Rate of radiation-induced microbleed formation on 7T MRI relates to cognitive impairment in young patients treated with radiation therapy for a brain tumor.
Rate of radiation-induced microbleed formation on 7T MRI relates to cognitive impairment in young patients treated with radiation therapy for a brain tumor.
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DOI：
10.1016/j.radonc.2020.09.028
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Lupo JM
中科院分区：
文献类型：
--
作者：
Morrison MA;Mueller S;Felton E;Jakary A;Stoller S;Avadiappan S;Yuan J;Molinaro AM;Braunstein S;Banerjee A;Hess CP;Lupo JM
放射治疗（RT）对于许多脑肿瘤的治疗至关重要，但已知会导致认知能力下降和脑微出血（CMB）形式的血管损伤。在一个调查RT后动脉病和卒中风险的大型试验中招募的儿童、青少年和年轻人的一个子集中，我们评估了RT后CMB的患病率，检查了CMB和认知障碍的危险因素，并将其纵向发展与认知能力变化联系起来。25例患者（平均17岁，范围：10-25岁）接受了7-T MRI和认知评估。19例患者在1个月至20年前接受了全脑或局灶性RT治疗，而6例未接受放射治疗的后颅窝肿瘤患者作为对照。使用半自动软件在7 T磁敏感加权成像（SWI）上检测到CMB，这是该人群中的首次使用。7 T SWI的CMB检测灵敏度高于先前在较低场强下报告的灵敏度，在至少1年前接受RT治疗的患者中100%检测到一个或多个CMB。CMB定位于剂量靶向脑体积，风险因素包括全脑RT（p=0.05）、较高的RT剂量（p=0.01）、RT后时间增加（p=0.03）和RT期间年龄较小（p=0.01）。除了RT剂量外，这些因素与记忆力受损有关。一部分患者的随访数据显示，随着言语记忆能力的恶化，CMB计数成比例增加（r=-0.85，p =0.03）。在青年时期接受RT治疗与CMB的慢性发展有关，随着时间的推移，CMB会随着记忆障碍而发展。
Radiation therapy (RT) is essential to the management of many brain tumors, but has been known to lead to cognitive decline and vascular injury in the form of cerebral microbleeds (CMBs). In a subset of children, adolescents, and young adults recruited from a larger trial investigating arteriopathy and stroke risk after RT, we evaluated the prevalence of CMBs after RT, examined risk factors for CMBs and cognitive impairment, and related their longitudinal development to cognitive performance changes. Twenty-five patients (mean 17 years, range:10–25 years) underwent 7-Tesla MRI and cognitive assessment. 19 patients were treated with whole-brain or focal RT 1-month to 20-years prior, while 6 non-irradiated patients with posterior-fossa tumors served as controls. CMBs were detected on 7T susceptibility-weighted imaging (SWI) using semi-automated software, a first use in this population. CMB detection sensitivity with 7T SWI was higher than previously reported at lower field strengths, with one or more CMBs detected in 100% of patients treated with RT at least 1-year prior. CMBs were localized to dose-targeted brain volumes with risk factors including whole-brain RT (p=0.05), a higher RT dose (p=0.01), increasing time since RT (p=0.03), and younger age during RT (p=0.01). Apart from RT dose, these factors were associated with impaired memory performance. Follow-up data in a subset of patients revealed a proportional increase in CMB count with worsening verbal memory performance (r=−0.85,p=0.03). Treatment with RT during youth is associated with the chronic development of CMBs that evolve with memory impairment over time.
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影响因子：
4.7
作者：
Greene-Schloesser D;Robbins ME;Peiffer AM;Shaw EG;Wheeler KT;Chan MD
通讯作者：
Chan MD
DOI：
10.1016/j.bbadis.2016.01.015
发表时间：
2016-05
期刊：
Biochimica et biophysica acta
影响因子：
--
作者：
Kalaria RN;Akinyemi R;Ihara M
通讯作者：
Ihara M
影响因子：
15.9
作者：
Lupo, Janine M.;Molinaro, Annette M.;Nelson, Sarah J.
通讯作者：
Nelson, Sarah J.
DOI：
10.1016/j.ijrobp.2011.05.046
发表时间：
2012-03-01
影响因子：
7
作者：
Lupo, Janine M.;Chuang, Cynthia F.;Nelson, Sarah J.
通讯作者：
Nelson, Sarah J.
影响因子：
--
作者：
Osorio, Diana S;Allen, Jeffrey C
通讯作者：
Allen, Jeffrey C