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. 2013 Jan;37(1):101-8. doi: 10.1002/jmri.23788. Epub 2012 Sep 12.

Abstract

Purpose: To detect radiation-induced changes of temporal lobe normal-appearing white mater (NAWM) following radiation therapy (RT) for nasopharyngeal carcinoma (NPC).

Materials and methods: Seventy-five H(1)-MR spectroscopy and diffusion-tensor imaging (DTI) examinations were performed in 55 patients before and after receiving fractionated radiation therapy (total dose; 66-75GY). We divided the dataset into six groups, a pre-RT control group and five other groups based on time after completion of RT. N-acetylaspartic acid (NAA)/choline (Cho), NAA/creatine (Cr), Cho/Cr, mean diffusibility (MD), functional anisotropy (FA), radial diffusibility (λ(⊥)), and axial diffusibility (λ(||)) were calculated.

Results: NAA/Cho and NAA/Cr decreased and λ(⊥) increased significantly within 1 year after RT compared with pre-RT. After 1 year, NAA/Cho, NAA/Cr, and λ(⊥) were not significantly different from pre-RT. In all post-RT groups, FA decreased significantly. λ(||) decreased within 9 months after RT compared with pre-RT, but was not significantly different from pre-RT more than 9 months after RT.

Conclusion: DTI and H(1)-MR spectroscopy can be used to detect early radiation-induced changes of temporal lobe NAWM following radiation therapy for NPC. Metabolic alterations and water diffusion characteristics of temporal lobe NAWM in patients with NPC after RT were dynamic and transient.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anisotropy
  • Biomarkers / metabolism
  • Brain / pathology*
  • Brain / radiation effects
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / radiotherapy
  • Carcinoma
  • Decision Making
  • Diffusion
  • Diffusion Tensor Imaging / methods*
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Magnetic Resonance Spectroscopy / methods*
  • Male
  • Middle Aged
  • Models, Statistical
  • Nasopharyngeal Carcinoma
  • Nasopharyngeal Neoplasms / pathology*
  • Nasopharyngeal Neoplasms / radiotherapy
  • Nerve Fibers, Myelinated / pathology
  • Nerve Fibers, Myelinated / radiation effects
  • Radiation Injuries / diagnosis*
  • Radiation Injuries / pathology
  • Radiotherapy / adverse effects
  • Temporal Lobe / pathology*
  • Temporal Lobe / radiation effects

Substances

  • Biomarkers