Format

Send to

Choose Destination
Radiat Oncol. 2015 Oct 17;10:211. doi: 10.1186/s13014-015-0518-1.

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

Pospisil P1,2, Kazda T3,4,5, Bulik M6,7,8, Dobiaskova M9,10, Burkon P11,12, Hynkova L13,14, Slampa P15,16, Jancalek R17,18.

Author information

1
Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic. ppospisil@mou.cz.
2
Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53, Brno, Czech Republic. ppospisil@mou.cz.
3
Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic. tomas.kazda@mou.cz.
4
Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53, Brno, Czech Republic. tomas.kazda@mou.cz.
5
International Clinical Research Center, St. Anne's University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic. tomas.kazda@mou.cz.
6
International Clinical Research Center, St. Anne's University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic. martin.bulik@fnusa.cz.
7
Department of Diagnostic Imaging, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic. martin.bulik@fnusa.cz.
8
Department of Diagnostic Imaging, St. Anne's University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic. martin.bulik@fnusa.cz.
9
International Clinical Research Center, St. Anne's University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic. marie.dobiaskova@fnusa.cz.
10
Department of Clinical Psychology, St. Anne's University Hospital Brno, Pekarska 53, Brno, Czech Republic. marie.dobiaskova@fnusa.cz.
11
Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic. burkon@mou.cz.
12
Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53, Brno, Czech Republic. burkon@mou.cz.
13
Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic. hynkova@mou.cz.
14
Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53, Brno, Czech Republic. hynkova@mou.cz.
15
Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic. slampa@mou.cz.
16
Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53, Brno, Czech Republic. slampa@mou.cz.
17
Department of Neurosurgery - St. Anne's University Hospital Brno, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic. radim.jancalek@fnusa.cz.
18
Department of Neurosurgery, St. Anne's University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic. radim.jancalek@fnusa.cz.

Abstract

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, by (1)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-radiotherapy (1)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 by (1)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.

PMID:
26474857
PMCID:
PMC4609038
DOI:
10.1186/s13014-015-0518-1
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center