N S Voon1, F N Lau2, R Zakaria3, S A Md Rani4, F Ismail5, H A Manan6, N Yahya7. 1. Diagnostic Imaging and Radiotherapy, Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300 Kuala Lumpur, Malaysia. 2. Department of Radiotherapy and Oncology, National Cancer Institute, 62250 Putrajaya, Malaysia. 3. Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000 Kuala Lumpur, Malaysia. 4. Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000 Kuala Lumpur, Malaysia. 5. Department of Radiotherapy and Oncology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000 Kuala Lumpur, Malaysia. 6. Functional Image Processing Laboratory, Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000 Kuala Lumpur, Malaysia. 7. Diagnostic Imaging and Radiotherapy, Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300 Kuala Lumpur, Malaysia. Electronic address: azrulyahya@ukm.edu.my.
Abstract
PURPOSE: Nasopharyngeal carcinoma (NPC) radiotherapy (RT) irradiates parts of the brain which may cause cerebral tissue changes. This study aimed to systematically review the brain microstructure changes using MRI-based measures, diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI) and voxel-based morphometry (VBM) and the impact of dose and latency following RT. METHODS: PubMed and Scopus databases were searched based on PRISMA guideline to determine studies focusing on changes following NPC RT. RESULTS: Eleven studies fulfilled the inclusion criteria. Microstructural changes occur most consistently in the temporal region. The changes were correlated with latency in seven studies; fractional anisotropy (FA) and gray matter (GM) volume remained low even after a longer period following RT and areas beyond irradiation site with reduced FA and GM measures. For dosage, only one study showed correlation, thus requiring further investigations. CONCLUSION: DTI, DKI and VBM may be used as a surveillance tool in detecting brain microstructural changes of NPC patients which correlates to latency and brain areas following RT.
PURPOSE: Nasopharyngeal carcinoma (NPC) radiotherapy (RT) irradiates parts of the brain which may cause cerebral tissue changes. This study aimed to systematically review the brain microstructure changes using MRI-based measures, diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI) and voxel-based morphometry (VBM) and the impact of dose and latency following RT. METHODS: PubMed and Scopus databases were searched based on PRISMA guideline to determine studies focusing on changes following NPC RT. RESULTS: Eleven studies fulfilled the inclusion criteria. Microstructural changes occur most consistently in the temporal region. The changes were correlated with latency in seven studies; fractional anisotropy (FA) and gray matter (GM) volume remained low even after a longer period following RT and areas beyond irradiation site with reduced FA and GM measures. For dosage, only one study showed correlation, thus requiring further investigations. CONCLUSION: DTI, DKI and VBM may be used as a surveillance tool in detecting brain microstructural changes of NPC patients which correlates to latency and brain areas following RT.
Keywords:
Brain; Carcinome nasopharyngé; Cerveau; Diffusion Kurtosis Imaging; Diffusion Tensor Imaging; Imagerie Kurtosis de diffusion; Imagerie du tenseur de diffusion; Morphométrie à base de voxel; Nasopharyngeal Carcinoma; Voxel-Based Morphometry