Unchanged perfusion in normal-appearing white and grey matter of glioma patients nine months after proton beam irradiation

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

Abstract

Purpose: Radio(chemo)therapy is used as a standard treatment for glioma patients. The surrounding normal tissue is inevitably affected by the irradiation. The aim of this longitudinal study was to investigate perfusion alterations in the normal-appearing tissue after proton irradiation and assess the dose sensitivity of the normal tissue perfusion. Methods: In 14 glioma patients, a sub-cohort of a prospective clinical trial (NCT02824731), perfusion changes in normal-appearing white matter (WM), grey matter (GM) and subcortical GM structures, i.e. caudate nucleus, hippocampus, amygdala, putamen, pallidum and thalamus, were evaluated before treatment and at three-monthly intervals after proton beam irradiation. The relative cerebral blood volume (rCBV) was assessed with dynamic susceptibility contrast MRI and analysed as the percentage ratio between follow-up and baseline image (ΔrCBV). Radiation-induced alterations were evaluated using Wilcoxon signed rank test. Dose and time correlations were investigated with univariate and multivariate linear regression models. Results: No significant ΔrCBV changes were found in any normal-appearing WM and GM region after proton beam irradiation. A positive correlation with radiation dose was observed in the multivariate regression model applied to the combined ΔrCBV values of low (1–20 Gy), intermediate (21–40 Gy) and high (41–60 Gy) dose regions of GM (p < 0.001), while no time dependency was detected in any normal-appearing area. Conclusion: The perfusion in normal-appearing brain tissue remained unaltered after proton beam therapy. In further studies, a direct comparison with changes after photon therapy is recommended to confirm the different effect of proton therapy on the normal-appearing tissue.

Details

OriginalspracheEnglisch
Seiten (von - bis)141-149
Seitenumfang9
FachzeitschriftActa oncologica
Jahrgang62
Ausgabenummer2
PublikationsstatusVeröffentlicht - 1 Feb. 2023
Peer-Review-StatusJa

Externe IDs

PubMed 36801809
ORCID /0000-0002-7017-3738/work/146646035
WOS 000936043700001

Schlagworte

Schlagwörter

  • Dynamic susceptibility contrast, normal-appearing brain tissue, perfusion changes, proton beam irradiation, radio(chemo)therapy, relative cerebral blood volume, Radio(chemo)therapy, Relative cerebral blood volume, Proton beam irradiation, Perfusion changes, Normal-appearing brain tissue, Protons, Brain Neoplasms/diagnostic imaging, Prospective Studies, Humans, Magnetic Resonance Imaging/methods, Gray Matter/diagnostic imaging, Glioma/radiotherapy, Perfusion, Longitudinal Studies