J H Harreld1,2, P Zou3, N D Sabin3, A Edwards3, Y Han4, Y Li4, O Bieri5,6, R B Khan7, A Gajjar8, G Robinson8, T E Merchant9. 1. From the Department of Radiology (J.H.H.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire Julie.H.Harreld@Hitchcock.org. 2. Geisel School of Medicine (J.H.H.), Dartmouth College, Hanover, New Hampshire. 3. Departments of Diagnostic Imaging (P.Z., N.D.S., A.E.), St. Jude Children's Research Hospital, Memphis, Tennessee 4. Biostatistics (Y.H., Y.L.), St. Jude Children's Research Hospital, Memphis, Tennessee 5. Department of Radiology (O.B.), Division of Radiological Physics, University Hospital Basel, Basel, Switzerland. 6. Department of Biomedical Engineering (O.B), University of Basel, Allschwil, Switzerland. 7. Division of Neurology (R.B.K.), St. Jude Children's Research Hospital, Memphis, Tennessee 8. Department of Pediatrics, and Departments of Neuro-Oncology (A.G., G.R.), St. Jude Children's Research Hospital, Memphis, Tennessee 9. Radiation Oncology (T.E.M.), St. Jude Children's Research Hospital, Memphis, Tennessee.
Abstract
BACKGROUND AND PURPOSE: Radiation necrosis, for which abnormal WM enhancement is a hallmark, is an uncommon complication of craniospinal irradiation in children with medulloblastoma. The magnetization transfer ratio measures macromolecular content, dominated by myelin in the WM. We investigated whether the pretreatment supratentorial (nonsurgical) WM magnetization transfer ratio could predict patients at risk for radiation necrosis after radiation therapy for medulloblastoma. MATERIALS AND METHODS: Ninety-five eligible patients with medulloblastoma (41% female; mean age, 11.0 [SD, 5.4] years) had baseline balanced steady-state free precession MR imaging before proton or photon radiation therapy. Associations among baseline supratentorial magnetization transfer ratio, radiation necrosis (spontaneously resolving/improving parenchymal enhancement within the radiation field)3, age, and the presence of visible brain metastases were explored by logistic regression and parametric/nonparametric techniques as appropriate. RESULTS: Twenty-three of 95 (24.2%) children (44% female; mean age, 10.7 [SD, 6.7] years) developed radiation necrosis after radiation therapy (19 infratentorial, 1 supratentorial, 3 both). The mean pretreatment supratentorial WM magnetization transfer ratio was significantly lower in these children (43.18 versus 43.50, P = .03). There was no association between the supratentorial WM magnetization transfer ratio and age, sex, risk/treatment stratum, or the presence of visible brain metastases. CONCLUSIONS: A lower baseline supratentorial WM magnetization transfer ratio may indicate underlying structural WM susceptibility to radiation necrosis and may identify children at risk for developing radiation necrosis after craniospinal irradiation for medulloblastoma.
BACKGROUND AND PURPOSE: Radiation necrosis, for which abnormal WM enhancement is a hallmark, is an uncommon complication of craniospinal irradiation in children with medulloblastoma. The magnetization transfer ratio measures macromolecular content, dominated by myelin in the WM. We investigated whether the pretreatment supratentorial (nonsurgical) WM magnetization transfer ratio could predict patients at risk for radiation necrosis after radiation therapy for medulloblastoma. MATERIALS AND METHODS: Ninety-five eligible patients with medulloblastoma (41% female; mean age, 11.0 [SD, 5.4] years) had baseline balanced steady-state free precession MR imaging before proton or photon radiation therapy. Associations among baseline supratentorial magnetization transfer ratio, radiation necrosis (spontaneously resolving/improving parenchymal enhancement within the radiation field)3, age, and the presence of visible brain metastases were explored by logistic regression and parametric/nonparametric techniques as appropriate. RESULTS: Twenty-three of 95 (24.2%) children (44% female; mean age, 10.7 [SD, 6.7] years) developed radiation necrosis after radiation therapy (19 infratentorial, 1 supratentorial, 3 both). The mean pretreatment supratentorial WM magnetization transfer ratio was significantly lower in these children (43.18 versus 43.50, P = .03). There was no association between the supratentorial WM magnetization transfer ratio and age, sex, risk/treatment stratum, or the presence of visible brain metastases. CONCLUSIONS: A lower baseline supratentorial WM magnetization transfer ratio may indicate underlying structural WM susceptibility to radiation necrosis and may identify children at risk for developing radiation necrosis after craniospinal irradiation for medulloblastoma.
Authors: Erin S Murphy; Thomas E Merchant; Shengjie Wu; Xiaoping Xiong; Renin Lukose; Karen D Wright; Ibrahim Qaddoumi; Gregory T Armstrong; Alberto Broniscer; Amar Gajjar Journal: Int J Radiat Oncol Biol Phys Date: 2012-08-01 Impact factor: 7.038
Authors: L Pruzincová; J Steno; M Srbecký; P Kalina; B Rychlý; E Boljesíková; M Chorváth; M Novotný; V Procka; I Makaiová; V Belan Journal: Eur Radiol Date: 2009-05-27 Impact factor: 5.315
Authors: S Reed Plimpton; Nicholas Stence; Molly Hemenway; Todd C Hankinson; Nicholas Foreman; Arthur K Liu Journal: Pediatr Hematol Oncol Date: 2013-05-07 Impact factor: 1.969
Authors: Luciana Monteiro Moura; Matthew Kempton; Gareth Barker; Giovanni Salum; Ary Gadelha; Pedro Mario Pan; Marcelo Hoexter; Marco Antonio Gomes Del Aquilla; Felipe Almeida Picon; Mauricio Anés; Maria Concepcion Garcia Otaduy; Edson Amaro; Luis Augusto Rohde; Philip McGuire; Rodrigo Affonseca Bressan; João Ricardo Sato; Andrea Parolin Jackowski Journal: Magn Reson Imaging Date: 2015-12-18 Impact factor: 2.546
Authors: Nina Weishaupt; Angela Zhang; Robert A Deziel; R Andrew Tasker; Shawn N Whitehead Journal: Front Neurosci Date: 2016-03-02 Impact factor: 4.677