P01.01.A Lesion-Function Analysis from Multimodal Imaging and Normative Brain Atlases for Prediction of Cognitive Deficits in Glioma Patients

Neuro-Oncology, vol. 24, pp. ii23

Abstract

Abstract Background Cognitive deficits are common in glioma patients following multimodality therapy, but the relative impact of different types and locations of treatment-related brain damage and recurrent tumors on cognition is not well understood. Material and Methods In 121 WHO Grade III/IV glioma patients, structural MRI, O-(2-[18F]fluoroethyl)-L-tyrosine FET-PET, and neuropsychological testing were performed at a median interval of 14 months (range, 1-214 months) after therapy initiation. Resection cavities, T1-enhancing lesions, T2/FLAIR hyperintensities, and FET-PET positive tumor sites were semiautomatically segmented and elastically registered to a normative, resting state (RS) fMRI-based functional cortical network atlas and to the JHU atlas of white matter (WM) tracts, and their influence on cognitive test scores relative to a cohort of matched healthy subjects was assessed. Results T2/FLAIR hyperintensities presumably caused by radiation therapy covered more extensive brain areas than the other lesion types and significantly impaired cognitive performance in many domains when affecting left-hemispheric RS-nodes and WM-tracts as opposed to brain tissue damage caused by resection or recurrent tumors. Verbal episodic memory proved to be especially vulnerable to T2/FLAIR abnormalities affecting the nodes and tracts of the left temporal lobe. Conclusion In order to improve radiotherapy planning, publicly available brain atlases, in conjunction with elastic registration techniques, should be used, similar to neuronavigation in neurosurgery.

Authors 13

1. Martin Köcher

   Forschungszentrum Jülich · University of Cologne

   Affiliation as printed

   Research Center Juelich , Juelich , Germany

   University of Cologne , Cologne , Germany

2. Christiane Jockwitz

   Forschungszentrum Jülich

   Affiliation as printed

   Research Center Juelich , Juelich , Germany

3. Philipp Lohmann

   Forschungszentrum Jülich

   Affiliation as printed

   Research Center Juelich , Juelich , Germany

4. Gabi Stoffels

   Forschungszentrum Jülich

   Affiliation as printed

   Research Center Juelich , Juelich , Germany

5. F M Motthagy Aachen

   Forschungszentrum Jülich · RWTH Aachen University

   Affiliation as printed

   RWTH Aachen University , Aachen , Germany

   Research Center Juelich , Juelich , Germany

6. Maximilian Ingolf Ruge

   University of Cologne

   Affiliation as printed

   University of Cologne , Cologne , Germany

7. Christina Lucas

   University of Cologne

   Affiliation as printed

   University of Cologne , Cologne , Germany

8. Roland Goldbrunner

   University of Cologne

   Affiliation as printed

   University of Cologne , Cologne , Germany

9. Nadim Jon Shah

   Forschungszentrum Jülich

   Affiliation as printed

   Research Center Juelich , Juelich , Germany

10. Gereon R. Fink

    University of Cologne

    Affiliation as printed

    University of Cologne , Cologne , Germany

11. Norbert Galldiks

    University of Cologne

    Affiliation as printed

    University of Cologne , Cologne , Germany

12. Karl‐Josef Langen Aachen

    Forschungszentrum Jülich · RWTH Aachen University

    Affiliation as printed

    RWTH Aachen University , Aachen , Germany

    Research Center Juelich , Juelich , Germany

13. Svenja Caspers

    Forschungszentrum Jülich · Heinrich Heine University Düsseldorf

    Affiliation as printed

    Research Center Juelich , Juelich , Germany

    University Duesseldorf , Duesseldorf , Germany