Evaluating Radiation-Induced White Matter Changes in Patients with Recurrent Malignant Gliomas Under Treatment of Stereotactic Radiosurgery using Diffusion Tensor Imaging: Initial Results

Zheng Chang¹, John P. Kirkpatrick¹, Zhiheng Wang¹, Jing Cai¹, Fang-Fang Yin¹

Stereotactic radiosurgery (SRS) has been an effective treatment for brain tumors; however, few data are available regarding radiation-induced white matter (WM) damage by SRS. In this work, MR diffusion tensor imaging was used to investigate WM changes following SRS. Seven patients with gliomas were scanned before, 7-day and 2-month following SRS. Diffusion coefficient <D>, fractional anisotropy (FA), number of fibers (NF) were statistically calculated, with Wilcoxon signed-rank test. After SRS, <D> increased by 3.9% (p=0.610), and FA decreased significantly by 7.8% (p=0.02) with 36% decline of NF (p=0.11). The preliminary results suggest white matter protection shall be considered in SRS.