Z01 BC 010581 (Z01) | |||
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Title | 1H-Nuclear Magnetic Resonance Spectroscopic Imaging of the Brain in Patients who | ||
Institution | NCI, Bethesda, MD | ||
Principal Investigator | Warren, Katherine | NCI Program Director | N/A |
Cancer Activity | N/A | Division | CCR |
Funded Amount | $34,098 | Project Dates | 10/01/2004 - N/A |
Fiscal Year | 2007 | Project Type | Intramural |
Research Topics w/ Percent Relevance | Cancer Types w/ Percent Relevance | ||
Cancer Survivorship (30.0%) Childhood Cancers (40.0%) Neurosciences Research (40.0%) Nuclear Magnetic Resonance Imaging (NMR) (40.0%) |
Brain (100.0%) Nervous System (40.0%) |
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Research Type | |||
Technology and/or Marker Testing in a Clinical Setting Patient Care and Survivorship Issues |
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Abstract | |||
Background: Cancer patients are at risk for a variety of treatment-related, including neurotoxicity (NT). Manifestations of NT are both structural and functional in presentation, yet the association between the two is poorly defined. We performed a cross-sectional pilot study to explore the relationship between 1H-MRSI and NP functioning in cancer patients with or at risk for NT. Objective: To identify relationships between metabolite ratios determined by 1H-MRSI ratios and NP test scores as mechanisms to identify and evaluate NT in cancer patients. Design/Methods: MRI and 1H-MRSI were performed on 30 patients, ages 2.4 ? 40.5 yrs (mean 12.7 yrs, median 10.5 yrs), using a multi-slice, multi-voxel technique on a 1.5 T magnet. Eligible patients had a brain tumor, received systemic high dose chemotherapy, intrathecal therapy or cranial radiation, or had clinical NT from cancer treatment. Diagnoses included CNS tumor (n=19), lymphoma (n=9), and sarcoma (n=2). NT symptoms were present in 22 patients at enrollment. Cho:NAA, NAA:Cr and Cho:Cr ratios were determined in 8 pre-determined sites without tumor involvement. A battery of age-appropriate NP tests were administered within one week of imaging. The data were analyzed using Spearman rank correlations. Results: Mean full-scale IQ (FSIQ) score was 93.5 (median 96.5, range 61 ? 138). Mean Verbal IQ (VIQ) score was 95.2 (median 98.0, range 59 ? 141). Both FSIQ and VIQ scores were significantly correlated with 1H-MRSI in the basal ganglia (p<0.05). Academic tests of reading and arithmetic were also correlated with 1H-MRSI in the basal ganglia (p < .05). Behavioral assessments of socialization skills, internalizing behaviors, and quality of life were correlated with 1H-MRSI in the centrum semiovale, frontal grey matter, basal ganglia and thalamus (all ps < .05). Measures of expressive language (p < .05) and visual processing speed (p < .05) correlated with 1H-MRSI in the occipital-parietal white matter. Associations between measures of memory and 1H-MRSI in the hippocampus were identified as trends but did not reach statistical significance. Conclusions: This pilot study is the first to assess the relationship between NP testing and 1H-MRSI in cancer patients. Results indicate that 1H-MRSI may be useful in detecting functional CNS toxicities in cancer patients, but conclusions are limited by small sample size and heterogeneous population. Additional longitudinal study of 1H-MRSI and NP functioning in a homogeneous population is needed to further characterize NT in cancer patients. |