Dynamic contrast-enhanced magnetic resonance imaging as a biomarker for prediction of radiation-induced neurocognitive dysfunction.
Dynamic contrast-enhanced magnetic resonance imaging as a biomarker for prediction of radiation-induced neurocognitive dysfunction.
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DOI：
10.1158/1078-0432.ccr-08-1420
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发表时间：
2009-03-01
期刊：
影响因子：
--
通讯作者：
Lawrence TS
中科院分区：
文献类型：
--
作者：
Cao Y;Tsien CI;Sundgren PC;Nagesh V;Normolle D;Buchtel H;Junck L;Lawrence TS
确定早期评估脑微血管损伤是否可以预测脑放射治疗（RT）后的晚期神经认知功能障碍。10例接受部分脑RT的患者参加了前瞻性动态对比增强（DCE）MRI研究。在RT前、RT期间第3周和第6周以及RT后1个月和6个月获得DCE-MRI。在RT前和RT后MRI随访时进行神经心理学测试。分析RT期间神经认知功能早期延迟变化与血管参数早期变化之间的相关性。放疗后6个月内没有患者出现肿瘤进展。放疗期间高剂量区域的血管体积和血脑屏障（BBB）通透性显著增加，分别增加11%和52%。（P < .05），血管体积和BBB通透性的变化与RT和1周期间第3周和第6周扫描时累积的剂量相关。RT后一个月（P < .03）。RT后6个月语言学习评分的变化与RT期间左颞叶（P<0.02）和额叶（P <0.03）血管体积的变化以及左额叶BBB通透性的变化显著相关（P <0.007）。在回忆分数和BBB渗透性之间发现了类似的相关性。我们的数据表明，脑血管的早期变化可能预示着语言学习和总回忆的延迟改变，这是神经认知功能的重要组成部分。需要进一步的研究来验证这些发现。
To determine whether early assessment of cerebral microvessel injury can predict late neurocognitive dysfunction after brain radiation therapy (RT). Ten patients who underwent partial brain RT participated in a prospective dynamic contrast-enhanced (DCE) MRI study. DCE-MRI was acquired prior to, at week 3 and 6 during, and 1 month and 6 months after RT. Neuropsychological tests were performed pre-RT and at the post-RT MRI follow-ups. The correlations between early delayed changes in neurocognitive functions and early changes in vascular parameters during RT were analyzed. No patients had tumor progression up to 6 months after RT. Vascular volumes and blood-brain barrier (BBB) permeability increased significantly in the high dose regions during RT by 11% and 52% (P < .05), respectively, followed by a decrease after RT. Changes in both vascular volume and BBB permeability correlated with the doses accumulated at the time of scans at week 3 and 6 during RT and 1 month after RT (P < .03). Changes in verbal learning scores 6 months after RT were significantly correlated with changes in vascular volumes of left temporal (p<.02) and frontal lobes (P < .03) and changes in BBB permeability of left frontal lobes during RT (P < .007). Similar correlation was found between recall scores and BBB permeability. Our data suggest that the early changes in cerebral vasculature may predict delayed alterations in verbal learning and total recall, which are important components of neurocognitive function. Additional studies are required for validation of these findings.