Nikolaeva Alexandra, Pospelova Maria, Krasnikova Varvara, Makhanova Albina, Tonyan Samvel, Efimtsev Aleksandr, Levchuk Anatoliy, Trufanov Gennadiy, Voynov Mark, Sklyarenko Matvey, Samochernykh Konstantin, Alekseeva Tatyana, Combs Stephanie E, Shevtsov Maxim
Personalized Medicine Centre, Almazov National Medical Research Centre, Akkuratova Str. 2, 197341 Saint Petersburg, Russia.
Department of Radiation Oncology, Technishe Universität München (TUM), Klinikum rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany.
Pathophysiology. 2025 Mar 12;32(1):11. doi: 10.3390/pathophysiology32010011.
Chemotherapy-related cognitive impairment termed «chemobrain» is a prevalent complication in breast cancer survivors that requires early detection for the development of novel therapeutic approaches. Magnetic resonance voxel morphometry (MR morphometry), due to its high sensitivity, might be employed for the evaluation of the early changes in the volumes of brain structures in order to explore the «chemobrain» condition.
The open, prospective, single-center study enrolled 86 breast cancer survivors (43.3 ± 4.4 years) and age-matched 28 healthy female volunteers (44.0 ± 5.68). Conventional MR sequences (T1- and T2-weighted, TIRM, DWI, MPRAGE) were obtained in three mutually perpendicular planes to exclude an organ pathology of the brain. Additionally, the MPRAGE sequence was performed for subsequent MR morphometry of the volume of brain structures using the open VolBrain program. The evaluation was performed at two follow-up visits 6 months and 3 years after the completion of BC treatment.
According to the MR morphometry, breast cancer survivors presented with significantly decreased volumes of brain structures (including total brain volume, cerebellum volume, subcortical gray matter, etc.) as compared to healthy volunteers. Evaluation over the follow-up period of 3 years did not show the restoration of brain volume structures.
The data obtained employing MR morphometry revealed significant reductions (that were not detected on the conventional MR sequences) in both gray and white matter in breast cancer survivors following chemotherapy. This comprehensive analysis indicated the utility of MR morphometry in detecting subtle yet statistically significant neuroanatomical changes associated with cognitive and motor impairments in patients, which can in turn provide valuable insights into the extent of structural brain alterations, helping to identify specific regions that are most affected by treatment.
化疗相关的认知障碍，即所谓的“化疗脑”，是乳腺癌幸存者中普遍存在的并发症，需要早期检测以开发新的治疗方法。磁共振体素形态测量法（MR形态测量法）因其高灵敏度，可用于评估脑结构体积的早期变化，以探究“化疗脑”状况。
这项开放性、前瞻性、单中心研究招募了86名乳腺癌幸存者（43.3±4.4岁）以及年龄匹配的28名健康女性志愿者（44.0±5.68岁）。在三个相互垂直的平面上获取常规MR序列（T1加权、T2加权、TIRM、DWI、MPRAGE），以排除脑部器官病变。此外，使用开放式VolBrain程序对MPRAGE序列进行处理，以便随后对脑结构体积进行MR形态测量。在乳腺癌治疗完成后的6个月和3年这两个随访时间点进行评估。
根据MR形态测量法，与健康志愿者相比，乳腺癌幸存者的脑结构体积（包括全脑体积、小脑体积、皮质下灰质等）显著减小。在3年的随访期内，未发现脑体积结构恢复。
采用MR形态测量法获得的数据显示，乳腺癌幸存者化疗后灰质和白质均有显著减少（常规MR序列未检测到）。这项综合分析表明，MR形态测量法在检测与患者认知和运动障碍相关的细微但具有统计学意义的神经解剖学变化方面具有实用性，这反过来可以为脑结构改变的程度提供有价值的见解，有助于确定受治疗影响最严重的特定区域。
