Longitudinal Changes in Brain Diffusion MRI Indices during and after Proton Beam Therapy in a Child with Pilocytic Astrocytoma: A Case Report
Proton beam therapy (PBT) is an effective pediatric brain tumor treatment. However, the resulting microstructural changes within and around irradiated tumors are unknown. We retrospectively applied diffusion tensor imaging (DTI) and free-water imaging (FWI) on diffusion-weighted magnetic resonance i...
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| Format: | Article |
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MDPI AG
2021-12-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/1/26 |
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| author | Lisa Novello Nivedita Agarwal Sabina Vennarini Stefano Lorentini Domenico Zacà Anna Mussano Ofer Pasternak Jorge Jovicich |
| author_facet | Lisa Novello Nivedita Agarwal Sabina Vennarini Stefano Lorentini Domenico Zacà Anna Mussano Ofer Pasternak Jorge Jovicich |
| author_sort | Lisa Novello |
| collection | DOAJ |
| description | Proton beam therapy (PBT) is an effective pediatric brain tumor treatment. However, the resulting microstructural changes within and around irradiated tumors are unknown. We retrospectively applied diffusion tensor imaging (DTI) and free-water imaging (FWI) on diffusion-weighted magnetic resonance imaging (dMRI) data to monitor microstructural changes during the PBT and after 8 months in a pilocytic astrocytoma (PA) and normal-appearing white matter (NAWM). We evaluated the conventional MRI- and dMRI-derived indices from six MRI sessions (t0–t5) in a Caucasian child with a hypothalamic PA: at baseline (t0), during the PBT (t1–t4) and after 8 months (t5). The tumor voxels were classified as “solid” or “fluid” based on the FWI. While the tumor volume remained stable during the PBT, the dMRI analyses identified two different response patterns: (i) an increase in fluid content and diffusivity with anisotropy reductions in the solid voxels at t1, followed by (ii) smaller variations in fluid content but higher anisotropy in the solid voxels at t2–t4. At follow-up (t5), the tumor volume, fluid content, and diffusivity in the solid voxels increased. The NAWM showed dose-dependent microstructural changes. The use of the dMRI and FWI showed complex dynamic microstructural changes in the irradiated mass during the PBT and at follow-up, opening new avenues in our understanding of radiation-induced pathophysiologic mechanisms in tumors and the surrounding tissues. |
| first_indexed | 2024-03-10T01:39:13Z |
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| id | doaj.art-3cd92764b93b45019cfdbf5e97a8600c |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T01:39:13Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-3cd92764b93b45019cfdbf5e97a8600c2023-11-23T13:26:57ZengMDPI AGDiagnostics2075-44182021-12-011212610.3390/diagnostics12010026Longitudinal Changes in Brain Diffusion MRI Indices during and after Proton Beam Therapy in a Child with Pilocytic Astrocytoma: A Case ReportLisa Novello0Nivedita Agarwal1Sabina Vennarini2Stefano Lorentini3Domenico Zacà4Anna Mussano5Ofer Pasternak6Jorge Jovicich7Center for Mind/Brain Sciences (CIMeC), University of Trento, 38068 Rovereto, ItalyCenter for Mind/Brain Sciences (CIMeC), University of Trento, 38068 Rovereto, ItalyProton Therapy Center, Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), 38123 Trento, ItalyProton Therapy Center, Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), 38123 Trento, ItalyCenter for Mind/Brain Sciences (CIMeC), University of Trento, 38068 Rovereto, ItalyPediatric Radiotherapy Service, S. Anna Hospital, A.O. Città della Salute e della Scienza, 10121 Torino, ItalyDepartments of Psychiatry and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USACenter for Mind/Brain Sciences (CIMeC), University of Trento, 38068 Rovereto, ItalyProton beam therapy (PBT) is an effective pediatric brain tumor treatment. However, the resulting microstructural changes within and around irradiated tumors are unknown. We retrospectively applied diffusion tensor imaging (DTI) and free-water imaging (FWI) on diffusion-weighted magnetic resonance imaging (dMRI) data to monitor microstructural changes during the PBT and after 8 months in a pilocytic astrocytoma (PA) and normal-appearing white matter (NAWM). We evaluated the conventional MRI- and dMRI-derived indices from six MRI sessions (t0–t5) in a Caucasian child with a hypothalamic PA: at baseline (t0), during the PBT (t1–t4) and after 8 months (t5). The tumor voxels were classified as “solid” or “fluid” based on the FWI. While the tumor volume remained stable during the PBT, the dMRI analyses identified two different response patterns: (i) an increase in fluid content and diffusivity with anisotropy reductions in the solid voxels at t1, followed by (ii) smaller variations in fluid content but higher anisotropy in the solid voxels at t2–t4. At follow-up (t5), the tumor volume, fluid content, and diffusivity in the solid voxels increased. The NAWM showed dose-dependent microstructural changes. The use of the dMRI and FWI showed complex dynamic microstructural changes in the irradiated mass during the PBT and at follow-up, opening new avenues in our understanding of radiation-induced pathophysiologic mechanisms in tumors and the surrounding tissues.https://www.mdpi.com/2075-4418/12/1/26proton therapyfree-waterdiffusion MRIastrocytoma |
| spellingShingle | Lisa Novello Nivedita Agarwal Sabina Vennarini Stefano Lorentini Domenico Zacà Anna Mussano Ofer Pasternak Jorge Jovicich Longitudinal Changes in Brain Diffusion MRI Indices during and after Proton Beam Therapy in a Child with Pilocytic Astrocytoma: A Case Report Diagnostics proton therapy free-water diffusion MRI astrocytoma |
| title | Longitudinal Changes in Brain Diffusion MRI Indices during and after Proton Beam Therapy in a Child with Pilocytic Astrocytoma: A Case Report |
| title_full | Longitudinal Changes in Brain Diffusion MRI Indices during and after Proton Beam Therapy in a Child with Pilocytic Astrocytoma: A Case Report |
| title_fullStr | Longitudinal Changes in Brain Diffusion MRI Indices during and after Proton Beam Therapy in a Child with Pilocytic Astrocytoma: A Case Report |
| title_full_unstemmed | Longitudinal Changes in Brain Diffusion MRI Indices during and after Proton Beam Therapy in a Child with Pilocytic Astrocytoma: A Case Report |
| title_short | Longitudinal Changes in Brain Diffusion MRI Indices during and after Proton Beam Therapy in a Child with Pilocytic Astrocytoma: A Case Report |
| title_sort | longitudinal changes in brain diffusion mri indices during and after proton beam therapy in a child with pilocytic astrocytoma a case report |
| topic | proton therapy free-water diffusion MRI astrocytoma |
| url | https://www.mdpi.com/2075-4418/12/1/26 |
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