Weekly hippocampal diffusion changes during partial-brain radiation therapy for high-grade glioma: associations with dose and early memory change - Scorecard - MDSpire
Clinical Scorecard: Weekly hippocampal diffusion changes during partial-brain radiotherapy for high-grade glioma: links to radiation dose and early memory outcomes
At a Glance
Category
Detail
Condition
High-grade glioma treated with partial-brain radiotherapy
Key Mechanisms
Radiation exposure may affect normal brain tissue. ADC and FA are nonspecific diffusion MRI measures responsive to tissue-water mobility and microstructural architecture; they are not direct or validated indicators of irreversible radiation injury.
Target Population
Adults aged 18 years or older with histologically confirmed high-grade glioma and Karnofsky Performance Status of at least 60; 45 participants had evaluable serial diffusion imaging.
Care Setting
Prospective, single-arm observational imaging protocol during six weeks of partial-brain radiotherapy at a single institution.
Key Highlights
The study characterized weekly hippocampal ADC and FA during partial-brain radiotherapy and examined associations with planned hippocampal dose.
Participants received 60 Gy in 30 fractions over six weeks using IMRT or VMAT, with concurrent and subsequent adjuvant temozolomide.
MRI was acquired before radiotherapy and weekly during treatment; hippocampal regions of interest were manually contoured.
Learning and memory were assessed at baseline and Week 6 using the examiner-administered Cogstate C3 battery.
The supplied article excerpt does not include study results, so the direction or magnitude of diffusion changes and their associations cannot be reported.
Guideline-Based Recommendations
Diagnosis
No diagnostic recommendations are provided in the supplied excerpt; participants had histologically confirmed high-grade glioma.
Management
Study protocol: 60 Gy in 30 fractions over six weeks using IMRT or VMAT, with concurrent and subsequent adjuvant temozolomide. This is not a general treatment recommendation.
Monitoring & Follow-up
Study protocol: multiparametric MRI before radiotherapy and weekly during treatment.
Learning and memory were assessed at baseline and Week 6 using the Cogstate C3 battery.
Risks
The introduction states that irradiation of normal brain tissue may contribute to neurocognitive morbidity.
ADC and FA are nonspecific measures responsive to multiple tissue processes, not direct or validated indicators of irreversible radiation injury.
Patient & Prescribing Data
Forty-five adults with evaluable serial diffusion imaging, histologically confirmed high-grade glioma, and Karnofsky Performance Status of at least 60.
Study participants received 60 Gy in 30 fractions over six weeks with IMRT or VMAT, concurrent temozolomide, and subsequent adjuvant temozolomide.
Clinical Best Practices
Study interpretation: ADC and FA were treated as nonspecific imaging phenotypes, not direct evidence of a particular cellular injury mechanism.
Study procedure: bilateral hippocampal regions were manually contoured on high-resolution T1-weighted MRI for serial diffusion imaging.
Study procedure: memory change from baseline to Week 6 was assessed using the mean z score of the BPTX Lure Discrimination Index, FNMT, and OCL.
by Ory Haisraely, Bikash Panthi, Kyle Richard Noll, Eleni Konstantinopoulou, Andrew Elliott, Sara Thrower, Holly Langshaw, Wasif Talpur, Catherine Sullaway, Todd Swanson, Chenyang Wang, Martin C. Tom, Thomas Beckham, Wen Jiang, Debra Nana Yeboa, Mary Frances McAleer, Amol Ghia, Susan Lynne McGovern, Jing Li, Jeffrey Scott Wefel, Caroline Chung
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