Pre-symptomatic local brain activity and functional connectivity alterations in nasopharyngeal carcinoma patients who de
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ORIGINAL RESEARCH
Pre-symptomatic local brain activity and functional connectivity alterations in nasopharyngeal carcinoma patients who developed radiation encephalopathy following radiotherapy You-ming Zhang 1 & Jian-ming Gao 2,3,4 & Hong Zhou 5 & Li Li 3,4,6 & Li-zhi Liu 3,4,6 & Zai-de Han 1 & Xiao-ping Yi 1 & Wei-hua Liao 1,7
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Radiation encephalopathy (RE) is a common complication in patients with nasopharyngeal carcinoma (NPC) who have received radiotherapy (RT), and recent neuroimaging studies have shown brain alterations in Post-RT patients prior to RE. However, whether there are functional alterations between those Post-RT patients who are proved to have RE in follow-up and those who do not develop it remains largely unknown. Here, we used resting state functional MRI to explore regional homogeneity (ReHo) and functional connectivity (FC) alterations in Post-RT patients with (Post-RT RE proved; n = 18) or without (Post-RT non-RE; n = 22) RE at follow-up, also making comparisons with a Pre-RT group (n = 23). Compared with the Pre-RT group, patients in Post-RT non-RE and Post-RT RE proved groups showed concurrent increased and decreased ReHo values in different brain regions inside and/or outside the radiation field, with the alterations in ReHo tending to increase if RE occurred. Seed-based FC analysis showed that compared with the Post-RT non-RE group, patients in the Post-RT RE proved group had different changing patterns of FC between a region of interest (ROI) in the right temporal lobe and distant brain regions (mainly in the sensorimotor system and default mode network). Receiver operating characteristic (ROC) curve analysis showed that the altered ReHo value in the ROI had excellent diagnostic performance for differentiating NPC patients who developed RE in follow-up from those who did not, with an area under the curve (AUC) value of 0.94. These ReHo and FC findings may provide new insights into the early diagnosis of RE. Keywords Radiation encephalopathy . Nasopharyngeal carcinoma . Functional MRI . Regional homogeneity . Functional connectivity . ROC curve
You-ming Zhang, Jian-ming Gao and Hong Zhou contributed equally to this work. * Xiao-ping Yi [email protected] * Wei-hua Liao [email protected] 1
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Department of Radiology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha 410008, People’s Republic of China Department of Radiation Oncology, Sun Yat-sen University Cancer Center, No.651 Dongfeng Road East, Guangzhou 510060, People’s Republic of China State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China
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Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China
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Department of Radiology, the first Affiliated Hospital of University of South China, Hengyang, China
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Imaging Diagnosis and Interventional Center, Sun Yat-sen University Cancer Center, No.651 Dongfeng Road East, Guangzhou 510060, People’s Republic of Chin
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