Universität zu Köln

Kocher, Martin ORCID: 0000-0002-5674-9227, Jockwitz, Christiane, Lohmann, Philipp ORCID: 0000-0002-5360-046X, Stoffels, Gabriele, Filss, Christian, Mottaghy, Felix M., Ruge, Maximilian I., Weiss Lucas, Carolin ORCID: 0000-0001-6463-0034, Goldbrunner, Roland, Shah, Nadim J., Fink, Gereon R. ORCID: 0000-0002-8230-1856, Galldiks, Norbert, Langen, Karl-Josef ORCID: 0000-0003-1101-5075 and Caspers, Svenja ORCID: 0000-0001-5083-4669 (2021). Lesion-Function Analysis from Multimodal Imaging and Normative Brain Atlases for Prediction of Cognitive Deficits in Glioma Patients. Cancers, 13 (10). BASEL: MDPI. ISSN 2072-6694

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Abstract

Simple Summary This prospective cross-sectional study utilized standard structural MR imaging and amino acid PET in conjunction with brain atlases of gray matter functional regions and white matter tracts, and elastic registration techniques to estimate the influence of the type and location of treatment-related brain damage or recurrent tumors on cognitive functioning in a group of well-doing WHO Grade III/IV glioma patients at follow-up after treatment. The negative impact of T2/FLAIR hyperintensities, supposed to be mainly caused by radiotherapy, on cognitive performance far exceeded that of surgical brain defects or recurrent tumors. The affection of functional nodes and fiber tracts of the left hemisphere and especially of the left temporal lobe by T2/FLAIR hyperintensities was highly correlated with verbal episodic memory dysfunction. These observations imply that radiotherapy for gliomas of the left hemisphere should be individually tailored by means of publicly available brain atlases and registration techniques. Cognitive deficits are common in glioma patients following multimodality therapy, but the relative impact of different types and locations of treatment-related brain damage and recurrent tumors on cognition is not well understood. In 121 WHO Grade III/IV glioma patients, structural MRI, O-(2-[18F]fluoroethyl)-L-tyrosine FET-PET, and neuropsychological testing were performed at a median interval of 14 months (range, 1-214 months) after therapy initiation. Resection cavities, T1-enhancing lesions, T2/FLAIR hyperintensities, and FET-PET positive tumor sites were semi-automatically segmented and elastically registered to a normative, resting state (RS) fMRI-based functional cortical network atlas and to the JHU atlas of white matter (WM) tracts, and their influence on cognitive test scores relative to a cohort of matched healthy subjects was assessed. T2/FLAIR hyperintensities presumably caused by radiation therapy covered more extensive brain areas than the other lesion types and significantly impaired cognitive performance in many domains when affecting left-hemispheric RS-nodes and WM-tracts as opposed to brain tissue damage caused by resection or recurrent tumors. Verbal episodic memory proved to be especially vulnerable to T2/FLAIR abnormalities affecting the nodes and tracts of the left temporal lobe. In order to improve radiotherapy planning, publicly available brain atlases, in conjunction with elastic registration techniques, should be used, similar to neuronavigation in neurosurgery.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kocher, Martin UNSPECIFIED orcid.org/0000-0002-5674-9227 UNSPECIFIED Jockwitz, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Lohmann, Philipp UNSPECIFIED orcid.org/0000-0002-5360-046X UNSPECIFIED Stoffels, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED Filss, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Mottaghy, Felix M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weiss Lucas, Carolin UNSPECIFIED orcid.org/0000-0001-6463-0034 UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Shah, Nadim J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Galldiks, Norbert UNSPECIFIED UNSPECIFIED UNSPECIFIED Langen, Karl-Josef UNSPECIFIED orcid.org/0000-0003-1101-5075 UNSPECIFIED Caspers, Svenja UNSPECIFIED orcid.org/0000-0001-5083-4669 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-599993
DOI:	10.3390/cancers13102373
Journal or Publication Title:	Cancers
Volume:	13
Number:	10
Date:	2021
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2072-6694
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LOW-GRADE; TEST-B; TRAIL; RADIOTHERAPY; PERFORMANCE; SURGERY Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59999