Late structural alterations of cerebral white matter in long‐term survivors of childhood leukemia

Dellani, Paulo R.; Eder, Stefan J.; Gawehn, Joachim; Vučurević, Goran; Fellgiebel, Andreas; Müller, Matthias J.; Schmidberger, Heinz; Stoeter, P.; Gutjahr, P.

doi:10.1002/jmri.21364

Cited by 51 publications

(59 citation statements)

References 33 publications

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“…Similar results (elevated MD and reduced FA values) were found in the cerebral white matter of patients with Fabry's disease [22] and in long-term survivors of childhood leukemia, who had been treated by total head irradiation and chemotherapy during infancy [23].…”

Section: Assessment Of White Matter By Mean Diffusivity (Md) and Fracsupporting

confidence: 67%

Diffusion Tensor Imaging of Cerebral White Matter*

Stoeter¹,

Dellani²,

Vučurević³

2008

Clin Neuroradiol

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Diffusion tensor imaging (DTI) of the cerebral white matter has proven to be a promising tool with regard to demonstration of developmental changes during childhood and older age and of pathologic alterations by calculation of parameter maps of mean diffusivity (MD) and fractional anisotropy (FA) as well as to image the positions of the major fiber tracts by tractography. After a methodological introduction, the experiences with DTI collected in Mainz, Germany, during the last 5 years are presented. Special emphasis is on preoperative imaging of the corticospinal tract and optic radiation and the computation of FA-based templates (atlases) which can be used for observer-independent evaluation of FA and MD group differences and supra-and infratentorial probabilistic tractography. ZusammenfassungDiffusion Tensor Imaging (DTI) des zerebralen Marklagers hat sich als eine sehr effiziente Methode erwiesen, um die Entwicklung des Marklagers während der Kindheit und seine Regression im Alter sowie pathologische Veränderungen durch die Berechnung der mittleren Diffusivität (MD) und fraktionellen Anisotropie (FA) zu untersuchen. Außerdem können die großen Faserbahnen mittels Traktographie dargestellt werden. Nach einer kurzen Einführung in die Methode werden die Mainzer Erfahrungen dargestellt, die die Autoren in den vergangenen 5 Jahren mit DTI gewonnen haben. Als besondere Schwerpunkte werden dabei die präoperative Darstellung der Pyramidenbahn und der Sehbahn sowie die Konstruktion von FA-und MD-basierten Templates (Atlas) herausgestellt, die eine untersucherunabhängige Auswertung dieser Parameter sowie eine supra-und infratentorielle Traktographie an normalisierten Gruppendatensätzen ermöglichen. Schlüsselwörter: Diffusion Tensor Imaging · Template-Bildung · Fiber Tracking

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Section: Assessment Of White Matter By Mean Diffusivity (Md) and Fracsupporting

confidence: 67%

Diffusion Tensor Imaging of Cerebral White Matter*

Stoeter¹,

Dellani²,

Vučurević³

2008

Clin Neuroradiol

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“…For adult survivors of childhood cancer, white matter has been observed to have higher diffusion and decreased directionality (i.e. FA) compared to similar aged controls with no history of cancer treatment (Dellani et al, 2008, von der Weid, 2008, Khong et al, 2006). Vulnerability of white matter to irradiation has been shown to be driven by mechanisms including reduced blood flow via vascular damage and less or ill-formed myelin via a reduced oligodendrocytes progenitor pool and increased cytokine expression (as reviewed in (Belka et al, 2001, Greene-Schloesser et al, 2012)).…”

Section: Discussionmentioning

confidence: 99%

Radiation-induced cognitive impairment and altered diffusion tensor imaging in a juvenile rat model of cranial radiotherapy

Peiffer¹,

Creer²,

Linville³

et al. 2014

International Journal of Radiation Biology

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Purpose Assess the long term effects of fractionated whole brain irradiation (fWBI) using diffusion tensor imaging (DTI) and behavior in a pediatric rodent model for the clinical presentation of adult pediatric cancer survivors. Materials and Methods Five week old, male F344xBN rats were randomized to receive 0, 5, or 6.5 Gy fractions biweekly for 3 weeks, resulting in Sham, Irradiated-30 (IR-30) and IR-39 Gy total dose groups. Magnetic Resonance Imaging occurred at 1, 3, 6 and 9 months with behavioral assessment at 10–11 months post-fWBI. Results Irradiation reduced brain size (p<0.001) and body weight (p<0.001) proportionate to dose. At 1 month post-fWBI and throughout follow-up, diffusion was reduced in IR-30 and IR-39 relative to shams (p<0.001). IR-30 but not IR-39 rats were impaired relative to Shams on the reversal trial of the Morris Water Maze (p<0.05), and IR-30 rats preferred a striatum-mediated strategy (p<0.06). Conclusions Hippocampal performance was impaired in IR-30 but not IR-39 animals. While gross size differences exist, white matter integrity is preserved in rats after fWBI at 5 weeks. This significant departure from childhood cancer survivors and single fraction rodent studies where white matter degradation is a prominent feature are discussed.

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“…Significant relationships between DTI parameters and IQ have been found in brain tumor and ALL survivors who received CR [Khong et al, 2006;Mabbott et al, 2006]. More recent use of DTI in adult survivors of childhood ALL (treated with CR and chemotherapy) showed WM structural alterations [Dellani et al, 2008]. Future investigations would profitably focus on the relationship between DTI parameters and basic neuropsychological processes (e.g., processing speed, attention, and working memory) which may underlie IQ performance.…”

Section: Neuroimaging and Neurocognitive Outcomesmentioning

confidence: 95%

Neurodevelopmental sequelae of pediatric acute lymphoblastic leukemia and its treatment

Janzen

Spiegler

2008

Dev Disabil Res Revs

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This review will describe the neurocognitive outcomes associated with pediatric acute lymphoblastic leukemia (ALL) and its treatment. The literature is reviewed with the aim of addressing methodological issues, treatment factors, risks and moderators, special populations, relationship to neuroimaging findings, and directions for future research. It is concluded that neurocognitive outcomes for the majority of children with standard-risk ALL treated according to current chemotherapy protocols is relatively good, but subgroups of children are more significantly compromised. As medical treatments advance and survival rates continue to improve, neurocognitive outcomes and other quality of life indicators will become increasingly important. Preventing or ameliorating treatment-related neuropsychological sequelae represents the next major challenge in pediatric ALL.

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Late structural alterations of cerebral white matter in long‐term survivors of childhood leukemia

Cited by 51 publications

References 33 publications

Diffusion Tensor Imaging of Cerebral White Matter*

Diffusion Tensor Imaging of Cerebral White Matter*

Radiation-induced cognitive impairment and altered diffusion tensor imaging in a juvenile rat model of cranial radiotherapy

Neurodevelopmental sequelae of pediatric acute lymphoblastic leukemia and its treatment

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