| Title: |
Cerebral microbleeds in adult survivors of childhood acute lymphoblastic leukemia treated with cranial radiation |
| Authors: |
Phillips, NS; Hillenbrand, CM; Mitrea, BG; Yan, J; Li, C; Scoggins, MA; Merchant, TE; Armstrong, GT; Srivastava, D; Pui, CH; Robison, LL; Hudson, MM; Krull, KR; Sabin, ND |
| Source: |
urn:ISSN:2045-2322 ; Scientific Reports, 10, 1 |
| Publisher Information: |
Nature Research. |
| Publication Year: |
2020 |
| Collection: |
UNSW Sydney (The University of New South Wales): UNSWorks |
| Subject Terms: |
32 Biomedical and Clinical Sciences; 3202 Clinical Sciences; Radiation Oncology; Neurodegenerative; Childhood Leukemia; Pediatric Research Initiative; Acquired Cognitive Impairment; Brain Disorders; Neurosciences; Biomedical Imaging; Rare Diseases; Orphan Drug; Pediatric Cancer; Physical Injury - Accidents and Adverse Effects; Hematology; Clinical Research; Cancer; Adult; Cancer Survivors; Cerebral Hemorrhage; Cranial Irradiation; Cross-Sectional Studies; Dose-Response Relationship; Radiation; Female; Frontal Lobe; Humans; Magnetic Resonance Imaging; Male; Mental Status and Dementia Tests |
| Description: |
Cranial radiation therapy is associated with white matter-specific brain injury, cortical volume loss, mineralization, microangiopathy and neurocognitive impairment in survivors of childhood acute lymphoblastic leukemia. In this retrospective cross-sectional analysis, neurocognitive testing and 3 T brain MRI’s were obtained in 101 survivors treated with cranial radiation. Small focal intracerebral hemorrhages only visible on exquisitely sensitive MRI sequences were identified and localized using susceptibility weighted imaging. Modified Poisson regression was used to assess the effect of cranial radiation on cumulative number and location of microbleeds in each brain region, and multiple linear regression was used to evaluate microbleeds on neurocognitive outcomes, adjusting for age at diagnosis and sex. At least one microbleed was present in 85% of survivors, occurring more frequently in frontal lobes. Radiation dose of 24 Gy conveyed a 5-fold greater risk (95% CI 2.57–10.32) of having multiple microbleeds compared to a dose of 18 Gy. No significant difference was found in neurocognitive scores with either the absence or presence of microbleeds or their location. Greater prevalence of microbleeds in our study compared to prior reports is likely related to longer time since treatment, better sensitivity of SWI for detection of microbleeds and the use of a 3 T MRI platform. © The Author(s) 2020. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
https://hdl.handle.net/1959.4/unsworks_78057 |
| DOI: |
10.1038/s41598-020-57682-8 |
| Availability: |
https://hdl.handle.net/1959.4/unsworks_78057; https://unsworks.unsw.edu.au/bitstreams/6c1fe2d9-c2dc-4f11-a128-f686a11f1a93/download; https://doi.org/10.1038/s41598-020-57682-8 |
| Rights: |
open access ; https://purl.org/coar/access_right/c_abf2 ; CC BY ; https://creativecommons.org/licenses/by/4.0/ ; free_to_read ; Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
| Accession Number: |
edsbas.520FFA05 |
| Database: |
BASE |