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Quantifying Cognitive Decrements Caused by Cranial Radiotherapy
Published on: October 18, 2011
Characterization and quantification of cerebral edema induced by synchrotron x-ray microbeam radiation therapy
Raphaël Serduc1, Yohan van de Looij, Gilles Francony
1INSERM, U836, F-38043 Grenoble, France. serduc@esrf.fr
Abstract:
Cerebral edema is one of the main acute complications arising after irradiation of brain tumors. Microbeam radiation therapy (MRT), an innovative experimental radiotherapy technique using spatially fractionated synchrotron x-rays, has been shown to spare radiosensitive tissues such as mammal brains. The aim of this study was to determine if cerebral edema occurs after MRT using diffusion-weighted MRI and microgravimetry. Prone Swiss nude mice's heads were positioned horizontally in the synchrotron x-ray beam and the upper part of the left hemisphere was irradiated in the antero-posterior direction by an array of 18 planar microbeams (25 mm wide, on-center spacing 211 mm, height 4 mm, entrance dose 312 Gy or 1000 Gy). An apparent diffusion coefficient (ADC) was measured at 7 T 1, 7, 14, 21 and 28 days after irradiation. Eventually, the cerebral water content (CWC) was determined by microgravimetry. The ADC and CWC in the irradiated (312 Gy or 1000 Gy) and in the contralateral non-irradiated hemispheres were not significantly different at all measurement times, with two exceptions: (1) a 9% ADC decrease (p < 0.05) was observed in the irradiated cortex 1 day after exposure to 312 Gy, (2) a 0.7% increase (p < 0.05) in the CWC was measured in the irradiated hemispheres 1 day after exposure to 1000 Gy. The results demonstrate the presence of a minor and transient cellular edema (ADC decrease) at 1 day after a 312 Gy exposure, without a significant CWC increase. One day after a 1000 Gy exposure, the CWC increased, while the ADC remained unchanged and may reflect the simultaneous presence of cellular and vasogenic edema. Both types of edema disappear within a week after microbeam exposure which may confirm the normal tissue sparing effect of MRT.
Insights
Microbeam radiation therapy (MRT) shows potential for sparing brain tissue. Studies indicate transient cerebral edema after MRT, resolving within a week, suggesting a normal tissue sparing effect.
Area of Science:
- Radiotherapy and Oncology
- Neuroscience
- Medical Imaging
Background:
- Cerebral edema is a significant complication of brain tumor irradiation.
- Microbeam radiation therapy (MRT) uses spatially fractionated synchrotron x-rays and shows promise for sparing sensitive tissues like the brain.
- Assessing cerebral edema post-MRT is crucial for understanding its safety and efficacy.
Purpose of the Study:
- To investigate the occurrence and characteristics of cerebral edema following MRT in a preclinical model.
- To evaluate the temporal dynamics of edema using diffusion-weighted MRI and microgravimetry.
Main Methods:
- Prone Swiss nude mice underwent irradiation of the brain hemisphere using planar microbeams (312 Gy or 1000 Gy).
- Diffusion-weighted MRI (apparent diffusion coefficient, ADC) was measured at multiple time points post-irradiation (1-28 days).
- Cerebral water content (CWC) was determined by microgravimetry.
Main Results:
- A minor, transient decrease in ADC (cellular edema) was observed 1 day after 312 Gy, without significant CWC increase.
- A transient increase in CWC (vasogenic edema) was noted 1 day after 1000 Gy, with unchanged ADC.
- Both ADC and CWC returned to baseline levels within one week post-irradiation for both doses.
Conclusions:
- MRT induces only minor and transient cerebral edema, which resolves within a week.
- The observed edema patterns suggest a normal tissue sparing effect of MRT.
- These findings support the potential of MRT for brain tumor treatment with reduced side effects.
