Measuring the impact of treatment on memory functions in pediatric posterior fossa tumor survivors using diffusion tensor imaging.
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BACKGROUND AND PURPOSE: The aim of the present prospective exploratory study was to investigate the long-term impact of treatment on brain structure integrity and memory functions in pediatric posterior fossa tumor (PFT) survivors using diffusion tensor imaging (DTI), to determine whether the latter could provide useful biomarkers of memory impairment. MATERIAL AND METHODS: Sixty participants were included in this study, divided into three groups: 22 irradiated PFT, 17 non-irradiated PFT, and 21 healthy controls. All underwent memory tests and multimodal MRI, including a DTI sequence. Mean diffusivity and fractional anisotropy values were extracted for bilateral brain structures involved in memory, in order to carry out between-group comparisons and calculate correlations with memory test scores and radiotherapy doses. Statistical tests were two-sided, and p values < 0.05 were considered statistically significant. RESULTS: DTI metrics were significantly higher for irradiated PFT survivors than in non-irradiated PFT survivors and controls (p < 0.05). Memory test scores were significantly lower for PFT survivors, particularly irradiated patients (p < 0.02), and were correlated with DTI metrics. (-0.27 < r < -0.62, p < 0.04). DTI metrics were correlated with either total or maximum dose for some structures. CONCLUSION: Preliminary results of this study point to microstructural damage in memory-related brain areas in PFT survivors, particularly in irradiated patients, and identify DTI metrics as potential biomarkers of memory deficit.