Multiparametric structural imaging biomarkers of early white matter microstructural changes during and after glioblastoma chemoradiotherapy: diffusion tensor imaging and diffusion kurtosis imaging

Miloš A. Lučić; Igor Djan; Olivera Šveljo; Silvija  Lučić; Olivera Ivanov; Mladen Bjelan; Dušan Ilić

doi:10.2298/VSP250525083L

Miloš A. Lučić University of Novi Sad, *Faculty of Medicine, Novi Sad, Serbia; Oncology Institute of Vojvodina, †Radiology Department, ||Nuclear Medicine Department, Sremska Kamenica, Serbia
Igor Djan Oncology Institute of Vojvodina, ‡Radiotherapy Clinic, Sremska Kamenica, Serbia
Olivera Šveljo University of Novi Sad, §Faculty for Technical Sciences, Novi Sad, Serbia; Oncology Institute of Vojvodina, , †Radiology Department, Sremska Kamenica, Serbia
Silvija Lučić University of Novi Sad, *Faculty of Medicine, Novi Sad, Serbia
Olivera Ivanov University of Novi Sad, *Faculty of Medicine, Novi Sad, Serbia
Mladen Bjelan University of Novi Sad, *Faculty of Medicine, Novi Sad, Serbia
Dušan Ilić University of Novi Sad, §Faculty for Technical Sciences, Novi Sad, Serbia

DOI: https://doi.org/10.2298/VSP250525083L

Ključne reči: biomarkeri;, mozak, povrede;, radiohemioterapija;, magnetna rezonanca, difuziona;, snimanje, difuziono, tenzorsko;, glioblastom.

Sažetak

Uvod/Cilj. Prepoznavanje ranih promena izazvanih zračenjem u beloj masi je od velike važnosti. Cilj rada bio je da se ispita moguća primena parametara difuzionog tenzorskog snimanja (diffusion tensor imaging - DTI) i difuzionog snimanja kurtoze (diffusion kurtosis imaging - DKI) kao biomarkera ranih promena mikrostrukture moždanog tkiva, tokom lečenja novodijagnostikovanog glioblastoma hemioradioterapijom (HRT). Metode. Ukupno 42 bolesnika obolela od glioblastoma, koji su posle hirurške resekcije/biopsije podvrgnuti HRT, snimljena su tri puta magnetnom rezonancom (MR): pre terapije, posle 16 frakcija i posle 33 frakcije. Regioni od interesa (ROI), sa ukupnim dozama zračenja od 59,4 Gy (ROI 1), 39,6 Gy (ROI 2) i 19,8 Gy (ROI 3), identifikovani su korišćenjem koregistrovanih aksijalnih planova raspodele doze/histograma zapremine doze i snimaka MR. Za svaki ROI izračunati su, izmereni i analizirani sledeći DTI parametri: frakciona anizotropija (FA), radijalna difuzivnost (RD), aksijalna difuzivnost (AD) i srednja difuzivnost (SD). Odgovarajući DKI parametri uključivali su: radijalnu kurtozu (RK), aksijalnu kurtozu (AK) i srednju kurtozu (SK). Rezultati. Značajno smanjenje vrednosti FA utvrđeno je u ROI 1 (ukupna isporučena doza 59,4 Gy) posle isporučenih 16 i 33 frakcija, dok su ostali parametri DTI i SK pokazali značajno povećanje. U ROI 1 utvrđen je opadajući trend RK i AK, koji je potvrđen statistički i posle 16 i posle 33 isporučene frakcije. U ROI 2 (ukupna isporučena doza 39,6 Gy), vrednost FA bila je značajno smanjena i posle 16 i posle 33 frakcije, dok su RD, AD, SD i SK bili povećani posle 16 frakcija, a potom smanjeni posle 33 frakcije. Vrednost RK u ROI 2 pokazala je značajno smanjenje nakon 16 i 33 frakcije, a u vrednostima AK nisu ustanovljene promene. U ROI 3 (ukupna isporučena doza 19,8 Gy) nisu primećene značajne promene ni u jednom od izmerenih DTI ili DKI parametara. Zaključak. Metrički parametri DTI i DKI mogu poslužiti kao biomarkeri ranih promena tokom i posle HRT, obezbeđujući informacije koje pružaju bolje razumevanje složene dinamike ranih promena mikrostrukture bele mase, kao odgovor na HRT glioblastoma.

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Multiparametrijski strukturni slikovni biomarkeri ranih promena mikrostrukture bele mase tokom i nakon hemoradioterapije glioblastoma: difuziono tenzorsko snimanje i difuziono snimanje kurtoze

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