ORIGINAL RESEARCH article
Front. Oncol.
Sec. Neuro-Oncology and Neurosurgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1406340
This article is part of the Research TopicImaging to Guide Treatment in Brain TumorsView all 3 articles
Relationship between DTI-MRI derived metrics and radiotherapy dose range in the contralateral cerebrum in lower grade glioma
Provisionally accepted
Justyna Kłos1,2*
Hildebrand Dijkstra2Hiska L van der Weide3Jan H Potze2Peter F Sinnige3
Kelvin Ng Wei Siang3,4Rudi A.J.O. Dierckx1,2Ronald J.H. Borra1,2Miranda C.A. Kramer3
Anouk van der Hoorn2- 1University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen, Netherlands
- 2Department of Radiology & Nucleair Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, Netherlands
- 3Department of Radiation Oncology, University Medical Center Groningen, Groningen, Netherlands
- 4Department of Radiotherapy, Cancer Institute, Erasmus Medical Center, Rotterdam, Netherlands
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background and Purpose: To evaluate the value of diffusion tensor imaging (DTI) MRI derived fractional anisotropy (FA) and apparent diffusion coefficient (ADC) for both white matter (WM) and grey matter (GM) of the contralateral cerebrum following radiotherapy (RT) for supratentorial lower grade glioma (LGG) as markers for radiotherapy-induced brain damage (RIBD).Materials and Methods: 14 patients were analysed. WM and GM were segmented using automated software (cNeuro) and the mean FA and ADC were extracted per RT dose bin (0-10, 10-20, 20-30, 30-40, 40-50, >50 Gy) of WM and GM. One way ANOVA with post-hoc Bonferroni’s test were used to analyse differences in FA and ADC between dose bins. Fluid-attenuated inversion recovery (FLAIR) hyperintensities were segmented in a semi-automated manner and correlated with a percentual difference in ADC and FA between dose bin ≥50 Gy and the mean of lower dose bins. Furthermore, the correlation of raw values of these 3 metrics within dose bins was explored, and potential relations of changes to clinical parameters. Results: We observed changes in FA of WM for dose bin >50 Gy ((F(5, 74) = 5.461, p=0.0002)), but no changes in FA of GM and no changes in ADC for both WM and GM. The percentual change in ADC and FA in WM of dose bin >50 Gy did not correlate with the total volume of FLAIR hyperintensities of the contralateral cerebrum, and also the raw values of these metrics did not correlate within the >50 Gy dose bin, and only correlated with the Total Radiotherapy Dose delivered to the supratentorial brain. Conclusion: In the late phase after RT for LGG (average > 3 years), DTI-MRI derived FA values decreased significantly in WM in the cerebrum contralateral to the tumour, while no changes were observed in GM or in ADC values. The FA decrease is only observed in areas receiving the highest RT dose, allows for a localized assessment in the individual patient, and is not correlated with the observed total load of FLAIR hyperintensities within the contralateral cerebrum or changes in ADC, suggesting DTI-MRI and FLAIR derived metrics reflect RIBD in different ways.
Keywords: Radiotherapy, Glioma, Fractional anisotrophy, brain damage, DTI - Diffusion tensor imaging, FLAIR (Fluid attenuated inversion recovery)
Received: 24 Mar 2024; Accepted: 13 Jun 2025.
Copyright: © 2025 Kłos, Dijkstra, van der Weide, Potze, Sinnige, Siang, Dierckx, Borra, Kramer and Hoorn. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Justyna Kłos, University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen, Netherlands
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.