Petr Pospisil1, Tomas Kazda2, Ludmila Hynkova1, Martin Bulik3, Marie Dobiaskova4, Petr Burkon1, Nadia N Laack5, Pavel Slampa1, Radim Jancalek6. 1. Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic. 2. Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic; International Clinical Research Center, St. Anne's University Hospital Brno, Czech Republic. 3. Department of Diagnostic Imaging, St. Anne's University Hospital Brno, Czech Republic. 4. Department of Clinical Psychology, St. Anne's University Hospital Brno, Czech Republic. 5. Department of Radiation Oncology, Mayo Clinic, Rochester, United States. 6. Department of Neurosurgery - St. Anne's University Hospital Brno, Faculty of Medicine, Masaryk University, Czech Republic; Department of Neurosurgery, St. Anne's University Hospital Brno, Czech Republic. Electronic address: radim.jancalek@fnusa.cz.
Abstract
BACKGROUND AND PURPOSE: The aim of this prospective study is to evaluate post-whole brain radiotherapy (WBRT) changes in hippocampal concentration of N-acetylaspartate (h-tNAA) as a marker of neuronal loss and to correlate those changes to neurocognitive function. MATERIAL AND METHODS: Thirty-five patients with brain metastases underwent baseline single slice multi-voxel MR spectroscopy (MRS) examination for measurement of hippocampal h-tNAA together with baseline battery of neurocognitive tests focused on memory (Auditory Verbal Learning Test and Brief Visuospatial Memory Test - Revised) as well as quality of life questionnaires (EORTC QLQ-C30 a EORTC QLQ-BN20). Eighteen patients completed follow-up evaluation four months after standard WBRT (2 laterolateral fields, 10×3.0Gy, 6MV photons) and were included in this analysis. MRS and cognitive examinations were repeated and compared to baseline measurements. RESULTS: Statistically significant decreases in h-tNAA were observed in the right (8.52-7.42mM; -12.9%, 95%CI: -7.6 to -16.4%) as well as in the left hippocampus (8.64-7.60mM; -12%, 95%CI: -7.9 to -16.2%). Statistically significant decline was observed in all AVLT and BVMT-R subtests with exception of AVLT_Recognition. Quality of life declined after WBRT (mean Δ -14.1±20.3 points in transformed 0-100 point scale; p=0.018) with no correlation to changes in hippocampal metabolite concentrations. Moderate positive correlation was observed between left h-tNAA concentration decrease and AVLT_TR decline (r=+0.32; p=0.24) as well as with AVLT_DR (r=+0.33; p=0.22) decline. Changes in right h-tNAA/Cr negatively correlated with AVLT_DR (r=-0.48; p=0.061). No correlation between right hippocampus h-tNAA and memory decline (AVLT) was observed. CONCLUSIONS: Our results suggest hippocampal NAA concentrations decline after WBRT and MRS may be a useful biomarker for monitoring neuronal loss after radiotherapy.
BACKGROUND AND PURPOSE: The aim of this prospective study is to evaluate post-whole brain radiotherapy (WBRT) changes in hippocampal concentration of N-acetylaspartate (h-tNAA) as a marker of neuronal loss and to correlate those changes to neurocognitive function. MATERIAL AND METHODS: Thirty-five patients with brain metastases underwent baseline single slice multi-voxel MR spectroscopy (MRS) examination for measurement of hippocampal h-tNAA together with baseline battery of neurocognitive tests focused on memory (Auditory Verbal Learning Test and Brief Visuospatial Memory Test - Revised) as well as quality of life questionnaires (EORTC QLQ-C30 a EORTC QLQ-BN20). Eighteen patients completed follow-up evaluation four months after standard WBRT (2 laterolateral fields, 10×3.0Gy, 6MV photons) and were included in this analysis. MRS and cognitive examinations were repeated and compared to baseline measurements. RESULTS: Statistically significant decreases in h-tNAA were observed in the right (8.52-7.42mM; -12.9%, 95%CI: -7.6 to -16.4%) as well as in the left hippocampus (8.64-7.60mM; -12%, 95%CI: -7.9 to -16.2%). Statistically significant decline was observed in all AVLT and BVMT-R subtests with exception of AVLT_Recognition. Quality of life declined after WBRT (mean Δ -14.1±20.3 points in transformed 0-100 point scale; p=0.018) with no correlation to changes in hippocampal metabolite concentrations. Moderate positive correlation was observed between left h-tNAA concentration decrease and AVLT_TR decline (r=+0.32; p=0.24) as well as with AVLT_DR (r=+0.33; p=0.22) decline. Changes in right h-tNAA/Cr negatively correlated with AVLT_DR (r=-0.48; p=0.061). No correlation between right hippocampus h-tNAA and memory decline (AVLT) was observed. CONCLUSIONS: Our results suggest hippocampal NAA concentrations decline after WBRT and MRS may be a useful biomarker for monitoring neuronal loss after radiotherapy.
Authors: Jaymin Jhaveri; En Cheng; Sibo Tian; Zachary Buchwald; Mudit Chowdhary; Yuan Liu; Theresa W Gillespie; Jeffrey J Olson; Aidnag Z Diaz; Alfredo Voloschin; Bree R Eaton; Ian R Crocker; Mark W McDonald; Walter J Curran; Kirtesh R Patel Journal: Front Oncol Date: 2018-11-28 Impact factor: 6.244
Authors: Wenzhao Sun; Jun Zhang; Yixuan Wang; Meining Chen; Jianli Wang; Li Chen; Lixia Lu; Xiaowu Deng Journal: Technol Cancer Res Treat Date: 2022 Jan-Dec
Authors: Tomas Kazda; Adam Dziacky; Petr Burkon; Petr Pospisil; Marek Slavik; Zdenek Rehak; Radim Jancalek; Pavel Slampa; Ondrej Slaby; Radek Lakomy Journal: Radiol Oncol Date: 2018-06-06 Impact factor: 4.214
Authors: Tomas Kazda; Adela Misove; Petr Burkon; Petr Pospisil; Ludmila Hynkova; Iveta Selingerova; Adam Dziacky; Renata Belanova; Martin Bulik; Zdenek Rehak; Alexandr Poprach; Ondrej Slama; Pavel Slampa; Ondrej Slaby; Radim Jancalek; Radek Lakomy Journal: Biomed Res Int Date: 2018-12-13 Impact factor: 3.411