방사선종양학

본문글자크기
  • [Radiother Oncol .] Volumetric changes in gray matter after radiotherapy detected with longitudinal magnetic resonance imaging in glioma patients

    [Radiother Oncol .] Volumetric changes in gray matter after radiotherapy detected with longitudinal magnetic resonance imaging in glioma patients

    서울의대 / 이혜인, 장범섭*

  • 출처
    Radiother Oncol .
  • 등재일
    2022 Oct 5
  • 저널이슈번호
    176:157-164
  • 내용

    바로가기  >

    Abstract
    Background and purpose: We evaluated volumetric changes in the gray matter (GM) after radiotherapy (RT) and identified factors that were strongly associated with GM volume reduction.

    Materials and methods: A total of 461 magnetic resonance imagings (MRI) from 105 glioma patients treated with postoperative RT was retrospectively analyzed. Study patients' MRIs were collected at five time points: before RT and 1 month, 6 months, 1 year, and 2 years after RT. Using the 'FastSurfer' platform, a deep learning-based neuroimaging pipeline, 73 regions were automatically segmented from longitudinal MRIs and their volumetric changes were calculated. Regions were grouped into 10 functional fields. A multivariable linear mixed-effects model was established to identify the potential predictors of significant volume reduction.

    Results: The median age was 50 years (range, 16-86 years). Forty-seven (44.8 %) patients were female and 68 (64.8 %) had glioblastoma. Postoperative RT was delivered at 54-60 Gy with or without concurrent chemotherapy. At 2 years after RT, the median volumetric changes in the overall, ipsilateral, and contralateral GM were -3.5%, -4.5%, and -2.4%, respectively. The functional fields of cognition and execution of movement showed the greatest volume reductions. In the multivariable linear mixed model, female sex (normalized coefficient = -0.14, P < 0.001) and the interaction between age at RT and days after RT (normalized coefficient = -6.48e-6, P < 0.001) were significantly associated with GM reduction. The older patients received RT, the greater volume reduction was seen over time. However, in patients with relatively younger age (e.g., 45, 50, and 60 years for hippocampus, Broca area, and Wernicke area, respectively), the volume was not significantly reduced.

    Conclusions: GM volume reduction was identified after RT that could lead to long-term treatment sequelae. Particularly for susceptible patients, individualized treatment and prevention strategies are needed.

     

     

     

     

     

    Affiliations

    Hye In Lee 1, Min Kyoung Kang 2, Kihwan Hwang 3, Chae-Yong Kim 3, Yu Jung Kim 4, Koung Jin Suh 4, Byung Se Choi 5, Gheeyoung Choe 6, In Ah Kim 7, Bum-Sup Jang 8
    1Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
    2Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Republic of Korea.
    3Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
    4Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
    5Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
    6Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
    7Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
    8Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: bigwiz83@gmail.com.

     

  • 키워드
    Brain atrophy; Glioma; Gray matter; Magnetic resonance imaging; Radiotherapy.
  • 덧글달기
    덧글달기
       IP : 35.171.159.141

    등록