Medical Physics Department, Isfahan University of Medical Science, Isfahan, Iran.
Isfahan Milad Hospital, Deputy Manager in Research & Education, Head, Department of Radiation Oncology, Isfahan, Iran.
Biomed Res Int. 2021 Mar 4;2021:6616992. doi: 10.1155/2021/6616992. eCollection 2021.
To compare the sensitivity of MRS metabolites and MoCA and ACE-R cognitive tests in the detection of radiation-induced injury in low grade glioma (LGG) patients in early and early delayed postradiation stages.
MRS metabolite ratios of NAA/Cr and Cho/Cr, ACE-R and MoCA cognitive tests, and dosimetric parameters in corpus callosum were analyzed during RT and up to 6-month post-RT for ten LGG patients.
Compared to pre RT baseline, a significant decline in both NAA/Cr and Cho/Cr in the corpus callosum was seen at the 4th week of RT, 1, 3, and 6-month post-RT. These declines were detected at least 3 months before the detection of declines in cognitive functions by ACE-R and MoCA tools. Moreover, NAA/Cr alterations at 4th week of RT and 1-month post-RT were significantly negatively correlated with the mean dose received by the corpus callosum, as well as the corpus callosum 40 Gy dose volume, i.e., the volume of the corpus callosum receiving a dose greater than 40 Gy.
MRS-based biomarkers may be more sensitive than the state-of-the-art cognitive tests in the prediction of postradiation cognitive impairments. They would be utilized in treatment planning and dose sparing protocols, with a specific focus on the corpus callosum in the radiation therapy of LGG patients.
比较磁共振波谱（MRS）代谢物与蒙特利尔认知评估（MoCA）和简易认知评估量表（ACE-R）认知测试在检测低级别胶质瘤（LGG）患者早期及早期延迟放疗后放射性损伤中的敏感性。
分析 10 例 LGG 患者放疗期间及放疗后 6 个月的 MRS 代谢物 N-乙酰天冬氨酸（NAA）/肌酸（Cr）和胆碱（Cho）/Cr 比值、ACE-R 和 MoCA 认知测试以及胼胝体的剂量学参数。
与放疗前基线相比，胼胝体的 NAA/Cr 和 Cho/Cr 在放疗第 4 周、1、3 和 6 个月时均显著下降。这些下降至少在 ACE-R 和 MoCA 工具检测到认知功能下降之前 3 个月出现。此外，放疗第 4 周和 1 个月时的 NAA/Cr 改变与胼胝体所受平均剂量以及胼胝体 40Gy 剂量体积呈显著负相关，即胼胝体接受大于 40Gy 剂量的体积。
基于 MRS 的生物标志物在预测放疗后认知障碍方面可能比目前的认知测试更敏感。它们将被用于治疗计划和剂量节省方案，特别是在 LGG 患者的放疗中对胼胝体的关注。
