Document Detail

Diffusion tensor imaging screening of radiation-induced changes in the white matter after prophylactic cranial irradiation of patients with small cell lung cancer: first results of a prospective study.
MedLine Citation:
PMID:  17974610     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Diffusion tensor imaging (DTI) will show abnormal fractional anisotropy (FA) in the normal-appearing brain after prophylactic cranial irradiation (PCI). These abnormalities will be more accentuated in patients with underlying vascular risk factors. MATERIALS AND METHODS: A prospective study by use of DTI and conventional T2-weighted MR images was performed with a 1.5T unit with 16 patients with small cell lung cancer and undergoing PCI. All of the T2-weighted images were evaluated with respect to abnormalities in signal intensity of white matter as markers of radiation damage. Measurements of FA were performed before, at the end of, and 6 weeks after radiation therapy. On the FA maps, the bifrontal white matter, the corona radiata, the cerebellum, and the brain stem were evaluated. FA values were compared with respect to age, demographic, and vascular risk factors. Statistical analyses (Friedman test, Wilcoxon test, and Mann-Whitney U test) were performed. RESULTS: Fractional anisotropy decreased significantly in supratentorial and infratentorial normal-appearing white matter from the beginning to the end of PCI (P < .01). A further decline in FA occurred 6 weeks after irradiation (P < .05). A stronger reduction in FA was observed in patients with more than 1 vascular risk factor. There was an age-related reduction of white matter FA. Patients 65 years and older showed a trend toward a stronger reduction in FA. CONCLUSION: During the acute phase, after PCI, patients with many vascular risk factors showed stronger damage in the white matter compared with patients with only 1 risk factor.
T Welzel; A Niethammer; U Mende; S Heiland; F Wenz; J Debus; R Krempien
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-11-01
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  29     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-14     Completed Date:  2008-04-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  379-83     Citation Subset:  IM    
Department of Radiooncology, University of Heidelberg, Heidelberg, Germany.
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MeSH Terms
Carcinoma, Small Cell / prevention & control*,  radiotherapy*
Diffusion Magnetic Resonance Imaging / methods*
Dose Fractionation
Lung Neoplasms / prevention & control,  radiotherapy*
Magnetic Resonance Imaging / methods
Middle Aged
Nerve Fibers, Myelinated / pathology*,  radiation effects*
Pilot Projects
Radiation Injuries / etiology*,  pathology*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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