Long-term effects of radiation therapy on white matter of the corpus callosum: a diffusion tensor imaging study in children

• Published in: Pediatric radiology 2017-12, Vol.47 (13), p.1809-1816
• Main Authors: Makola, Monwabisi, Douglas Ris, M., Mahone, E. Mark, Yeates, Keith Owen, Cecil, Kim M.
• Format: Article
• Language: English
• Subjects: Anisotropy; Brain; Brain cancer; Brain Neoplasms - radiotherapy; Brain tumors; Chemotherapy; Child; Children; Cognitive ability; Corpus callosum; Corpus Callosum - pathology; Corpus Callosum - radiation effects; Diffusion rate; Diffusion Tensor Imaging - methods; Female; Humans; Image processing; Imaging; Long-term effects; Longitudinal Studies; Magnetic resonance imaging; Male; Medicine; Medicine & Public Health; Neuroimaging; Neuroradiology; Nuclear Medicine; Oncology; Original Article; Patients; Pediatrics; Radiation; Radiation damage; Radiation effects; Radiation therapy; Radiology; Risk Factors; Risk taking; Substantia alba; Surgery; Surgical equipment; Time Factors; Treatment Outcome; Ultrasound; United States; White Matter - pathology; White Matter - radiation effects
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s00247-017-3955-1

Background Despite improving survival rates, children are at risk for long-term cognitive and behavioral difficulties following the diagnosis and treatment of a brain tumor. Surgery, chemotherapy and radiation therapy have all been shown to impact the developing brain, especially the white matter. Objective The purpose of this study was to determine the long-term effects of radiation therapy on white matter integrity, as measured by diffusion tensor imaging, in pediatric brain tumor patients 2 years after the end of radiation treatment, while controlling for surgical interventions. Materials and methods We evaluated diffusion tensor imaging performed at two time points: a baseline 3 to 12 months after surgery and a follow-up approximately 2 years later in pediatric brain tumor patients. A region of interest analysis was performed within three regions of the corpus callosum. Diffusion tensor metrics were determined for participants ( n =22) who underwent surgical tumor resection and radiation therapy and demographically matched with participants ( n =22) who received surgical tumor resection only. Results Analysis revealed that 2 years after treatment, the radiation treated group exhibited significantly lower fractional anisotropy and significantly higher radial diffusivity within the body of the corpus callosum compared to the group that did not receive radiation. Conclusion The findings indicate that pediatric brain tumor patients treated with radiation therapy may be at greater risk of experiencing long-term damage to the body of the corpus callosum than those treated with surgery alone.