients who underwent fractionated, partial brain RT for primary brain tumors. Study patients had high-resolution, 3-dimensional volumetric MRI before and 1 year after RT. Images were processed using software with clearance from the US Food and Drug Administration and Conformité Européene marking for automated measurement of hippocampal volume. Automated results were inspected visually for accuracy. Tumor and surgical changes were censored. Mean hippocampal dose was tested for correlation with hippocampal atrophy 1 year after RT. Average hippocampal volume change was also calculated for hippocampi receiving high (>40 Gy) or low (<10 Gy) mean RT dose. A multivariate analysis was conducted with linear mixed-effects modeling to evaluate other potential predictors of hippocampal volume change, including patient (random effect), age, hemisphere, sex, seizure history, and baseline volume. Statistical significance was evaluated at α = 0.05. Results: Mean hippocampal dose was significantly correlated with hippocampal volume loss (r=−0.24, P=.03). Mean hippocampal volume was significantly reduced 1 year after high-dose RT (mean −6%, P=.009) but not after low-dose RT. In multivariate analysis, both RT dose and patient age were significant predictors of hippocampal atrophy (P<.01). Conclusions: The hippocampus demonstrates radiation dose–dependent atrophy after treatment for brain tumors. Quantitative MRI is a noninvasive imaging technique capable of measuring radiation effects on intracranial structures. This technique could be investigated as a potential biomarker for development of reliable dose constraints for improved cognitive outcomes.},
doi = {10.1016/J.IJROBP.2016.10.035},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 97,
place = {United States},
year = {Wed Feb 01 00:00:00 EST 2017},
month = {Wed Feb 01 00:00:00 EST 2017}
}