White matter tract changes in pediatric posterior fossa brain tumor survivors after surgery and chemotherapy

Jeffrey Tanedo; Niharika Gajawelli; Sharon Guo; Mary Baron Nelson; Natasha Lepore

doi:10.3389/fnimg.2022.845609

White matter tract changes in pediatric posterior fossa brain tumor survivors after surgery and chemotherapy

Front Neuroimaging. 2022 Sep 20:1:845609. doi: 10.3389/fnimg.2022.845609. eCollection 2022.

Authors

Jeffrey Tanedo^{1

2}, Niharika Gajawelli¹, Sharon Guo¹, Mary Baron Nelson^{1

3}, Natasha Lepore^{1

2

3}

Affiliations

¹ CIBORG Laboratory, Department of Radiology, Children's Hospital Los Angeles, Los Angeles, CA, United States.
² Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, United States.
³ Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.

Abstract

Background: Survivors of pediatric posterior fossa brain tumors are susceptible to the adverse effects of treatment as they grow into adulthood. While the exact neurobiological mechanisms of these outcomes are not yet understood, the effects of treatment on white matter (WM) tracts in the brain can be visualized using diffusion tensor (DT) imaging. We investigated these WM microstructural differences using the statistical method tract-specific analysis (TSA). We applied TSA to the DT images of 25 children with a history of posterior fossa tumor (15 treated with surgery, 10 treated with surgery and chemotherapy) along with 21 healthy controls. Between these 3 groups, we examined differences in the most used DTI metric, fractional anisotropy (FA), in 11 major brain WM tracts.

Results: Lower FA was found in the splenium of the corpus callosum (CC), the bilateral corticospinal tract (CST), the right inferior frontal occipital fasciculus (IFOF) and the left uncinate fasciculus (UF) in children with brain tumors as compared to healthy controls. Lower FA, an indicator of microstructural damage to WM, was observed in 4 of the 11 WM tracts examined in both groups of children with a history of posterior fossa tumor, with an additional tract unique to children who received surgery and chemotherapy (left UF).

Conclusions: Our findings indicate that a history of tumor in the posterior fossa and surgical resection may have effects on the WM in other parts of the brain.

Keywords: diffusion tensor (DT) MRI; long term adverse effects; posterior fossa tumors; tract specific analysis; white matter (WM).