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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:2200-2206, October 2005
© 2005 American Society of Neuroradiology

BRAIN

Evaluation of Treatment-Induced Cerebral White Matter Injury by Using Diffusion-Tensor MR Imaging: Initial Experience

Sawako Kitahara^a, Satoshi Nakasu^b, Kiyoshi Murata^a, Keizen Sho^a and Ryuta Ito^a

^a Departments of Radiology, Shiga University of Medical Science, Shiga, Japan
^b Department of Neurosurgery, Shiga University of Medical Science, Shiga, Japan

Address correspondence to Sawako Kitahara, MD, Department of Radiology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan

BACKGROUND AND PURPOSE: Treatment with chemotherapy and radiation therapy for brain tumors can cause white matter (WM) injury. Conventional MR imaging, however, cannot always depict treatment-induced transient WM abnormalities. We investigated the ability of diffusion-tensor (DT) MR imaging and proton MR spectroscopy to detect the treatment-induced transient changes within normal-appearing WM.

METHODS: DT MR imaging and proton MR spectroscopy were performed in 8 patients treated with a combination of surgery, chemotherapy, and radiation therapy for brain tumors (17 examinations) and 11 age-matched controls. Apparent diffusion coefficient (ADC) value, fractional anisotropy (FA) value, and N-acetylaspartate (NAA)/creatine (Cr) ratio were obtained from 27 hemispheres with normal-appearing WM in the patients. We divided the datasets of isotropic ADC, FA, and NAA/Cr, on the basis of the time period after completion of radiation therapy, into 4 groups: group 1 (0–2 months; n = 10), group 2 (3–5 months; n = 5), group 3 (6–9 months; n = 7), and group 4 (10–12 months; n = 5). We compared averages of mean isotropic ADC, mean FA, and NAA/Cr of each patient group with those of the control group by using a t test.

RESULTS: In the group 2, averages of mean FA and NAA/Cr decreased and average of mean isotopic ADC increased in comparison with those of the control group (P = .004, .04, and .0085, respectively). There were no significant differences in the averages between the control group and patient groups 1, 3, and 4.

CONCLUSION: DT MR imaging and proton MR spectroscopy can provide quantitative indices that may reflect treatment-induced transient derangement of normal-appearing WM.

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