School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece.
Hellenic Military Academy, Vari, Athens, Greece.
Brain Topogr. 2021 Mar;34(2):167-181. doi: 10.1007/s10548-020-00811-3. Epub 2021 Jan 5.
The golden standard of treating Small Cell Lung Cancer (SCLC) entails application of platinum-based chemotherapy, is often accompanied by Prophylactic Cranial Irradiation (PCI), which have been linked to neurotoxic side-effects in cognitive functions. The related existing neuroimaging research mainly focuses on the effect of PCI treatment in life quality and expectancy, while little is known regarding the distinct adverse effects of chemotherapy. In this context, a multimodal MRI analysis based on structural and functional brain data is proposed in order to evaluate chemotherapy-specific effects on SCLC patients. Data from 20 patients (after chemotherapy and before PCI) and 14 healthy controls who underwent structural MRI, DTI and resting state fMRI were selected in this study. From a structural aspect, the proposed analysis included volumetry and thickness measurements on structural MRI data for assessing gray matter dissimilarities, as well as deterministic tractography and Tract-Based Spatial Statistics (TBSS) on DTI data, aiming to investigate potential white matter abnormalities. Functional data were also processed on the basis of connectivity analysis, evaluating brain network parameters to identify potential manifestation of functional inconsistencies. By comparing patients to healthy controls, the obtained results revealed statistically significant differences, with the patients' brains presenting reduced volumetry/thickness and fractional anisotropy values, accompanied by prominent differences in functional connectivity measurements. All above mentioned findings were observed in patients that underwent chemotherapy.
治疗小细胞肺癌（SCLC）的金标准是应用铂类化疗，常伴有预防性颅脑照射（PCI），这与认知功能的神经毒性副作用有关。相关的现有神经影像学研究主要集中在 PCI 治疗对生活质量和预期寿命的影响上，而对化疗的独特不良反应知之甚少。在这种情况下，提出了一种基于结构和功能脑数据的多模态 MRI 分析方法，以评估化疗对 SCLC 患者的特异性影响。本研究选择了 20 名（化疗后和 PCI 前）患者和 14 名健康对照者进行结构 MRI、DTI 和静息态 fMRI 检查。从结构方面来看，所提出的分析包括对结构 MRI 数据进行容积测量和厚度测量，以评估灰质差异，以及对 DTI 数据进行确定性追踪和基于束的空间统计学（TBSS）分析，以研究潜在的白质异常。还基于连接分析对功能数据进行处理，评估脑网络参数以识别功能不一致的潜在表现。通过将患者与健康对照组进行比较，得到的结果显示出统计学上的显著差异，患者的大脑表现出体积/厚度和各向异性分数值降低，同时功能连接测量也存在明显差异。所有这些发现都发生在接受化疗的患者中。
