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Related Concept Videos

Brain Imaging01:14

Brain Imaging

Brain imaging technologies provide critical insights into both the structure and function of the human brain, enabling medical professionals and researchers to diagnose, study, and treat neurological disorders or psychiatric disorders more effectively.
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans),  magnetic resonance imaging (MRI),  functional magnetic resonance imaging (fMRI), and Transcranial Magnetic Stimulation (TMS).

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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
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Brain tumor therapy-induced changes in normal-appearing brainstem measured with longitudinal diffusion tensor

Chiaho Hua1, Thomas E Merchant, Amar Gajjar

  • 1Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA. Chia-Ho.Hua@stjude.org

International Journal of Radiation Oncology, Biology, Physics
|June 14, 2011
PubMed
Summary

Childhood brain tumor patients receiving radiation therapy showed varied brainstem white matter injury and recovery patterns. Early changes in fractional anisotropy (FA) may predict long-term recovery over five years.

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Area of Science:

  • Neuroimaging
  • Pediatric Oncology
  • Radiation Oncology

Background:

  • Childhood brain tumors require multimodal treatment, including radiation therapy.
  • Radiation can induce long-term changes in normal-appearing brain tissue.
  • Diffusion Tensor Imaging (DTI) is sensitive to white matter microstructural changes.

Purpose of the Study:

  • To characterize therapy-induced changes in normal-appearing brainstems of childhood brain tumor patients using serial DTI.
  • To correlate DTI findings with radiation dose and treatment types.

Main Methods:

  • 109 DTI studies from 20 pediatric brain tumor patients (aged 4-23) with normal-appearing brainstems were analyzed.
  • Patients received craniospinal irradiation and chemotherapy or irradiation with erlotinib.
  • Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were mapped and compared to radiation dose and healthy controls.

Main Results:

  • Three longitudinal patterns of FA and ADC changes were observed: stable, initial deviation with recovery, and progressive deviation.
  • Maximal FA decline often occurred 1.5-3.5 years post-radiation, with full recovery possible within 4 years.
  • Radiation dose alone did not predict long-term recovery patterns; early FA decline indicated incomplete recovery.

Conclusions:

  • Individual variations in brainstem white matter injury and recovery exist after therapy in pediatric brain tumor patients.
  • Early changes in brainstem anisotropy (FA) may indicate the long-term recovery trend over five years.
  • Serial DTI can monitor and potentially predict outcomes of radiation-induced brainstem injury.