Dataset Information

Retrospective assessment of MRI-based volumetric changes of normal tissues in glioma patients following radio(chemo)therapy.

ABSTRACT: In glioma patients, linac-based photon beam irradiation is a widely applied therapy, which achieves highly conformal target volume coverage, but is also known to cause side-effects to adjacent areas of healthy tissue. Apart from subjective measures, such as quality of life assessment and neurocognitive function tests, objective methods to quantify tissue damage are needed to assess this impact. Magnetic resonance imaging (MRI) is a well-established method for brain tumor diagnoses as well as assessing treatment response. In this study, we retrospectively assessed volumetric changes of gray matter (GM) and white matter (WM) in glioma patients following photon irradiation using a heterogeneous MRI-dataset obtained in routine clinical practice at different sites with imaging parameters and magnetic field strengths. We found a significant reduction in WM volume at one year [Formula: see text] and two years [Formula: see text] post radio(chemo)therapy whereas corresponding GM volumes did not change significantly ([Formula: see text] and [Formula: see text], respectively). More importantly, we also found large variations in the segmented tissue volumes caused by the heterogeneous MR data, thus potentially masking more subtle tissue changes over time. On the basis of these observations, we present suggestions regarding data acquisitions in future prospective MR studies to assess such volumetric changes.

SUBMITTER: Gommlich A

PROVIDER: S-EPMC5862681 | biostudies-other | 2018 Jan

REPOSITORIES: biostudies-other

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Retrospective assessment of MRI-based volumetric changes of normal tissues in glioma patients following radio(chemo)therapy.

Gommlich Andreas A Raschke Felix F Wahl Hannes H Troost Esther G C EGC

Clinical and translational radiation oncology 20171122

In glioma patients, linac-based photon beam irradiation is a widely applied therapy, which achieves highly conformal target volume coverage, but is also known to cause side-effects to adjacent areas of healthy tissue. Apart from subjective measures, such as quality of life assessment and neurocognitive function tests, objective methods to quantify tissue damage are needed to assess this impact. Magnetic resonance imaging (MRI) is a well-established method for brain tumor diagnoses as well as ass ...[more]

PMID: 29594238

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Project description:BackgroundRadiotherapy treatment of head and neck cancer affects local arteries and increases the risk of stroke. This study aimed at a closer characterization of this damage and its development in time with a longitudinal study set up.MethodsMale patients treated between 2011 and 2016 for hypopharyngeal carcinoma were identified from the in-house clinical data base. They were included into the study if besides the planning CT at least one additional CT image was available from follow-up (13 patients) or at least two MRI scans (16 patients of which 2 were already included). All patients received radiotherapy, and chemotherapy was administered to 16 patients. The time from the beginning of radiotherapy to the last available image ranged from 2 months to 4.5 years. For six segments of the carotid arteries, the number and volume of atherosclerotic plaques were determined from the CT scans, and the intima media thickness from the MRI scans. Information on comorbid cardiovascular disease, hypertension and diabetes mellitus was retrieved from medical records.ResultsTotal plaque volume rose from 0.25 cm3 before to 0.33 cm3 after therapy but this was not significant (p = 0.26). The mean number of plaques increased from 5.7 to 8.1 (p = 0.002), and the intima media thickened from 1.17 mm to 1.35 mm (p = 0.002). However, the mean intima media thickness practically did not change in patients with comorbid diabetes mellitus (p-value for homogeneity: 0.03). For patients without diabetes mellitus, dynamics of both plaque number and intima media thickness, was consistent with an increase until about one year after therapy and no further progression thereafter.ConclusionOur study confirmed the thickening of artery walls and the increase in the number of plaques. Results imply that definitive radiation damage to the artery walls can be determined not earlier than about one year after radiotherapy and there is no substantial deterioration thereafter. Reasons for the absence of an observable intima media thickening in patients with diabetes are unclear.

Project description:PurposeThis prospective study evaluated the use of vascular, extracellular and restricted diffusion for cytometry in tumours (VERDICT) MRI to investigate the tissue microstructure in glioma. VERDICT-derived parameters were correlated with both histological features and tumour subtype and were also used to explore the peritumoural region.MethodsFourteen consecutive treatment-naïve patients (43.5 years ± 15.1 years, six males, eight females) with suspected glioma underwent diffusion-weighted imaging including VERDICT modelling. Tumour cell radius and intracellular and combined extracellular/vascular volumes were estimated using a framework based on linearisation and convex optimisation. An experienced neuroradiologist outlined the peritumoural oedema, enhancing tumour and necrosis on T2-weighted imaging and contrast-enhanced T1-weighted imaging. The same regions of interest were applied to the co-registered VERDICT maps to calculate the microstructure parameters. Pathology sections were analysed with semi-automated software to measure cellularity and cell size.ResultsVERDICT parameters were successfully calculated in all patients. The imaging-derived results showed a larger intracellular volume fraction in high-grade glioma compared to low-grade glioma (0.13 ± 0.07 vs. 0.08 ± 0.02, respectively; p = 0.05) and a trend towards a smaller extracellular/vascular volume fraction (0.88 ± 0.07 vs. 0.92 ± 0.04, respectively; p = 0.10). The conventional apparent diffusion coefficient was higher in low-grade gliomas compared to high-grade gliomas, but this difference was not statistically significant (1.22 ± 0.13 × 10-3 mm2/s vs. 0.98 ± 0.38 × 10-3 mm2/s, respectively; p = 0.18).ConclusionThis feasibility study demonstrated that VERDICT MRI can be used to explore the tissue microstructure of glioma using an abbreviated protocol. The VERDICT parameters of tissue structure correlated with those derived on histology. The method shows promise as a potential test for diagnostic stratification and treatment response monitoring in the future.Key points• VERDICT MRI is an advanced diffusion technique which has been correlated with histopathological findings obtained at surgery from patients with glioma in this study. • The intracellular volume fraction measured with VERDICT was larger in high-grade tumours compared to that in low-grade tumours. • The results were complementary to measurements from conventional diffusion-weighted imaging, and the technique could be performed in a clinically feasible timescale.

Dataset Information

Retrospective assessment of MRI-based volumetric changes of normal tissues in glioma patients following radio(chemo)therapy.

Publications

Retrospective assessment of MRI-based volumetric changes of normal tissues in glioma patients following radio(chemo)therapy.

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