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Effects of chemotherapy on the brain in childhood: diffusion tensor imaging of subtle white matter damage

  • Paediatric Neuroradiology
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Abstract

Introduction

With reducing mortality in children with hematological malignancies, the survivors' quality of life regarding development of chronic neurological disturbances is important. We aimed to determine whether chemotherapy affects white matter (WM).

Methods

Using brain diffusion tensor imaging, we evaluated 17 patients (15 with acute lymphoblastic leukemia, 2 with non-Hodgkin's lymphoma; 9 male, 8 female; age, 1.6–13 years) before and after chemotherapy. We measured the quantitative values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) at the regions of interest (ROIs) such as periventricular WM, corona radiata, posterior limb of the internal capsule, and corpus callosum. We assessed sensorimotor and callosal tracts by tractography.

Results

Reduction in FA and increase in ADC were significant at the ROIs of the left and right anterior periventricular WM and corona radiata and at the tract passing through the genu. A significant reduction in FA with a nonsignificant increase in ADC was seen at the ROI of the genu and at the tracts passing through the body and isthmus.

Conclusion

Chemotherapy in children with hematological malignancies predominantly affects the frontal WM. This finding might indicate a negative effect of chemotherapy on neurological development in children with hematological malignancies.

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Acknowledgments

We thank Professor Ikumitsu Nagasaki, Department of Mathematics, Kyoto Prefectural University of Medicine, for his advice about statistical analyses.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Shigemi Morioka, Masafumi Morimoto, Tatsuji Hasegawa, Takashi Morita, Masaharu Moroto, Kenichi Isoda, Tomohiro Chiyonobu, Toshihiko Imamura, Akira Nishimura & Hajime Hosoi

  2. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Kei Yamada

  3. Department of Pediatrics, Jichi Medical University School of Medicine, Tochigi, Japan

    Akira Morimoto

Authors
  1. Shigemi Morioka
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  2. Masafumi Morimoto
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  3. Kei Yamada
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  4. Tatsuji Hasegawa
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  5. Takashi Morita
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  6. Masaharu Moroto
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  8. Tomohiro Chiyonobu
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  9. Toshihiko Imamura
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  10. Akira Nishimura
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  11. Akira Morimoto
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  12. Hajime Hosoi
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Correspondence to Masafumi Morimoto.

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Morioka, S., Morimoto, M., Yamada, K. et al. Effects of chemotherapy on the brain in childhood: diffusion tensor imaging of subtle white matter damage. Neuroradiology 55, 1251–1257 (2013). https://doi.org/10.1007/s00234-013-1245-7

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  • DOI: https://doi.org/10.1007/s00234-013-1245-7

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