Metabolic alterations: A biomarker for radiation induced normal brain injury-an MR spectroscopy study

P. C. Sundgren, V. Nagesh, A. Elias, C. Tsien, L. Junck, D. M.Gomez Hassan, T. S. Lawrence, T. L. Chenevert, L. Rogers, P. McKeever, Y. Cao

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Abstract

Purpose: To assess if interval changes in metabolic status in normal cerebral tissue after radiation therapy (RT) can be detected by 2D CSI (chemical shift imaging) proton spectroscopy. Materials and Methods: Eleven patients with primary brain tumors undergoing cranial radiation therapy (RT) were included. 2D-CSI MRS was performed before, during, and after the course of RT with the following parameters: TE/TR 144/1500 ms, field of view (FOV) 24, thickness 10 mm, matrix 16 × 16. The metabolic ratios choline/creatine (Cho/Cr), N-acetylaspartate (NAA)/Cr, and NAA/Cho in normal brain tissue were calculated. Results: NAA/Cr and Cho/Cr were significantly decreased at week 3 during RT and at 1 month and 6 months after RT compared to values prior to RT (P < 0.01). The NAA/Cr ratio decreased by -0.19 ± 0.05 (mean ± standard error [SE]) at week 3 of RT, -0.14 ± 0.06 at the last week of RT, -0.14 ± 0.05 at 1 month after RT, and -0.30 ± 0.08 at 6 months after RT compared to the pre-RT value of 1.43 ± 0.04. The Cho/Cr ratio decreased by -0.27 ± 0.05 at week 3 of RT, - 0.11 ± 0.05 at the last week of RT, -0.26 ± 0.05 at 1 month after RT and -0.25 ± 0.07 at 6 months after RT from the pre-RT value of 1.29 ±± 0.03. Changes in Cho/Cr were correlated with the interaction of the radiation dose and dose-volume at week 3 of RT, during the last week of RT (P < 0.005), and at 1 month after RT (P = 0.017).

Original languageEnglish
Pages (from-to)291-297
Number of pages7
JournalJournal of Magnetic Resonance Imaging
Volume29
Issue number2
DOIs
StatePublished - Feb 1 2009

Keywords

  • Irradiation
  • Magnetic resonance spectroscopy
  • Normal brain

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    Sundgren, P. C., Nagesh, V., Elias, A., Tsien, C., Junck, L., Hassan, D. M. G., Lawrence, T. S., Chenevert, T. L., Rogers, L., McKeever, P., & Cao, Y. (2009). Metabolic alterations: A biomarker for radiation induced normal brain injury-an MR spectroscopy study. Journal of Magnetic Resonance Imaging, 29(2), 291-297. https://doi.org/10.1002/jmri.21657