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Dockrell S, McCabe MG, Kamaly-Asl I, Kilday JP, Stivaros SM. Radiological Predictors of Cognitive Impairment in Paediatric Brain Tumours Using Multiparametric Magnetic Resonance Imaging: A Review of Current Practice, Challenges and Future Directions. Cancers (Basel) 2025; 17:947. [PMID: 40149283 PMCID: PMC11940392 DOI: 10.3390/cancers17060947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2025] [Revised: 03/06/2025] [Accepted: 03/08/2025] [Indexed: 03/29/2025] Open
Abstract
Paediatric brain tumours and their treatments are associated with long-term cognitive impairment. While the aetiology of cognitive impairment is complex and multifactorial, multiparametric Magnetic Resonance Imaging (MRI) can identify many risk factors including tumour location, damage to eloquent structures and tumour phenotype. Hydrocephalus and raised intracranial pressure can be observed, along with risk factors for post-operative paediatric cerebellar mutism syndrome or epilepsy. MRI can also identify complications of surgery or radiotherapy and monitor treatment response. Advanced imaging sequences provide valuable information about tumour and brain physiology, but clinical use is limited by extended scanning times and difficulties in processing and analysis. Brain eloquence classifications exist, but focus on adults with neurological deficits and are outdated. For the analysis of childhood tumours, limited numbers within tumour subgroups and the investigation of long-term outcomes necessitate using historical scans and/or multi-site collaboration. Variable imaging quality and differing acquisition parameters limit the use of segmentation algorithms and radiomic analysis. Harmonisation can standardise imaging in collaborative research, but can be challenging, while data-sharing produces further logistical challenges. Consequently, most research consists of small single-centre studies limited to regional analyses of tumour location. Technological advances reducing scanning times increase the feasibility of clinical acquisition of high-resolution standardised imaging including advanced physiological sequences. The RAPNO and SIOPE paediatric brain tumour imaging guidelines have improved image standardisation, which will benefit future collaborative imaging research. Modern machine learning techniques provide more nuanced approaches for integration and analysis of the complex and multifactorial data involved in cognitive outcome prediction.
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Affiliation(s)
- Simon Dockrell
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester M13 9PL, UK;
- Children’s Brain Tumour Research Network, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (I.K.-A.); (J.-P.K.)
- The Geoffrey Jefferson Brain Research Centre, Northern Care Alliance NHS Foundation Trust, Salford M6 8FJ, UK;
| | - Martin G. McCabe
- The Geoffrey Jefferson Brain Research Centre, Northern Care Alliance NHS Foundation Trust, Salford M6 8FJ, UK;
- The Christie NHS Foundation Trust, Manchester M0 4BX, UK
- Division of Cancer Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Ian Kamaly-Asl
- Children’s Brain Tumour Research Network, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (I.K.-A.); (J.-P.K.)
- The Geoffrey Jefferson Brain Research Centre, Northern Care Alliance NHS Foundation Trust, Salford M6 8FJ, UK;
| | - John-Paul Kilday
- Children’s Brain Tumour Research Network, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (I.K.-A.); (J.-P.K.)
- The Geoffrey Jefferson Brain Research Centre, Northern Care Alliance NHS Foundation Trust, Salford M6 8FJ, UK;
- Division of Cancer Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Stavros M. Stivaros
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester M13 9PL, UK;
- Children’s Brain Tumour Research Network, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (I.K.-A.); (J.-P.K.)
- The Geoffrey Jefferson Brain Research Centre, Northern Care Alliance NHS Foundation Trust, Salford M6 8FJ, UK;
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Liu Y, Xiang L, Liu FY, Yahya N, Chai JN, Hamid HA, Lu Q, Manan HA. Accuracy of Radiomics in the Identification of Extrathyroidal Extension and BRAF V600E Mutations in Papillary Thyroid Carcinoma: A Systematic Review and Meta-analysis. Acad Radiol 2025; 32:1385-1397. [PMID: 39765435 DOI: 10.1016/j.acra.2024.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 11/04/2024] [Accepted: 11/04/2024] [Indexed: 02/03/2025]
Abstract
RATIONALE AND OBJECTIVES Extrathyroidal extension (ETE) and BRAFV600E mutation in papillary thyroid cancer (PTC) increase mortality and recurrence risk. Preoperative identification presents considerable challenges. Although radiomics has emerged as a potential tool for identifying ETE and BRAFV600E mutation, systematic evidence supporting its effectiveness remains insufficient. Therefore, this paper aims to determine the effectiveness of radiomics in detecting ETE and BRAFV600E mutations in PTC. MATERIALS AND METHODS PubMed, Web of Science, Cochrane, and Embase databases were searched until May 7th, 2024. The Radiomics Quality Score tool assessed bias risk. Subgroup analyses based on radiomics and clinical characteristics were conducted. RESULTS Our systematic review included 19 studies, encompassing 5337 PTC cases. Among these, 12 articles focused on ETE and seven articles focused on BRAFV600E mutations. For the identification of ETE in the validation set, the summarized machine learning (ML) models demonstrated 0.80c-index (95%CI: 0.77-0.83), 0.77 sensitivity (95%CI: 0.72-0.81), and 0.78 specificity (95%CI: 0.73-0.82). Radiomics based on ultrasound demonstrated 0.82c-index (95%CI: 0.78-0.86), 0.77 sensitivity (95%CI: 0.68-0.84), and 0.84 specificity (95%CI: 0.75-0.91). For the identification of BRAFV600E mutations in the validation set, the summarized ML models showed 0.80c-index (95%CI: 0.72-0.87), 0.76 sensitivity (95%CI: 0.67-0.84), and 0.88 specificity (95%CI: 0.77-0.94). ML models based on ultrasound-guided radiomics had 0.81c-index (95%CI: 0.74-0.89), 0.79 sensitivity (95%CI: 0.71-0.86), and 0.87 specificity (95%CI: 0.74-0.94). CONCLUSION Radiomics in identifying ETE and BRAFV600E mutation have high c-index, sensitivity, and specificity, especially images from ultrasound, demonstrating the potential for diagnosing ETE and BRAFV600E mutations in PTC.
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Affiliation(s)
- Yan Liu
- Department of Radiology and Intervention, Hospital Pakar Kanak-Kanak (UKM Specialist Children's Hospital), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia (Y.L., F.Y.L., J.N.C., H.A.H., H.A.M.); Department of Ultrasound, Affiliated Hospital of Pan Zhihua University, Panzhihua, 61700, Sichuan Province, China (Y.L., L.X.); Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu 641400, China (Y.L., Q.L.)
| | - Ling Xiang
- Department of Ultrasound, Affiliated Hospital of Pan Zhihua University, Panzhihua, 61700, Sichuan Province, China (Y.L., L.X.)
| | - Fang-Yue Liu
- Department of Radiology and Intervention, Hospital Pakar Kanak-Kanak (UKM Specialist Children's Hospital), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia (Y.L., F.Y.L., J.N.C., H.A.H., H.A.M.)
| | - Noorazrul Yahya
- Diagnostic Imaging & Radiotherapy Program, Faculty of Health Sciences, School of Diagnostic & Applied Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia (N.Y.)
| | - Jia-Ning Chai
- Department of Radiology and Intervention, Hospital Pakar Kanak-Kanak (UKM Specialist Children's Hospital), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia (Y.L., F.Y.L., J.N.C., H.A.H., H.A.M.)
| | - Hamzaini Abdul Hamid
- Department of Radiology and Intervention, Hospital Pakar Kanak-Kanak (UKM Specialist Children's Hospital), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia (Y.L., F.Y.L., J.N.C., H.A.H., H.A.M.)
| | - Qiang Lu
- Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu 641400, China (Y.L., Q.L.); Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, China (Q.L.)
| | - Hanani Abdul Manan
- Department of Radiology and Intervention, Hospital Pakar Kanak-Kanak (UKM Specialist Children's Hospital), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia (Y.L., F.Y.L., J.N.C., H.A.H., H.A.M.); Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia (H.A.M.).
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Tensaouti F, Arribarat G, Cabarrou B, Pollidoro L, Courbière N, Sévely A, Roques M, Chaix Y, Péran P, Baudou E, Laprie A. Measuring the impact of treatment on memory functions in pediatric posterior fossa tumor survivors using diffusion tensor imaging. Radiother Oncol 2025; 202:110599. [PMID: 39490416 DOI: 10.1016/j.radonc.2024.110599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 10/21/2024] [Accepted: 10/23/2024] [Indexed: 11/05/2024]
Abstract
BACKGROUND AND PURPOSE The aim of the present prospective exploratory study was to investigate the long-term impact of treatment on brain structure integrity and memory functions in pediatric posterior fossa tumor (PFT) survivors using diffusion tensor imaging (DTI), to determine whether the latter could provide useful biomarkers of memory impairment. MATERIAL AND METHODS Sixty participants were included in this study, divided into three groups: 22 irradiated PFT, 17 non-irradiated PFT, and 21 healthy controls. All underwent memory tests and multimodal MRI, including a DTI sequence. Mean diffusivity and fractional anisotropy values were extracted for bilateral brain structures involved in memory, in order to carry out between-group comparisons and calculate correlations with memory test scores and radiotherapy doses. Statistical tests were two-sided, and p values < 0.05 were considered statistically significant. RESULTS DTI metrics were significantly higher for irradiated PFT survivors than in non-irradiated PFT survivors and controls (p < 0.05). Memory test scores were significantly lower for PFT survivors, particularly irradiated patients (p < 0.02), and were correlated with DTI metrics. (-0.27 < r < -0.62, p < 0.04). DTI metrics were correlated with either total or maximum dose for some structures. CONCLUSION Preliminary results of this study point to microstructural damage in memory-related brain areas in PFT survivors, particularly in irradiated patients, and identify DTI metrics as potential biomarkers of memory deficit.
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Affiliation(s)
- Fatima Tensaouti
- Radiation Oncology Department, Oncopole Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France; ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France.
| | - Germain Arribarat
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Bastien Cabarrou
- Biostatistics & Health Data Science Unit, Oncopole Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, Toulouse, France
| | - Lisa Pollidoro
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Nicolas Courbière
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Annick Sévely
- Radiology Department, Toulouse University Hospital, Toulouse, France
| | - Margaux Roques
- Radiology Department, Toulouse University Hospital, Toulouse, France
| | - Yves Chaix
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Eloïse Baudou
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Anne Laprie
- Radiation Oncology Department, Oncopole Claudius Regaud- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France; ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
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Habibi AT, Alaya IB, Tensaouti F, Baudou E, Arribarat G, Pollidoro L, Péran P, Chaix Y, Labidi S, Laprie A. Impact of Pediatric Posterior Fossa Tumor Treatments on Working Memory Tracts Using Resting-State fMRI and Tractography. J Neuroimaging 2025; 35:e70007. [PMID: 39789950 DOI: 10.1111/jon.70007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Revised: 12/23/2024] [Accepted: 12/24/2024] [Indexed: 01/12/2025] Open
Abstract
BACKGROUND AND PURPOSE Working memory, a primary cognitive domain, is often impaired in pediatric brain tumor survivors, affecting their attention and processing speed. This study investigated the long-term effects of treatments, including surgery, radiotherapy (RT), and chemotherapy (CT), on working memory tracts in children with posterior fossa tumors (PFTs) using resting-state functional MRI (rs-fMRI) and diffusion MRI tractography. METHODS This study included 16 medulloblastoma (MB) survivors treated with postoperative RT and CT, 14 pilocytic astrocytoma (PA) survivors treated with surgery alone, and 16 healthy controls from the Imaging Memory after Pediatric Cancer in children, adolescents, and young adults study (NCT04324450). Working memory tracts were identified by combining seed masks from rs-fMRI maps and whole-brain tractography from diffusion MRI. Connectivity alterations were assessed qualitatively and quantitatively, alongside neuropsychological evaluations and correlations with behavioral outcomes and mean supratentorial dose. RESULTS Compared to controls, MB survivors exhibited significant impairments in the working memory network, including reductions in tract volume (TV), fiber density, fiber cross-section (FC), mean streamline length (MLS), and fractional anisotropy (FA) (all p = 0.04). Lower working memory scores were correlated with reduced TV and FA in MB survivors. Higher mean supratentorial doses were associated with lower TV, FC, and FA values across multiple tracts, particularly in the arcuate and superior longitudinal fasciculi. CONCLUSIONS Tractography-derived features highlighted white matter damage as a biomarker of treatment-related neurotoxicity in PFTs survivors. These findings underscore the detrimental impact of RT and CT on working memory networks and emphasize the importance of preserving cognitive function during treatment planning.
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Affiliation(s)
- Abir Troudi Habibi
- University of Tunis El Manar, Higher Institute of Medical Technologies of Tunis, Research Laboratory of Biophysics and Medical Technologies LR13ES07, Tunis, Tunisia
- Toulouse NeuroImaging Center (ToNIC), INSERM, University of Toulouse Paul Sabatier, Toulouse, France
| | - Ines Ben Alaya
- University of Tunis El Manar, Higher Institute of Medical Technologies of Tunis, Research Laboratory of Biophysics and Medical Technologies LR13ES07, Tunis, Tunisia
| | - Fatima Tensaouti
- Toulouse NeuroImaging Center (ToNIC), INSERM, University of Toulouse Paul Sabatier, Toulouse, France
- Radiation Oncology Department, Claudius Regaud Institute, Toulouse University Cancer Institute, Oncopole, Toulouse, France
| | - Eloïse Baudou
- Toulouse NeuroImaging Center (ToNIC), INSERM, University of Toulouse Paul Sabatier, Toulouse, France
- Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Germain Arribarat
- Toulouse NeuroImaging Center (ToNIC), INSERM, University of Toulouse Paul Sabatier, Toulouse, France
| | - Lisa Pollidoro
- Toulouse NeuroImaging Center (ToNIC), INSERM, University of Toulouse Paul Sabatier, Toulouse, France
| | - Patrice Péran
- Toulouse NeuroImaging Center (ToNIC), INSERM, University of Toulouse Paul Sabatier, Toulouse, France
| | - Yves Chaix
- Toulouse NeuroImaging Center (ToNIC), INSERM, University of Toulouse Paul Sabatier, Toulouse, France
- Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Salam Labidi
- University of Tunis El Manar, Higher Institute of Medical Technologies of Tunis, Research Laboratory of Biophysics and Medical Technologies LR13ES07, Tunis, Tunisia
| | - Anne Laprie
- Toulouse NeuroImaging Center (ToNIC), INSERM, University of Toulouse Paul Sabatier, Toulouse, France
- Radiation Oncology Department, Claudius Regaud Institute, Toulouse University Cancer Institute, Oncopole, Toulouse, France
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Drabek-Maunder ER, Mankad K, Aquilina K, Dean JA, Nisbet A, Clark CA. Using diffusion MRI to understand white matter damage and the link between brain microstructure and cognitive deficits in paediatric medulloblastoma patients. Eur J Radiol 2024; 177:111562. [PMID: 38901074 DOI: 10.1016/j.ejrad.2024.111562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/09/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE Survivors of medulloblastoma face a range of challenges after treatment, involving behavioural, cognitive, language and motor skills. Post-treatment outcomes are associated with structural changes within the brain resulting from both the tumour and the treatment. Diffusion magnetic resonance imaging (MRI) has been used to investigate the microstructure of the brain. In this review, we aim to summarise the literature on diffusion MRI in patients treated for medulloblastoma and discuss future directions on how diffusion imaging can be used to improve patient quality. METHOD This review summarises the current literature on medulloblastoma in children, focusing on the impact of both the tumour and its treatment on brain microstructure. We review studies where diffusion MRI has been correlated with either treatment characteristics or cognitive outcomes. We discuss the role diffusion MRI has taken in understanding the relationship between microstructural damage and cognitive and behavioural deficits. RESULTS We identified 35 studies that analysed diffusion MRI changes in patients treated for medulloblastoma. The majority of these studies found significant group differences in measures of brain microstructure between patients and controls, and some of these studies showed associations between microstructure and neurocognitive outcomes, which could be influenced by patient characteristics (e.g. age), treatment, radiation dose and treatment type. CONCLUSIONS In future, studies would benefit from being able to separate microstructural white matter damage caused by the tumour, tumour-related complications and treatment. Additionally, advanced diffusion modelling methods can be explored to understand and describe microstructural changes to white matter.
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Affiliation(s)
- Emily R Drabek-Maunder
- UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London WC1N 1EH, UK; UCL Dept of Medical Physics and Biomedical Engineering, Malet Place, Gower St, London WC1E 6BT, UK; Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK.
| | - Kshitij Mankad
- UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London WC1N 1EH, UK; Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - Kristian Aquilina
- UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London WC1N 1EH, UK; Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - Jamie A Dean
- UCL Dept of Medical Physics and Biomedical Engineering, Malet Place, Gower St, London WC1E 6BT, UK
| | - Andrew Nisbet
- UCL Dept of Medical Physics and Biomedical Engineering, Malet Place, Gower St, London WC1E 6BT, UK
| | - Chris A Clark
- UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London WC1N 1EH, UK; Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
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Voon NS, Manan HA, Yahya N. Remote assessment of cognition and quality of life following radiotherapy for nasopharyngeal carcinoma: deep-learning-based predictive models and MRI correlates. J Cancer Surviv 2024; 18:1297-1308. [PMID: 37010777 PMCID: PMC10069366 DOI: 10.1007/s11764-023-01371-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/22/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE Irradiation of the brain regions from nasopharyngeal carcinoma (NPC) radiotherapy (RT) is frequently unavoidable, which may result in radiation-induced cognitive deficit. Using deep learning (DL), the study aims to develop prediction models in predicting compromised cognition in patients following NPC RT using remote assessments and determine their relation to the quality of life (QoL) and MRI changes. METHODS Seventy patients (20-76 aged) with MRI imaging (pre- and post-RT (6 months-1 year)) and complete cognitive assessments were recruited. Hippocampus, temporal lobes (TLs), and cerebellum were delineated and dosimetry parameters were extracted. Assessments were given post-RT via telephone (Telephone Interview Cognitive Status (TICS), Telephone Montreal Cognitive Assessment (T-MoCA), Telephone Mini Addenbrooke's Cognitive Examination (Tele-MACE), and QLQ-H&N 43). Regression and deep neural network (DNN) models were used to predict post-RT cognition using anatomical and treatment dose features. RESULTS Remote cognitive assessments were inter-correlated (r > 0.9). TLs showed significance in pre- and post-RT volume differences and cognitive deficits, that are correlated with RT-associated volume atrophy and dose distribution. Good classification accuracy based on DNN area under receiver operating curve (AUROC) for cognitive prediction (T-MoCA AUROC = 0.878, TICS AUROC = 0.89, Tele-MACE AUROC = 0.919). CONCLUSION DL-based prediction models assessed using remote assessments can assist in predicting cognitive deficit following NPC RT. Comparable results of remote assessments in assessing cognition suggest its possibility in replacing standard assessments. IMPLICATIONS FOR CANCER SURVIVORS Application of prediction models in individual patient enables tailored interventions to be provided in managing cognitive changes following NPC RT.
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Affiliation(s)
- Noor Shatirah Voon
- Diagnostic Imaging and Radiotherapy, Centre for Diagnostic, Therapeutic and Investigative Sciences (CODTIS), Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300, Kuala Lumpur, Malaysia
- National Cancer Institute, Ministry of Health, Jalan P7, Presint 7, 62250, Putrajaya, Malaysia
| | - Hanani Abdul Manan
- Functional Image Processing Laboratory, Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Noorazrul Yahya
- Diagnostic Imaging and Radiotherapy, Centre for Diagnostic, Therapeutic and Investigative Sciences (CODTIS), Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300, Kuala Lumpur, Malaysia.
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Hagan AJ, Bailey S, Verity SJ. Barriers to the use of Methylphenidate in Pediatric Neuro-oncology Services. Cogn Behav Neurol 2024; 37:57-61. [PMID: 37724747 DOI: 10.1097/wnn.0000000000000357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/11/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Survivors of childhood CNS tumors are at a significant risk of chronic and multifaceted neurocognitive late effects. Recent findings indicate the potential utility of methylphenidate in addressing neurocognitive and academic plateauing and improving quality-of-life outcomes in this clinical population. However, the prescription of methylphenidate in neuro-oncology services remains inconsistent. OBJECTIVE To explore the neurocognitive assessment and rehabilitative interventions (including the use of methylphenidate) offered to survivors of childhood CNS tumors within mainland UK. METHOD We used a semi-structured questionnaire to gather qualitative data from clinical psychologists and neuropsychologists within National Health Service pediatric neuro-oncology principal treatment centers (PTCs) during May 2018. Thematic analytical methods were used to explore themes within the collected data. RESULTS Eleven (58%) of the 19 PTCs returned the completed questionnaire. Respondents reported inadequate resource of psychology in many pediatric neuro-oncology PTCs, which limited the provision of methylphenidate to a restricted proportion of the patient group (i.e., those with the most profound neurocognitive difficulties). Respondents reported an interest in exploring the utility of methylphenidate in their patient group yet described a lack of appropriate evidence of its efficacy. In addition, respondents highlighted the need for the provision of accessible research summaries and treatment protocols addressing the use of methylphenidate. CONCLUSION We anticipate that national collaboration between clinicians and researchers working in the cancer survivorship field will support the advancement of interventions such as methylphenidate for the growing clinical population of survivors of childhood CNS tumors.
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Affiliation(s)
| | - Simon Bailey
- Paediatric Neuro-Oncolgy, Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, Newcastle-upon-Tyne, England
- Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
| | - Sarah J Verity
- Departments of Paediatric Health Psychology
- Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, England
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Voon NS, Manan HA, Yahya N. Role of resting-state functional MRI in detecting brain functional changes following radiotherapy for head and neck cancer: a systematic review and meta-analysis. Strahlenther Onkol 2023; 199:706-717. [PMID: 37280382 DOI: 10.1007/s00066-023-02089-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 04/23/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE Increasing evidence implicates changes in brain function following radiotherapy for head and neck cancer as precursors for brain dysfunction. These changes may thus be used as biomarkers for early detection. This review aimed to determine the role of resting-state functional magnetic resonance imaging (rs-fMRI) in detecting brain functional changes. METHODS A systematic search was performed in the PubMed, Scopus, and Web of Science (WoS) databases in June 2022. Patients with head and neck cancer treated with radiotherapy and periodic rs-fMRI assessments were included. A meta-analysis was performed to determine the potential of rs-fMRI for detecting brain changes. RESULTS Ten studies with a total of 513 subjects (head and neck cancer patients, n = 437; healthy controls, n = 76) were included. A significance of rs-fMRI for detecting brain changes in the temporal and frontal lobes, cingulate cortex, and cuneus was demonstrated in most studies. These changes were reported to be associated with dose (6/10 studies) and latency (4/10 studies). A strong effect size (r = 0.71, p < 0.001) between rs-fMRI and brain changes was also reported, suggesting rs-fMRI's capability for monitoring brain alterations. CONCLUSION Resting-state functional MRI is a promising tool for detecting brain functional changes following head and neck radiotherapy. These changes are correlated with latency and prescription dose.
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Affiliation(s)
- Noor Shatirah Voon
- Diagnostic Imaging and Radiotherapy, Centre of Diagnostic, Therapeutic and Investigative Sciences, Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300, Kuala Lumpur, Malaysia
- Department of Radiotherapy & Oncology, National Cancer Institute, Putrajaya, Malaysia
| | - Hanani Abdul Manan
- Functional Image Processing Laboratory, Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Noorazrul Yahya
- Diagnostic Imaging and Radiotherapy, Centre of Diagnostic, Therapeutic and Investigative Sciences, Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300, Kuala Lumpur, Malaysia.
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