Hippocampal proton MR spectroscopy as a novel approach in the assessment of radiation injury and the correlation to neurocognitive function impairment: initial experiences

Radiation Oncology

Radim Jancalek⁶  Pavel Slampa⁵  Ludmila Hynkova⁵  Petr Burkon⁵  Marie Dobiaskova⁴  Martin Bulik²  Tomas Kazda¹  Petr Pospisil³ 

[1] International Clinical Research Center, St. Anne’s University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic;Department of Diagnostic Imaging, St. Anne’s University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic;Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic;Department of Clinical Psychology, St. Anne’s University Hospital Brno, Pekarska 53, Brno, Czech Republic;Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53, Brno, Czech Republic;Department of Neurosurgery, St. Anne’s University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic

关键词: Magnetic resonance spectroscopy;    Neurocognitive function;    Radiation injury;    Hippocampus;   

Others  :  1228935
DOI  :  10.1186/s13014-015-0518-1

 received in 2015-05-25, accepted in 2015-10-06,  发布年份 2015

【 摘 要 】

Background

The hippocampus is considered as the main radiosensitive brain structure responsible for postradiotherapy cognitive decline. We prospectively assessed correlation of memory change to hippocampal N-acetylaspartate (h-tNAA) concentration, a neuronal density and viability marker, by¹ H-MR spectroscopy focused on the hippocampus.

Methods

Patients with brain metastases underwent whole brain radiotherapy (WBRT) to a dose of 30 Gy in ten fractions daily. Pre-radiotherapy¹ H-MR spectroscopy focused on the h-tNAA concentration and memory testing was performed. Memory was evaluated by Auditory Verbal Learning Test (AVLT) and Brief Visuospatial Memory Test-Revised (BVMT-R). Total recall, recognition and delayed recall were reported. The both investigation procedures were repeated 4 months after WBRT and the h-tNAA and memory changes were correlated.

Results

Of the 20 patients, ten passed whole protocol. The h-tNAA concentration significantly decreased from pre-WBRT 8.9, 8.86 and 8.88 [mM] in the right, left and both hippocampi to 7.16, 7.65 and 7.4 after WBRT, respectively. In the memory tests a significant decrease was observed in AVLT total-recall, BVMT-R total-recall and BVMT-R delayed-recall. Weak to moderate correlations were observed between left h-tNAA and AVLT recognition and all BVMT-R subtests and between the right h-tNAA and AVLT total-recall.

Conclusions

A significant decrease in h-tNAA after WBRT was proven by¹ H-MR spectroscopy as a feasible method for the in vivo investigation of radiation injury. Continuing patient recruitment focusing on other cognitive tests and metabolites is needed.

【 授权许可】

   
2015 Pospisil et al.

【 图 表 】

Fig. 1.

Fig. 2.

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