Assessing changes in brain structure in new-onset children with acute lymphoblastic leukemia

Area of Science:

• Neuroimaging
• Pediatric Oncology
• Radiology

Background:

• Brain structure injury is known after acute lymphoblastic leukemia (ALL) treatment.
• Alterations in new-onset pediatric ALL are not well understood.

Purpose of the Study:

• To explore white matter (WM) and grey matter (GM) alterations in new-onset pediatric ALL.
• Utilize surface-based morphometry (SBM) and tract-based spatial statistics (TBSS).

Main Methods:

• Recruited 35 pediatric ALL patients and 33 typically developing (TD) children.
• Acquired 3D T1-weighted and diffusion tensor imaging (DTI).
• Compared DTI metrics, cortical GM features, and deep GM nuclei volume between groups.

Main Results:

• Pediatric ALL showed decreased cortical surface area, thickness, and volume in several brain regions.
• Increased fractional anisotropy (FA) was noted in the corpus callosum and superior corona radiata.
• Reduced volumes were observed in bilateral thalamus, caudate, hippocampus, and right putamen.

Conclusions:

• New-onset pediatric ALL exhibits widespread brain structural abnormalities.
• These findings suggest the disease itself can cause brain structural injury prior to chemotherapy.
• MRI is a sensitive tool for early detection of brain damage in pediatric ALL.