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Long-term effects of radiation therapy on white matter of the corpus callosum: a diffusion tensor imaging study in children

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Abstract

Background

Despite improving survival rates, children are at risk for long-term cognitive and behavioral difficulties following the diagnosis and treatment of a brain tumor. Surgery, chemotherapy and radiation therapy have all been shown to impact the developing brain, especially the white matter.

Objective

The purpose of this study was to determine the long-term effects of radiation therapy on white matter integrity, as measured by diffusion tensor imaging, in pediatric brain tumor patients 2 years after the end of radiation treatment, while controlling for surgical interventions.

Materials and methods

We evaluated diffusion tensor imaging performed at two time points: a baseline 3 to 12 months after surgery and a follow-up approximately 2 years later in pediatric brain tumor patients. A region of interest analysis was performed within three regions of the corpus callosum. Diffusion tensor metrics were determined for participants (n=22) who underwent surgical tumor resection and radiation therapy and demographically matched with participants (n=22) who received surgical tumor resection only.

Results

Analysis revealed that 2 years after treatment, the radiation treated group exhibited significantly lower fractional anisotropy and significantly higher radial diffusivity within the body of the corpus callosum compared to the group that did not receive radiation.

Conclusion

The findings indicate that pediatric brain tumor patients treated with radiation therapy may be at greater risk of experiencing long-term damage to the body of the corpus callosum than those treated with surgery alone.

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Acknowledgements

Funding to support this work came from the National Institutes of Health grant numbers R01 CA112182, R01 ES027724 and the Intellectual & Development Disabilities Research Center, at Kennedy Krieger Institute, grant number U54 HD079123.

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Authors and Affiliations

  1. College of Medicine, University of Cincinnati, Cincinnati, OH, USA

    Monwabisi Makola

  2. Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA

    M. Douglas Ris

  3. Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA

    E. Mark Mahone

  4. Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    E. Mark Mahone

  5. Department of Psychology, Alberta Children’s Hospital Research Institute, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada

    Keith Owen Yeates

  6. Imaging Research Center, Cincinnati Children’s Hospital Medical Center, MLC 5033, 3333 Burnet Ave., Cincinnati, OH, 45229, USA

    Kim M. Cecil

  7. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Kim M. Cecil

  8. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Kim M. Cecil

  9. Neuroscience Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Kim M. Cecil

  10. Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Kim M. Cecil

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  1. Monwabisi Makola
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  2. M. Douglas Ris
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Correspondence to Kim M. Cecil.

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Makola, M., Douglas Ris, M., Mahone, E.M. et al. Long-term effects of radiation therapy on white matter of the corpus callosum: a diffusion tensor imaging study in children. Pediatr Radiol 47, 1809–1816 (2017). https://doi.org/10.1007/s00247-017-3955-1

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  • DOI: https://doi.org/10.1007/s00247-017-3955-1

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