Long-term cerebral metabolite changes on proton magnetic resonance spectroscopy in patients cured of acute lymphoblastic leukemia with previous intrathecal methotrexate and cranial irradiation prophylaxis
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AbstractPurpose: To evaluate the long-term brain metabolite changes on H-1-MRS in acute lymphoblastic leukemia (ALL) patients who had intrathecal methotrexate (ITMTX) and cranial irradiation (CRT) for central nervous system (CNS) prophylaxis against CNS relapse, Methods and Materials: Thirty-seven ALL patients 112 females, 25 males) with history of ITMTX and CRT for CNS prophylaxis were studied. Age ranges at the time of diagnosis and at magnetic resonance examination were 0.8-13 years and 12-27 years, respectively. The interval since diagnosis was 5.6-19 years. T2-weighted and gradient-recalled echo (GRE) magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (H-1-MRS) were performed to assess brain injury. Results: On MRI, 3 leukoencephalopathy (LEP) and 1 infarct were detected. Twenty-two patients had evidence of hemosiderin, On H-1-MRS no statistically significant difference in choline (Cho)/creatine (Cr) and N-acetylaspartate (NAA)/Cr was associated with LEP, A Lower Cho/Cr (p = 0.006) and NAA/Cr (p = 0.078) was observed in brains with hemosiderin, Linear-regression analysis showed no statistically significant relationship between NAA/Cr or Cho/Cr with age at diagnosis, but there was a statistically significant decreasing trend of NAA/Cr and Cho/Cr with the interval since diagnosis. Conclusion: Long-term brain injury in ALL survivors after CNS prophylaxis with ITMTX and CRT was reflected by decreasing NAA/Cr and Cho/Cr with the interval since diagnosis. The lower Cho/Cr associated with hemosiderin but not LEP suggested a different pathophysiology for these brain lesions. (C) 2001 Elsevier Science Inc.
All Author(s) ListChan YL, Roebuck DJ, Yuen MP, Yeung KW, Lau KY, Li CK, Chik KW
Journal nameInternational Journal of Radiation Oncology - Biology - Physics
Year2001
Month7
Day1
Volume Number50
Issue Number3
PublisherELSEVIER SCIENCE INC
Pages759 - 763
ISSN0360-3016
LanguagesEnglish-United Kingdom
Keywordsacute lymphoblastic leukemia; cranial irradiation; methotrexate; proton magnetic resonance spectroscopy
Web of Science Subject CategoriesOncology; ONCOLOGY; Radiology, Nuclear Medicine & Medical Imaging; RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Last updated on 2020-25-06 at 02:39