Radiation-induced abnormal cortical thickness in patients with nasopharyngeal carcinoma after radiotherapy.
Radiation-induced abnormal cortical thickness in patients with nasopharyngeal carcinoma after radiotherapy.
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鼻咽癌放疗后放疗引起的皮质厚度异常
DOI：
10.1016/j.nicl.2017.02.025
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Huang R
中科院分区：
文献类型：
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作者：
Lin J;Lv X;Niu M;Liu L;Chen J;Xie F;Zhong M;Qiu S;Li L;Huang R
常规MRI研究表明，鼻咽癌患者放疗后多年内发生放射性脑坏死，可累及大脑灰质，损害脑功能。然而，放疗后早期GM表现正常的鼻咽癌患者，其放射所致的脑形态改变仍不清楚。在本研究中，我们获得了三组患者的高分辨率脑结构MRI数据，包括22例放疗前(Pre-RT)鼻咽癌患者(Pre-RT)，22例放疗后早期延迟阶段(Post-RT-ED)的鼻咽癌患者(Post-RT-ED)和20例晚期鼻咽癌患者(Post-RT-LD)，分析鼻咽癌患者放疗后皮质厚度的变化。使用基于顶点表面的形态计量学(SBM)方法，我们检测到RT-ED后组与RT前组相比，中央前回(PreCG)皮质厚度显著降低。与放疗前比较，RT-LD组大鼠双侧顶下叶、左侧扣带回峡部、左侧颞上沟左侧及左侧枕外区皮质厚度明显增加，与RT-ED组比较，双侧PreCG区皮质厚度明显增加。与ROI-WISE SBM方法相似的分析也发现了一致的结果。这些结果表明，放射性脑损伤主要发生在RT-LD组，放疗后皮质厚度的变化在不同时期是动态的。我们的研究结果可能反映了GM正常的鼻咽癌患者放射性脑损伤的发病机制，为了在放疗中保护GM，有必要进行早期干预。在放疗后GM正常的鼻咽癌患者中，仅在PreCG中发现放射诱导的皮质厚度异常，放疗后的皮质厚度较放疗前组降低。放疗后LD较放疗前和放疗后均有广泛的皮质厚度异常。鼻咽癌患者放疗后皮质厚度的变化在不同时期是动态的。
Conventional MRI studies showed that radiation-induced brain necrosis in patients with nasopharyngeal carcinoma (NPC) in years after radiotherapy (RT) could involve brain gray matter (GM) and impair brain function. However, it is still unclear the radiation-induced brain morphological changes in NPC patients with normal-appearing GM in the early period after RT. In this study, we acquired high-resolution brain structural MRI data from three groups of patients, 22 before radiotherapy (pre-RT) NPC patients with newly diagnosed but not yet medically treated, 22 NPC patients in the early-delayed stage after radiotherapy (post-RT-ED), and 20 NPC patients in the late-delayed stage after radiotherapy (post-RT-LD), and then analyzed the radiation-induced cortical thickness alteration in NPC patients after RT. Using a vertex-wise surface-based morphometry (SBM) approach, we detected significantly decreased cortical thickness in the precentral gyrus (PreCG) in the post-RT-ED group compared to the pre-RT group. And the post-RT-LD group showed significantly increased cortical thickness in widespread brain regions, including the bilateral inferior parietal, left isthmus of the cingulate, left bank of the superior temporal sulcus and left lateral occipital regions, compared to the pre-RT group, and in the bilateral PreCG compared to the post-RT-ED group. Similar analysis with ROI-wise SBM method also found the consistent results. These results indicated that radiation-induced brain injury mainly occurred in the post-RT-LD group and the cortical thickness alterations after RT were dynamic in different periods. Our findings may reflect the pathogenesis of radiation-induced brain injury in NPC patients with normal-appearing GM and an early intervention is necessary for protecting GM during RT. Found radiation-induced abnormal cortical thickness in NPC patients with normal-appearing GM after RT Only in the PreCG, the post-RT-ED showed decreased cortical thickness compared to pre-RT group. The post-RT-LD had widespread abnormal cortical thickness than either the pre-RT or post-RT-ED groups. Alterations of cortical thickness in NPC patients after RT are dynamic in different periods.