Effect of therapeutic ionizing radiation on the human brain

R. Grant Steen, David Spence, Shengjie Wu, Xiaoping Xiong, Larry E. Kun, Thomas E. Merchant

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

We test a hypothesis that fractionated radiation therapy within a therapeutic dose range is associated with a dose-related change in normal brain, detectable by quantitative magnetic resonance imaging. A total of 33 patients were examined by quantitative magnetic resonance imaging to measure brain tissue spin-lattice relaxation time (T1) before treatment, and at various times during and after radiation therapy. A T1 map was generated at each time point, and radiation therapy isodose contours were superimposed on the corresponding segmented T1 map. Changes in white matter and gray matter T1 were analyzed as a function of radiation therapy dose and time since treatment, controlling for patient age and tumor site. In white matter, a dose level of more than 20Gy was associated with a dose-dependent decrease in T1 over time, which became significant 6 months after treatment. There was no significant change in T1 of gray matter over time, at radiation therapy doses of less than 60Gy. However, GM in close proximity to the tumor had a lower T1 before therapy. Our results represent the first radiation dose-response data derived from pediatric brain in vivo. These findings confirm that white matter is more vulnerable to radiation-induced change than is gray matter, and suggest that T1 mapping is sensitive to radiation-related changes over a broad dose range (20 to 60Gy). Human white matter T1 is not sensitive to radiation therapy of less than 20Gy, and gray matter T1 is unchanged over the dose range used to treat human brain tumor. The reduction of gray matter T1 near the tumor could result from compression of cortical parenchyma near the growing tumor mass, or from tumor cell invasion directly into the parenchyma. If brain T1 is a surrogate for radiation effect, reducing the volume of normal white matter receiving more than 20Gy could be an important treatment planning goal.

Original languageEnglish (US)
Pages (from-to)787-795
Number of pages9
JournalAnnals of Neurology
Volume50
Issue number6
DOIs
StatePublished - Dec 17 2001

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Therapeutic Uses
Ionizing Radiation
Radiotherapy
Brain
Radiation
Neoplasms
Therapeutics
Magnetic Resonance Imaging
Radiation Effects
Brain Neoplasms
White Matter
Gray Matter
Pediatrics

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Grant Steen, R., Spence, D., Wu, S., Xiong, X., Kun, L. E., & Merchant, T. E. (2001). Effect of therapeutic ionizing radiation on the human brain. Annals of Neurology, 50(6), 787-795. https://doi.org/10.1002/ana.10029

Effect of therapeutic ionizing radiation on the human brain. / Grant Steen, R.; Spence, David; Wu, Shengjie; Xiong, Xiaoping; Kun, Larry E.; Merchant, Thomas E.

In: Annals of Neurology, Vol. 50, No. 6, 17.12.2001, p. 787-795.

Research output: Contribution to journalArticle

Grant Steen, R, Spence, D, Wu, S, Xiong, X, Kun, LE & Merchant, TE 2001, 'Effect of therapeutic ionizing radiation on the human brain', Annals of Neurology, vol. 50, no. 6, pp. 787-795. https://doi.org/10.1002/ana.10029
Grant Steen R, Spence D, Wu S, Xiong X, Kun LE, Merchant TE. Effect of therapeutic ionizing radiation on the human brain. Annals of Neurology. 2001 Dec 17;50(6):787-795. https://doi.org/10.1002/ana.10029
Grant Steen, R. ; Spence, David ; Wu, Shengjie ; Xiong, Xiaoping ; Kun, Larry E. ; Merchant, Thomas E. / Effect of therapeutic ionizing radiation on the human brain. In: Annals of Neurology. 2001 ; Vol. 50, No. 6. pp. 787-795.
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