title: Effects of chemotherapy on the brain in childhood: diffusion tensor imaging of subtle white matter damage.
abstract: BACKGROUND
  With reducing mortality in children with hematological malignancies, the survivors' quality of life regarding development of chronic neurological disturbances is important. We aimed to determine whether chemotherapy affects white matter (WM).
  
  
  METHODS
  Using brain diffusion tensor imaging, we evaluated 17 patients (15 with acute lymphoblastic leukemia, 2 with non-Hodgkin's lymphoma; 9 male, 8 female; age, 1.6-13 years) before and after chemotherapy. We measured the quantitative values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) at the regions of interest (ROIs) such as periventricular WM, corona radiata, posterior limb of the internal capsule, and corpus callosum. We assessed sensorimotor and callosal tracts by tractography.
  
  
  RESULTS
  Reduction in FA and increase in ADC were significant at the ROIs of the left and right anterior periventricular WM and corona radiata and at the tract passing through the genu. A significant reduction in FA with a nonsignificant increase in ADC was seen at the ROI of the genu and at the tracts passing through the body and isthmus.
  
  
  CONCLUSIONS
  Chemotherapy in children with hematological malignancies predominantly affects the frontal WM. This finding might indicate a negative effect of chemotherapy on neurological development in children with hematological malignancies.
authors.affiliation: Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Shigemi
authors.initials: S
authors.lastname: Morioka
authors.forename: Masafumi
authors.initials: M
authors.lastname: Morimoto
authors.forename: Kei
authors.initials: K
authors.lastname: Yamada
authors.forename: Tatsuji
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Morita
authors.forename: Masaharu
authors.initials: M
authors.lastname: Moroto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Isoda
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Chiyonobu
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Imamura
authors.forename: Akira
authors.initials: A
authors.lastname: Nishimura
authors.forename: Akira
authors.initials: A
authors.lastname: Morimoto
authors.forename: Hajime
authors.initials: H
authors.lastname: Hosoi
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001927:Brain Diseases / Q000139:chemically induced* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D005625:Frontal Lobe / Q000187:drug effects* / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000187:drug effects* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
references.citation: Cancer. 2006 Feb 15;106(4):941-9
references.pmid: 16411228
references.citation: AJR Am J Roentgenol. 2002 Dec;179(6):1515-22
references.pmid: 12438047
references.citation: J Clin Oncol. 2006 Feb 20;24(6):884-90
references.pmid: 16484697
references.citation: Neuroimage. 2005 May 15;26(1):195-205
references.pmid: 15862219
references.citation: Lancet. 2008 Mar 22;371(9617):1030-43
references.pmid: 18358930
references.citation: AJNR Am J Neuroradiol. 2008 Apr;29(4):792-7
references.pmid: 18184841
references.citation: Radiology. 1988 Jan;166(1 Pt 1):173-80
references.pmid: 3336675
references.citation: J Inherit Metab Dis. 2005;28(3):311-43
references.pmid: 15868466
references.citation: Brain. 2003 Apr;126(Pt 4):751-2
references.pmid: 12615635
references.citation: J Pediatr Hematol Oncol. 2011 Aug;33(6):450-8
references.pmid: 21646917
references.citation: AJNR Am J Neuroradiol. 2003 Apr;24(4):734-40
references.pmid: 12695214
references.citation: Neuroreport. 1999 Sep 9;10(13):2817-21
references.pmid: 10511446
references.citation: AJNR Am J Neuroradiol. 2009 Nov;30(10):1947-54
references.pmid: 19643920
references.citation: Biophys J. 1994 Jan;66(1):259-67
references.pmid: 8130344
references.citation: Curr Opin Neurol. 2009 Aug;22(4):362-9
references.pmid: 19571751
references.citation: Radiology. 2004 Jan;230(1):77-87
references.pmid: 14645885
references.citation: Pediatrics. 2008 Sep;122(3):500-6
references.pmid: 18762518
references.citation: Pediatr Res. 2011 Mar;69(3):249-54
references.pmid: 21131895
references.citation: Neuroimage. 2006 Jan 15;29(2):493-504
references.pmid: 16194615
references.citation: Curr Oncol Rep. 2007 Nov;9(6):459-65
references.pmid: 17991353
references.citation: J Neuropathol Exp Neurol. 1988 May;47(3):217-34
references.pmid: 3367155
references.citation: Magn Reson Imaging. 1999 Nov;17(9):1269-74
references.pmid: 10576712
references.citation: Cancer. 1976 Feb;37(2):853-7
references.pmid: 1062230
references.citation: Med Pediatr Oncol. 2002 May;38(5):320-8
references.pmid: 11979456
references.citation: NMR Biomed. 2002 Nov-Dec;15(7-8):435-55
references.pmid: 12489094