Structural MRI research in patients with nasopharyngeal carcinoma following radiotherapy: A DTI and VBM study

Leng,Xi; Fang,Peng; Lin,Huan; An,Jie; Tan,Xin; Zhang,Chi; Wu,Donglin; Shen,Wen; Qiu,Shijun

doi:10.3892/ol.2017.6968

Structural MRI research in patients with nasopharyngeal carcinoma following radiotherapy: A DTI and VBM study

Authors:
- Xi Leng
- Peng Fang
- Huan Lin
- Jie An
- Xin Tan
- Chi Zhang
- Donglin Wu
- Wen Shen
- Shijun Qiu
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Affiliations: Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China, College of Mechatronics and Automation, National University of Defense Technology, Changsha, Hunan 410073, P.R. China, Medical Imaging Center, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510405, P.R. China
Published online on: September 15, 2017 https://doi.org/10.3892/ol.2017.6968
Pages: 6091-6096

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Abstract

The aim of the present study was to investigate the microstructural characteristics of the brain lobes following radiotherapy (RT) for patients with nasopharyngeal carcinoma (NPC) at distinct times. Diffusion tensor imaging (DTI) and 3D‑T1‑weighted imaging was performed in 70 age‑ and sex‑matched subjects, 24 of whom were pre‑treatment patients. The patients were divided into three groups, according to the time following completion of RT. Fractional anisotropy (FA) and gray matter (GM) volume were determined. The DTI data were analyzed using tract‑based spatial statistics and the GM volume was analyzed using voxel‑based morphometry (VBM). Compared with the pre‑RT group, the mean FA values in the left parietal lobe white matter (WM) and right cerebellum decreased significantly in the post‑RT 0‑6 month group (P<0.05). In addition, the mean FA values in the right parietal lobe WM decreased significantly in the post‑RT 6‑12 month group (P<0.05), compared with the pre‑RT group. The FA level in the right temporal lobe remained significantly decreased, compared with that in the pre‑RT group (P<0.05) for 1 year after RT. Furthermore, compared with pre‑RT group, the GM volume in the bilateral frontal lobe, right occipital lobe, left parietal lobe, right temporal lobe and left cerebellum decreased significantly in the post‑RT 0‑6 month group (P<0.05), and in the bilateral temporal lobe, parietal lobe, right frontal lobe and left cerebellum, the GM volume decreased significantly in the post‑RT 6‑12 month group (P<0.05). The GM volume in the right temporal lobe, bilateral frontal lobe and bilateral cerebellum remained significantly decreased compared with that in the pre‑RT group (P<0.05) for 1 year after RT. A combination of DTI and VBM may be used to determine radiation‑induced brain injury in patients treated for NPC.

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1	Shanmugaratnam K, Chan SH, de-Thé G, Goh JE, Khor TH, Simons MJ and Tye CY: Histopathology of nasopharyngeal carcinoma: Correlations with epidemiology, survival rates and other biological characteristics. Cancer. 44:1029–1044. 1979. View Article : Google Scholar : PubMed/NCBI
2	Sun Y, Zhou GQ, Qi ZY, Zhang L, Huang SM, Liu LZ, Li L, Lin AH and Ma J: Radiation-induced temporal lobe injury after intensity modulated radiotherapy in nasopharyngeal carcinoma patients: A dose-volume-outcome analysis. BMC Cancer. 13:3972013. View Article : Google Scholar : PubMed/NCBI
3	Lee AW, Law SC, Ng SH, Chan DK, Poon YF, Foo W, Tung SY, Cheung FK and Ho JH: Retrospective analysis of nasopharyngeal carcinoma treated during 1976–1985: Late complications following megavoltage irradiation. Br J Radiol. 65:918–928. 1992. View Article : Google Scholar : PubMed/NCBI
4	Tang Y, Luo D, Rong X, Rong X, Shi X and Peng Y: Psychological disorders, cognitive dysfunction and quality of life in nasopharyngeal carcinoma patients with radiation-induced brain injury. PLoS One. 7:e365292012. View Article : Google Scholar : PubMed/NCBI
5	Glantz MJ, Burger PC, Friedman AH, Radtke RA, Massey EW and Schold SC Jr: Treatment of radiation-induced nervous system injury with heparin and warfarin. Neurology. 44:2020–2027. 1994. View Article : Google Scholar : PubMed/NCBI
6	Wang HZ, Qiu SJ, Lv XF, Wang YY, Liang Y, Xiong WF and Ouyang ZB: Diffusion tensor imaging and 1H-MRS study on radiation-induced brain injury after nasopharyngeal carcinoma radiotherapy. Clin Radiol. 67:340–345. 2012. View Article : Google Scholar : PubMed/NCBI
7	Xiong WF, Qiu SJ, Wang HZ and Lv XF: 1H-MR spectroscopy and diffusion tensor imaging of normal-appearing temporal white matter in patients with nasopharyngeal carcinoma after irradiation: Initial experience. J Magn Reson Imaging. 37:101–108. 2013. View Article : Google Scholar : PubMed/NCBI
8	Nelles M, Block W, Träber F, Wüllner U, Schild HH and Urbach H: Combined 3T diffusion tensor tractography and 1H-MR spectroscopy in motor neuron disease. AJNR Am J Neuroradiol. 29:1708–1714. 2008. View Article : Google Scholar : PubMed/NCBI
9	Yokoyama K, Matsuki M, Shimano H, Sumioka S, Ikenaga T, Hanabusa K, Yasuda S, Inoue H, Watanabe T, Miyashita M, et al: Diffusion tensor imaging in chronic subdural hematoma: Correlation between clinical signs and fractional anisotropy in the pyramidal tract. AJNR Am J Neuroradiol. 29:1159–1163. 2008. View Article : Google Scholar : PubMed/NCBI
10	Zhuang L, Wen W, Zhu W, Trollor J, Kochan N, Crawford J, Reppermund S, Brodaty H and Sachdev P: White matter integrity in mild cognitive impairment: A tract-based spatial statistics study. Neuroimage. 53:16–25. 2010. View Article : Google Scholar : PubMed/NCBI
11	Chan YL, Leung SF, King AD, Choi PH and Metreweli C: Late radiation injury to the temporal lobes: Morphologic evaluation at MR imaging. Radiology. 213:800–807. 1999. View Article : Google Scholar : PubMed/NCBI
12	Norris AM, Carrington BM and Slevin NJ: Late radiation change in the CNS: MR imaging following gadolinium enhancement. Clin Radiol. 52:356–362. 1997. View Article : Google Scholar : PubMed/NCBI
13	Lv XF, Zheng XL, Zhang WD, Liu LZ, Zhang YM, Chen MY and Li L: Radiation-induced changes in normal-appearing gray matter in patients with nasopharyngeal carcinoma: A magnetic resonance imaging voxel-based morphometry study. Neuroradiology. 56:423–430. 2014. View Article : Google Scholar : PubMed/NCBI
14	Smith SM, Jenkinson M, Johansen-Berg H, Rueckert D, Nichols TE, Mackay CE, Watkins KE, Ciccarelli O, Cader MZ, Matthews PM and Behrens TE: Tract-based spatial statistics: Voxelwise analysis of multi-subject diffusion data. Neuroimage. 31:1487–1505. 2006. View Article : Google Scholar : PubMed/NCBI
15	Smith SM and Nichols TE: Threshold-free cluster enhancement: Addressing problems of smoothing, threshold dependence and localisation in cluster inference. Neuroimage. 44:83–98. 2009. View Article : Google Scholar : PubMed/NCBI
16	Valk PE and Dillon WP: Radiation injury of the brain. AJNR Am J Neuroradiol. 12:45–62. 1991.PubMed/NCBI
17	Chong VF, Fan YF and Mukherji SK: Radiation-induced temporal lobe changes: CT and MR imaging characteristics. AJR Am J Roentgenol. 175:431–436. 2000. View Article : Google Scholar : PubMed/NCBI
18	Makki MI, Chugani DC, Janisse J and Chugani HT: Characteristics of abnormal diffusivity in normal-appearing white matter investigated with diffusion tensor MR imaging in tuberous sclerosis complex. AJNR Am J Neuroradiol. 28:1662–1667. 2007. View Article : Google Scholar : PubMed/NCBI
19	Kitahara S, Nakasu S, Murata K, Sho K and Ito R: Evaluation of treatment induced cerebral white matter injury by using diffusion-tensor MR imaging: Initial experience. AJNR Am J Neuroradiol. 26:2200–2206. 2005.PubMed/NCBI
20	Russo C, Fischbein N, Grant E and Prados MD: Late radiation injury following hyperfractionated craniospinal radiotherapy for primitive neuroectodermal tumor. Int J Radiat Oncol Biol Phys. 44:85–90. 1999. View Article : Google Scholar : PubMed/NCBI
21	Xavier S, Piek E, Fujii M, Javelaud D, Mauviel A, Flanders KC, Samuni AM, Felici A, Reiss M, Yarkoni S, et al: Amelioration of radiation-induced fibrosis: Inhibition of transforming growth factor-beta signaling by halofuginone. J Biol Chem. 279:15167–15176. 2004. View Article : Google Scholar : PubMed/NCBI
22	Kim SH, Lim DJ, Chung YG, Cho TH, Lim SJ, Kim WJ and Suh JK: Expression of TNF-alpha and TGF-beta 1 in the rat brain after a single high-dose irradiation. J Korean Med Sci. 17:242–248. 2002. View Article : Google Scholar : PubMed/NCBI
23	Parkin AJ and Hunkin NM: Memory loss following radiotherapy for nasal pharyngeal carcinoma-an unusual presentation of amnesia. Br J Clin Psychol. 30:349–357. 1991. View Article : Google Scholar : PubMed/NCBI
24	Cheung M, Chan AS, Law SC, Chan JH and Tse VK: Cognitive function of patients with nasopharyngeal carcinoma with and without temporal lobe radionecrosis. Arch Neurol. 57:1347–1352. 2000. View Article : Google Scholar : PubMed/NCBI
25	Özdemir Hİ, Eker MÇ, Zengin B, Yilmaz DA, İşman Haznedaroğlu D, Çınar C, Kitiş Ö, Akay A and Gönül AS: Gray matter changes in patients with deficit schizophrenia and non-deficit schizophrenia. Turk Psikiyatri Derq. 23:237–246. 2012.
26	Lai CH: Gray matter volume in major depressive disorder: A meta-analysis of voxel-based morphometry studies. Psychiatry Res. 211:37–46. 2013. View Article : Google Scholar : PubMed/NCBI
27	Schmidt-Wilcke T, Leinisch E, Straube A, Kämpfe N, Draganski B, Diener HC, Bogdahn U and May A: Gray matter decrease in patients with chronic tension type headache. Neurology. 65:1483–1486. 2005. View Article : Google Scholar : PubMed/NCBI
28	Shi L, Adams MM, Long A, Carter CC, Bennett C, Sonntag WE, Nicolle MM, Robbins M, D'Agostino R and Brunso-Bechtold JK: Spatial learning and memory deficits after whole-brain irradiation are associated with changes in NMDA receptor subunits in the hippocampus. Radiat Res. 166:892–899. 2006. View Article : Google Scholar : PubMed/NCBI
29	Tofilon PJ and Fike JR: The radioresponse of the central nervous system: A dynamic process. Radiat Res. 153:357–370. 2000. View Article : Google Scholar : PubMed/NCBI
30	Gazdzinski LM, Cormier K, Lu FG, Lerch JP, Wong CS and Nieman BJ: Radiation-induced alterations in mouse brain development characterized by magnetic resonance imaging. Int J Radiat Oncol Biol Phys. 84:e631–e638. 2012. View Article : Google Scholar : PubMed/NCBI
31	McDonald BC, Conroy SK, Ahles TA, West JD and Saykin AJ: Gray matter reduction associated with systemic chemotherapy for breast cancer: A prospective MRI study. Breast Cancer Res Treat. 123:819–828. 2010. View Article : Google Scholar : PubMed/NCBI