Perfusion decrease in healthy tissue following radiochemotherapy in glioblastoma patients

Ziel/Aim:

Decrease of perfusion as a side-effect of radio-chemotherapy was observed in several organs (1). However, the relation between the decrease and the radiation dose was not yet extensively studied. Non-invasive measurement of perfusion is now possible with a native MRI sequence called arterial spin labeling (ASL) (2) which offers a semi-quantitative alternative to [O-15]H2O PET measurement. The ASL measurement was used to study the regional perfusion changes in healthy tissue of glioblastoma patients undergoing radiochemotherapy.
Methodik/Methods:
Twenty-five patients (age 55.0±14.2 years) with glioblastoma multiforme were scanned in two (n=25) or three (n=13) sessions with interval 4.8 and 8.1 months from the first session, respectively. The ASL scan was co-registered with the treatment-planning CT and the dose plan. Perfusion changes between sessions were calculated in the hemisphere contralateral to the tumor. The perfusion changes were evaluated also in regions created by categorizing the individual dose maps into 10 Gy steps.
Ergebnisse/Results:
The relative perfusion decrease between the first two sessions was not significant (-2.4% and -7.5%) for the low dose regions 0 and 20 Gy. For the high-dose regions, the change was statistically significant and a decrease of -13.3% (20-30 Gy), -18.0% (30-40 Gy), -16.2% (40-50 Gy), and -16.8% (50-60 Gy) was observed. No further decrease of perfusion was observed on the third session. The mean regional changes were between -1.4% and 3.0% and the results were not statistically significant for any dose.
Schlussfolgerungen/Conclusions:
Global decrease of perfusion was observed in healthy tissue 3 months after the radiochemotherapy. The decrease was correlated with the dose received. No further decrease of perfusion was observed 6 months after the therapy.