Monwabisi Makola1, M Douglas Ris2, E Mark Mahone3,4, Keith Owen Yeates5, Kim M Cecil6,7,8,9,10. 1. College of Medicine, University of Cincinnati, Cincinnati, OH, USA. 2. Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. 3. Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA. 4. Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. Department of Psychology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada. 6. Imaging Research Center, Cincinnati Children's Hospital Medical Center, MLC 5033, 3333 Burnet Ave., Cincinnati, OH, 45229, USA. kim.cecil@cchmc.org. 7. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA. kim.cecil@cchmc.org. 8. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. kim.cecil@cchmc.org. 9. Neuroscience Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH, USA. kim.cecil@cchmc.org. 10. Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA. kim.cecil@cchmc.org.
Abstract
BACKGROUND: Despite improving survival rates, children are at risk for long-term cognitive and behavioral difficulties following the diagnosis and treatment of a brain tumor. Surgery, chemotherapy and radiation therapy have all been shown to impact the developing brain, especially the white matter. OBJECTIVE: The purpose of this study was to determine the long-term effects of radiation therapy on white matter integrity, as measured by diffusion tensor imaging, in pediatric brain tumor patients 2 years after the end of radiation treatment, while controlling for surgical interventions. MATERIALS AND METHODS: We evaluated diffusion tensor imaging performed at two time points: a baseline 3 to 12 months after surgery and a follow-up approximately 2 years later in pediatric brain tumor patients. A region of interest analysis was performed within three regions of the corpus callosum. Diffusion tensor metrics were determined for participants (n=22) who underwent surgical tumor resection and radiation therapy and demographically matched with participants (n=22) who received surgical tumor resection only. RESULTS: Analysis revealed that 2 years after treatment, the radiation treated group exhibited significantly lower fractional anisotropy and significantly higher radial diffusivity within the body of the corpus callosum compared to the group that did not receive radiation. CONCLUSION: The findings indicate that pediatric brain tumor patients treated with radiation therapy may be at greater risk of experiencing long-term damage to the body of the corpus callosum than those treated with surgery alone.
BACKGROUND: Despite improving survival rates, children are at risk for long-term cognitive and behavioral difficulties following the diagnosis and treatment of a brain tumor. Surgery, chemotherapy and radiation therapy have all been shown to impact the developing brain, especially the white matter. OBJECTIVE: The purpose of this study was to determine the long-term effects of radiation therapy on white matter integrity, as measured by diffusion tensor imaging, in pediatric brain tumorpatients 2 years after the end of radiation treatment, while controlling for surgical interventions. MATERIALS AND METHODS: We evaluated diffusion tensor imaging performed at two time points: a baseline 3 to 12 months after surgery and a follow-up approximately 2 years later in pediatric brain tumorpatients. A region of interest analysis was performed within three regions of the corpus callosum. Diffusion tensor metrics were determined for participants (n=22) who underwent surgical tumor resection and radiation therapy and demographically matched with participants (n=22) who received surgical tumor resection only. RESULTS: Analysis revealed that 2 years after treatment, the radiation treated group exhibited significantly lower fractional anisotropy and significantly higher radial diffusivity within the body of the corpus callosum compared to the group that did not receive radiation. CONCLUSION: The findings indicate that pediatric brain tumorpatients treated with radiation therapy may be at greater risk of experiencing long-term damage to the body of the corpus callosum than those treated with surgery alone.
Entities:
Keywords:
Brain; Brain tumor; Children; Corpus callosum; Diffusion tensor imaging; Magnetic resonance imaging; Radiation; White matter
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