Zhang You-Ming, Kang Ya-Fei, Zeng Jun-Jie, Li Li, Gao Jian-Ming, Liu Li-Zhi, Shi Liang-Rong, Liao Wei-Hua
Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.
School of Psychology, Shaanxi Normal University, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, China.
Front Neurosci. 2021 Jul 19;15:692575. doi: 10.3389/fnins.2021.692575. eCollection 2021.
Radiation encephalopathy (RE) is an important potential complication in patients with nasopharyngeal carcinoma (NPC) who undergo radiotherapy (RT) that can affect the quality of life. However, a functional imaging biomarker of pre-symptomatic RE has not yet been established. This study aimed to assess radiation-induced gray matter functional alterations and explore fractional amplitude of low-frequency fluctuation (fALFF) as an imaging biomarker for predicting or diagnosing RE in patients with NPC. A total of 60 patients with NPC were examined, 21 in the pre-RT cohort and 39 in the post-RT cohort. Patients in the post-RT cohort were further divided into two subgroups according to the occurrence of RE in follow-up: post-RT ( = 21) and post-RT ( = 18). Surface-based and volume-based fALFF were used to detect radiation-induced functional alterations. Functional derived features were then adopted to construct a predictive model for the diagnosis of RE. We observed that surface-based fALFF could sensitively detect radiation-induced functional alterations in the intratemporal brain regions (such as the hippocampus and superior temporal gyrus), as well as the extratemporal regions (such as the insula and prefrontal lobe); however, no significant intergroup differences were observed using volume-based fALFF. No significant correlation between fALFF and radiation dose to the ipsilateral temporal lobe was observed. Support vector machine (SVM) analysis revealed that surface-based fALFF in the bilateral superior temporal gyri and left insula exhibited impressive performance (accuracy = 80.49%) in identifying patients likely to develop RE. We conclude that surface-based fALFF may serve as a sensitive imaging biomarker in the prediction of RE.
放射性脑病（RE）是鼻咽癌（NPC）患者接受放射治疗（RT）时一种重要的潜在并发症，可影响生活质量。然而，尚无针对症状前RE的功能成像生物标志物。本研究旨在评估辐射诱导的灰质功能改变，并探索低频振幅分数（fALFF）作为预测或诊断NPC患者RE的成像生物标志物。共检查了60例NPC患者，其中放疗前队列21例，放疗后队列39例。放疗后队列中的患者根据随访中RE的发生情况进一步分为两个亚组：放疗后无RE组（n = 21）和放疗后有RE组（n = 18）。基于表面和基于体积的fALFF用于检测辐射诱导的功能改变。然后采用功能衍生特征构建RE诊断预测模型。我们观察到，基于表面的fALFF能够灵敏地检测颞叶内脑区（如海马体和颞上回）以及颞叶外脑区（如岛叶和前额叶）辐射诱导的功能改变；然而，基于体积的fALFF未观察到显著的组间差异。未观察到fALFF与同侧颞叶辐射剂量之间存在显著相关性。支持向量机（SVM）分析显示，双侧颞上回和左侧岛叶基于表面的fALFF在识别可能发生RE的患者方面表现出色（准确率 = 80.49%）。我们得出结论，基于表面的fALFF可能作为预测RE的敏感成像生物标志物。
