MR Image Changes of Normal-Appearing Brain Tissue after Radiotherapy
Radiotherapy is part of the standard treatment of most primary brain tumors. Large clinical target volumes and physical characteristics of photon beams inevitably lead to irradiation of surrounding normal brain tissue. This can cause radiation-induced brain injury. In particular, late brain injury,...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/13/7/1573 |
| _version_ | 1797539590930694144 |
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| author | Katharina Witzmann Felix Raschke Esther G. C. Troost |
| author_facet | Katharina Witzmann Felix Raschke Esther G. C. Troost |
| author_sort | Katharina Witzmann |
| collection | DOAJ |
| description | Radiotherapy is part of the standard treatment of most primary brain tumors. Large clinical target volumes and physical characteristics of photon beams inevitably lead to irradiation of surrounding normal brain tissue. This can cause radiation-induced brain injury. In particular, late brain injury, such as cognitive dysfunction, is often irreversible and progressive over time, resulting in a significant reduction in quality of life. Since 50% of patients have survival times greater than six months, radiation-induced side effects become more relevant and need to be balanced against radiation treatment given with curative intent. To develop adequate treatment and prevention strategies, the underlying cause of radiation-induced side-effects needs to be understood. This paper provides an overview of radiation-induced changes observed in normal-appearing brains measured with conventional and advanced MRI techniques and summarizes the current findings and conclusions. Brain atrophy was observed with anatomical MRI. Changes in tissue microstructure were seen on diffusion imaging. Vascular changes were examined with perfusion-weighted imaging and susceptibility-weighted imaging. MR spectroscopy revealed decreasing N-acetyl aspartate, indicating decreased neuronal health or neuronal loss. Based on these findings, multicenter prospective studies incorporating advanced MR techniques as well as neurocognitive function tests should be designed in order to gain more evidence on radiation-induced sequelae. |
| first_indexed | 2024-03-10T12:48:02Z |
| format | Article |
| id | doaj.art-0a3de401a6aa40a6a85ccc1a9113e685 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T12:48:02Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-0a3de401a6aa40a6a85ccc1a9113e6852023-11-21T13:19:01ZengMDPI AGCancers2072-66942021-03-01137157310.3390/cancers13071573MR Image Changes of Normal-Appearing Brain Tissue after RadiotherapyKatharina Witzmann0Felix Raschke1Esther G. C. Troost2Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology—OncoRay, Dresden, GermanyHelmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology—OncoRay, Dresden, GermanyHelmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology—OncoRay, Dresden, GermanyRadiotherapy is part of the standard treatment of most primary brain tumors. Large clinical target volumes and physical characteristics of photon beams inevitably lead to irradiation of surrounding normal brain tissue. This can cause radiation-induced brain injury. In particular, late brain injury, such as cognitive dysfunction, is often irreversible and progressive over time, resulting in a significant reduction in quality of life. Since 50% of patients have survival times greater than six months, radiation-induced side effects become more relevant and need to be balanced against radiation treatment given with curative intent. To develop adequate treatment and prevention strategies, the underlying cause of radiation-induced side-effects needs to be understood. This paper provides an overview of radiation-induced changes observed in normal-appearing brains measured with conventional and advanced MRI techniques and summarizes the current findings and conclusions. Brain atrophy was observed with anatomical MRI. Changes in tissue microstructure were seen on diffusion imaging. Vascular changes were examined with perfusion-weighted imaging and susceptibility-weighted imaging. MR spectroscopy revealed decreasing N-acetyl aspartate, indicating decreased neuronal health or neuronal loss. Based on these findings, multicenter prospective studies incorporating advanced MR techniques as well as neurocognitive function tests should be designed in order to gain more evidence on radiation-induced sequelae.https://www.mdpi.com/2072-6694/13/7/1573radiotherapyradiation-induced brain injuriesnormal-appearing brain tissuefunctional MRIanatomical MRIperfusion |
| spellingShingle | Katharina Witzmann Felix Raschke Esther G. C. Troost MR Image Changes of Normal-Appearing Brain Tissue after Radiotherapy Cancers radiotherapy radiation-induced brain injuries normal-appearing brain tissue functional MRI anatomical MRI perfusion |
| title | MR Image Changes of Normal-Appearing Brain Tissue after Radiotherapy |
| title_full | MR Image Changes of Normal-Appearing Brain Tissue after Radiotherapy |
| title_fullStr | MR Image Changes of Normal-Appearing Brain Tissue after Radiotherapy |
| title_full_unstemmed | MR Image Changes of Normal-Appearing Brain Tissue after Radiotherapy |
| title_short | MR Image Changes of Normal-Appearing Brain Tissue after Radiotherapy |
| title_sort | mr image changes of normal appearing brain tissue after radiotherapy |
| topic | radiotherapy radiation-induced brain injuries normal-appearing brain tissue functional MRI anatomical MRI perfusion |
| url | https://www.mdpi.com/2072-6694/13/7/1573 |
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