MRI-based brain structural changes following radiotherapy of Nasopharyngeal Carcinoma: A systematic review

Voon NS 1 , Lau FN 2 , Zakaria R 3 , Md Rani SA 4 , Ismail F 5 , Manan HA 6 Show all authors , Yahya N 7

Affiliations 

  • 1 Diagnostic Imaging and Radiotherapy, Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300 Kuala Lumpur, Malaysia
  • 2 Department of Radiotherapy and Oncology, National Cancer Institute, 62250 Putrajaya, Malaysia
  • 3 Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000 Kuala Lumpur, Malaysia
  • 4 Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000 Kuala Lumpur, Malaysia
  • 5 Department of Radiotherapy and Oncology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000 Kuala Lumpur, Malaysia
  • 6 Functional Image Processing Laboratory, Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000 Kuala Lumpur, Malaysia
  • 7 Diagnostic Imaging and Radiotherapy, Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300 Kuala Lumpur, Malaysia. Electronic address: azrulyahya@ukm.edu.my
Cancer Radiother, 2021 Feb;25(1):62-71.
PMID: 33414057 DOI: 10.1016/j.canrad.2020.07.008

Abstract

PURPOSE: Nasopharyngeal carcinoma (NPC) radiotherapy (RT) irradiates parts of the brain which may cause cerebral tissue changes. This study aimed to systematically review the brain microstructure changes using MRI-based measures, diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI) and voxel-based morphometry (VBM) and the impact of dose and latency following RT.

METHODS: PubMed and Scopus databases were searched based on PRISMA guideline to determine studies focusing on changes following NPC RT.

RESULTS: Eleven studies fulfilled the inclusion criteria. Microstructural changes occur most consistently in the temporal region. The changes were correlated with latency in seven studies; fractional anisotropy (FA) and gray matter (GM) volume remained low even after a longer period following RT and areas beyond irradiation site with reduced FA and GM measures. For dosage, only one study showed correlation, thus requiring further investigations.

CONCLUSION: DTI, DKI and VBM may be used as a surveillance tool in detecting brain microstructural changes of NPC patients which correlates to latency and brain areas following RT.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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