Related Experiment Video
Updated: Apr 6, 2026
Translational Orthotopic Models of Glioblastoma Multiforme
Published on: February 17, 2023
Standard chemoradiation for glioblastoma results in progressive brain volume loss
Morgan J Prust1, Kourosh Jafari-Khouzani1, Jayashree Kalpathy-Cramer1
1From Harvard Medical School (M.J.P., J.D.), Boston; and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology (M.J.P., K.J.-K., J.K.-C., P.P., E.R.G.), and Department of Neurology, Center for Neuro-Oncology (T.T.B., E.R.G., J.D.), Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Objective:
To investigate the effects of chemotherapy and cranial irradiation on normal brain tissue using in vivo neuroimaging in patients with glioblastoma.
Methods:
We used longitudinal MRI to monitor structural brain changes during standard treatment in patients newly diagnosed with glioblastoma. We assessed volumetric and diffusion tensor imaging measures in 14 patients receiving 6 weeks of chemoradiation, followed by up to 6 months of temozolomide chemotherapy alone. We examined changes in whole brain, gray matter (GM), white matter (WM), anterior lateral ventricle, and hippocampal volumes. Normal-appearing GM, WM, and hippocampal analyses were conducted within the hemisphere of lowest/absent tumor burden. We examined diffusion tensor imaging measures within the subventricular zone.
Results:
Whole brain (F = 2.41; p = 0.016) and GM (F = 2.13; p = 0.036) volume decreased during treatment, without significant WM volume change. Anterior lateral ventricle volume increased significantly (F = 65.51; p < 0.001). In participants analyzed beyond 23 weeks, mean ventricular volume increased by 42.2% (SE: 8.8%; t = 4.94; p < 0.005). Apparent diffusion coefficient increased within the subventricular zone (F = 7.028; p < 0.001). No significant changes were identified in hippocampal volume.
Conclusions:
We present evidence of significant and progressive treatment-associated structural brain changes in patients with glioblastoma treated with standard chemoradiation. Future studies using longitudinal neuropsychological evaluation are needed to characterize the functional consequences of these structural changes.
