Radiation Injury to the Normal Brain Measured by 3D-Echo-Planar Spectroscopic Imaging and Diffusion Tensor Imaging: Initial Experience

Sanjeev Chawla, Sumei Wang, Sungheon Kim, Sulaiman Sheriff, Peter Lee, Ramesh Rengan, Alexander Lin, Elias Melhem, Andrew A Maudsley, Harish Poptani

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: Whole brain radiation therapy (WBRT) may cause cognitive and neuropsychological impairment and hence objective assessment of adverse effects of radiation may be valuable to plan therapy. The purpose of our study was to determine the potential of echo planar spectroscopic imaging (EPSI) and diffusion tensor imaging (DTI) in detecting subacute radiation induced injury to the normal brain. MATERIALS AND METHODS: Four patients with brain metastases and three patients with lung cancer underwent cranial irradiation. These patients were subjected to 3D-EPSI and DTI at two time points (pre-radiation, and 1 month post-irradiation). Parametric maps of N-acetyl aspartate (NAA), creatine (Cr), choline (Cho), mean diffusivity (MD), and fractional anisotropy (FA) were generated and co-registered to post-contrast T1-weighted images. Normal appearing gray-matter and white-matter regions were compared between the two time points to assess sub-acute effects of radiation using independent sample t-tests. RESULTS: Significantly increased MD (P = .02), Cho/Cr (P = .02) and a trend towards a decrease in NAA/Cr (P = .06) was observed from the hippocampus. Significant decrease in FA (P = .02) from the centrum-semiovale and a significant increase in MD (P = .04) and Cho/Cr (P = .02) from genu of corpus-callosum was also observed. CONCLUSIONS: Our preliminary findings suggest that 3D-EPSI and DTI may provide quantitative measures of radiation induced injury to the normal brain.

Original languageEnglish
Pages (from-to)97-104
Number of pages8
JournalJournal of Neuroimaging
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Echo-Planar Imaging
Radiation Injuries
Diffusion Tensor Imaging
Creatine
Anisotropy
Radiation Effects
Brain
Cranial Irradiation
Corpus Callosum
Choline
Hippocampus
Lung Neoplasms
Radiotherapy
Radiation
Neoplasm Metastasis
N-acetylaspartate
phosphonium choline

Keywords

  • Diffusion tensor imaging
  • Echo-planar spectroscopic imaging
  • Prophylactic cranial irradiation
  • Radiation injury
  • Whole brain radiation therapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Radiation Injury to the Normal Brain Measured by 3D-Echo-Planar Spectroscopic Imaging and Diffusion Tensor Imaging : Initial Experience. / Chawla, Sanjeev; Wang, Sumei; Kim, Sungheon; Sheriff, Sulaiman; Lee, Peter; Rengan, Ramesh; Lin, Alexander; Melhem, Elias; Maudsley, Andrew A; Poptani, Harish.

In: Journal of Neuroimaging, Vol. 25, No. 1, 01.01.2015, p. 97-104.

Research output: Contribution to journalArticle

Chawla, Sanjeev ; Wang, Sumei ; Kim, Sungheon ; Sheriff, Sulaiman ; Lee, Peter ; Rengan, Ramesh ; Lin, Alexander ; Melhem, Elias ; Maudsley, Andrew A ; Poptani, Harish. / Radiation Injury to the Normal Brain Measured by 3D-Echo-Planar Spectroscopic Imaging and Diffusion Tensor Imaging : Initial Experience. In: Journal of Neuroimaging. 2015 ; Vol. 25, No. 1. pp. 97-104.
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T1 - Radiation Injury to the Normal Brain Measured by 3D-Echo-Planar Spectroscopic Imaging and Diffusion Tensor Imaging

T2 - Initial Experience

AU - Chawla, Sanjeev

AU - Wang, Sumei

AU - Kim, Sungheon

AU - Sheriff, Sulaiman

AU - Lee, Peter

AU - Rengan, Ramesh

AU - Lin, Alexander

AU - Melhem, Elias

AU - Maudsley, Andrew A

AU - Poptani, Harish

PY - 2015/1/1

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N2 - BACKGROUND AND PURPOSE: Whole brain radiation therapy (WBRT) may cause cognitive and neuropsychological impairment and hence objective assessment of adverse effects of radiation may be valuable to plan therapy. The purpose of our study was to determine the potential of echo planar spectroscopic imaging (EPSI) and diffusion tensor imaging (DTI) in detecting subacute radiation induced injury to the normal brain. MATERIALS AND METHODS: Four patients with brain metastases and three patients with lung cancer underwent cranial irradiation. These patients were subjected to 3D-EPSI and DTI at two time points (pre-radiation, and 1 month post-irradiation). Parametric maps of N-acetyl aspartate (NAA), creatine (Cr), choline (Cho), mean diffusivity (MD), and fractional anisotropy (FA) were generated and co-registered to post-contrast T1-weighted images. Normal appearing gray-matter and white-matter regions were compared between the two time points to assess sub-acute effects of radiation using independent sample t-tests. RESULTS: Significantly increased MD (P = .02), Cho/Cr (P = .02) and a trend towards a decrease in NAA/Cr (P = .06) was observed from the hippocampus. Significant decrease in FA (P = .02) from the centrum-semiovale and a significant increase in MD (P = .04) and Cho/Cr (P = .02) from genu of corpus-callosum was also observed. CONCLUSIONS: Our preliminary findings suggest that 3D-EPSI and DTI may provide quantitative measures of radiation induced injury to the normal brain.

AB - BACKGROUND AND PURPOSE: Whole brain radiation therapy (WBRT) may cause cognitive and neuropsychological impairment and hence objective assessment of adverse effects of radiation may be valuable to plan therapy. The purpose of our study was to determine the potential of echo planar spectroscopic imaging (EPSI) and diffusion tensor imaging (DTI) in detecting subacute radiation induced injury to the normal brain. MATERIALS AND METHODS: Four patients with brain metastases and three patients with lung cancer underwent cranial irradiation. These patients were subjected to 3D-EPSI and DTI at two time points (pre-radiation, and 1 month post-irradiation). Parametric maps of N-acetyl aspartate (NAA), creatine (Cr), choline (Cho), mean diffusivity (MD), and fractional anisotropy (FA) were generated and co-registered to post-contrast T1-weighted images. Normal appearing gray-matter and white-matter regions were compared between the two time points to assess sub-acute effects of radiation using independent sample t-tests. RESULTS: Significantly increased MD (P = .02), Cho/Cr (P = .02) and a trend towards a decrease in NAA/Cr (P = .06) was observed from the hippocampus. Significant decrease in FA (P = .02) from the centrum-semiovale and a significant increase in MD (P = .04) and Cho/Cr (P = .02) from genu of corpus-callosum was also observed. CONCLUSIONS: Our preliminary findings suggest that 3D-EPSI and DTI may provide quantitative measures of radiation induced injury to the normal brain.

KW - Diffusion tensor imaging

KW - Echo-planar spectroscopic imaging

KW - Prophylactic cranial irradiation

KW - Radiation injury

KW - Whole brain radiation therapy

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