[1]刘瑞,巩贯忠,杜珊珊,等.磁共振三维动脉自旋标记成像量化脑转移瘤放疗前后海马血流灌注变化[J].中国医学物理学杂志,2025,42(2):148-153.[doi:DOI:10.3969/j.issn.1005-202X.2025.02.002]
　LIU Rui,GONG Guanzhong,et al.Application of three-dimensional arterial spin labeling MR imaging to quantify changes in hippocampal perfusion before and after radiotherapy for brain metastases[J].Chinese Journal of Medical Physics,2025,42(2):148-153.[doi:DOI:10.3969/j.issn.1005-202X.2025.02.002]
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磁共振三维动脉自旋标记成像量化脑转移瘤放疗前后海马血流灌注变化()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
42
期数:
2025年第2期
页码:
148-153
栏目:
医学放射物理
出版日期:
2025-01-20

文章信息/Info

Title:
Application of three-dimensional arterial spin labeling MR imaging to quantify changes in hippocampal perfusion before and after radiotherapy for brain metastases
文章编号:
1005-202X（2025）02-0148-06
作者:
刘瑞1; 2; 巩贯忠2; 杜珊珊2; 孟康宁2; 王若峥3; 尹勇2
1.山东第一医科大学（山东省医学科学院）研究生部， 山东 济南250000； 2.山东省肿瘤防治研究院（山东省肿瘤医院）放射物理技术科， 山东 济南 250117； 3.新疆医科大学附属肿瘤医院放疗中心， 新疆 乌鲁木齐 830011
Author(s):
LIU Rui1;  2;  GONG Guanzhong2;  DU Shanshan2;  MENG Kangning2;  WANG Ruozheng3;  YIN Yong2
1. Graduate Department, Shandong First Medical University/Shandong Academy of Medical Sciences, Jinan 250000, China 2. Department of Radiation Physics, Shandong Cancer Institute/Shandong Cancer Hospital, Jinan 250117, China 3. Radiotherapy Center, Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China
关键词:
海马; 血流灌注; 放射治疗; 脑转移瘤; 磁共振成像; 三维动脉自旋转记
Keywords:
Keywords: hippocampus blood flow perfusion radiotherapy brain metastasis magnetic resonance imaging three-dimensional arterial spin labeling
分类号:
R816
DOI:
DOI:10.3969/j.issn.1005-202X.2025.02.002
文献标志码:
A
摘要:
目的：回顾性分析放疗（RT）前后海马血流灌注（CBF）及体积的变化，探究其与剂量的关系，为脑转移瘤（BMs）患者进行全脑放射治疗（WBRT）后海马反应的动态监测提供可行方法。方法：回顾性分析43例BMs患者RT前后的两次磁共振（MR）模拟定位图像，包括T1加权成像（T1WI）和三维动脉自旋标记（3D-ASL）成像。在T1WI上手动分割左右侧海马结构并统计海马体积，在3D-ASL图像上获取海马CBF。根据两次MR扫描的时间间隔和海马接受剂量分为时间间隔短［<30 d，平均（19.74±7.15） d］≤1 Gy组、1~30 Gy组和≥30 Gy组；时间间隔长［>3个月，平均（495.50±226.06） d］≤1 Gy组、1~30 Gy组和≥30 Gy组。分析RT后海马CBF和体积的变化规律及剂量-效应关系。结果：（1）共入组86个海马测量其CBF与体积变化情况，RT后海马CBF最小值（CBF-min）、最大值（CBF-max）、平均值（CBF-mean）及体积较RT前分别减少8.32%、7.31%、8.09%、4.11%（P<0.05）；海马CBF-min、CBF-max、CBF-mean的下降率分别较体积减小率高6.33%、7.01%、8.23%。（2）两次MR模拟定位扫描时间间隔短时，≤1 Gy组与1~30 Gy组海马CBF增加，增加率与海马接受的剂量呈正相关，≥30 Gy组海马CBF下降，除≤1 Gy组与1~30 Gy组外，其余剂量组的海马CBF变化率差异均有统计学意义（P<0.05）。3个剂量组海马的体积均略增长，增长率与海马接受的剂量呈正相关，差异均无统计学意义（P>0.05）。（3）两次MR模拟定位扫描时间间隔长时，3个剂量组的海马CBF与体积均呈下降趋势，下降率与海马接受的剂量呈正相关，除≤1 Gy组与1~30 Gy组外，其余剂量组的海马CBF变化率差异均有统计学意义（P<0.05），3个剂量组海马体积减小率的差异均有统计学意义（P<0.05）。结论：BMs患者接受RT后海马的CBF下降较体积减小更加敏感，有明显的时间及剂量依赖性，应该作为BMs在WBRT后追踪海马RT反应和预测放射性损伤的常规生物指标。
Abstract:
Abstract: Objective To retrospectively analyze the changes in cerebral blood flow (CBF) of hippocampus before and after radiotherapy (RT) and to explore its relationship with dose for providing a feasible approach for dynamically monitoring hippocampal response after whole brain radiation therapy in patients with brain metastases (BMs). Methods A retrospective analysis was conducted on magnetic resonance (MR) images from 43 BMs patients before and after RT, including T1-weighted imaging (T1WI) and three-dimensional arterial spin labeling (3D-ASL) imaging. Manual segmentation of the hippocampal structures was performed on T1WI to determine hippocampal volume, while CBF within the hippocampus was derived from 3D-ASL images. Patients were categorized into different groups according to the time interval between two MR scans and the dose received by the hippocampus, namely short time interval ［<30 d, with an average of (19.74±7.15) d］ ≤ 1 Gy, 1-30 Gy and ≥ 30 Gy groups long time interval ［>3 months, with an average of (495.50±226.06) d］ ≤ 1 Gy, 1-30 Gy and ≥ 30 Gy groups. The patterns of changes in hippocampal CBF and volume, as well as the dose-effect relationship following RT were analyzed. Results (1) A total of 86 hippocampi were enrolled, showing reductions of 8.32% in minimum CBF (CBF-min), 7.31% in maximum CBF (CBF-max), 8.09% in mean CBF (CBF-mean), and 4.11% in hippocampal volume after RT (P<0.05). The decrease rates of CBF-min, CBF-max and CBF-mean were 6.33%, 7.01% and 8.23% higher than the reduction rate of hippocampal volume, respectively. (2) With a brief interval between two MR simulation localization scans, hippocampal CBF in the groups receiving ≤ 1 Gy and 1-30 Gy exhibited an increase, with the increase rate positively correlated to the radiation dose absorbed by the hippocampus. Conversely, in the group receiving ≥ 30 Gy, hippocampal CBF decreased. The variations in the rate of hippocampal CBF change across the dose groups were statistically significant, except when comparing ≤ 1 Gy and 1-30 Gy groups (P<0.05). Additionally, the hippocampal volume in all 3 dose groups experienced a slight increase, with the growth rate also positively correlated to the radiation dose received by the hippocampus however, these differences were not statistically significant (P>0.05). (3) With a long interval between MR simulation localization scans, both hippocampal CBF and volume in all 3 dose groups demonstrated decreasing trends, with the decrease rate positively correlated to the radiation dose received by the hippocampus. Statistically significant differences in the rate of CBF change were noted among the dose groups, except for the comparison between ≤ 1 Gy and 1-30 Gy groups (P<0.05). The reduction rate of hippocampal volume across 3 dose groups was statistically significant (P<0.05). Conclusion The reduction in hippocampal CBF following RT in BMs patients is more sensitive than the reduction in hippocampal volume, exhibiting a pronounced dependence on both time and radiation dose. Consequently, CBF changes should be employed as a standard bioindicator for monitoring the response to hippocampal RT and predicting radiological injuries after whole brain radiotherapy in BMs patients.

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备注/Memo

备注/Memo:
【收稿日期】2024-10-12 【基金项目】山东省自然科学基金（ZR2023MH297） 【作者简介】刘瑞，硕士研究生，研究方向：影像引导下的放射治疗，E-mail: LiuRui732116441@163.com 【通信作者】尹勇，博士，研究员，博士生导师，主要从事肿瘤放射物理学、肿瘤精确放疗新技术、医学图像处理辅助精确放疗的研究和临床应用工作，E-mail: yinyongsd@126.com
更新日期/Last Update: 2025-01-22