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Early detection of radiation-induced injury and prediction of cognitive deficit by MRS metabolites in radiotherapy of low grade glioma
Zahra Alirezaei1,2, Mohammadreza Nazemzadeh3, Masoud Hasanpour3, Alireza Amouheidari4, and Sajad Iraji3
1Isfahan University of Medical Sciences, Isfahan, Iran (Islamic Republic of), 2Bushehr University of Medical Sciences, Bushehr, Iran (Islamic Republic of), 3Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of), 4Milad Hospital, Isfahan, Iran (Islamic Republic of)
NAA/Cr and Cho/Cr declined significantly at the 4th week of RT up to 6-month post-RT. The variation in NAA/Cr and Cho/Cr between the 4th week of RT and 1-month post-RT had significant correlation with the alteration in the score of MoCA-visuospatial and ACE-memory, between 3 and 6-month post-RT. 
Figure 1. a: Isodose curves of a treatment plan of a LGG patient with a Left Frontal tumor on Prowess Panther 5.5; b: An example of MRS metabolite peaks of a voxel on the CC, fused with T2W MRI on a 1.5 Tesla Siemens Magnetom Aera scanner.
Figure 2. Plots of the mean percantage difference in the mean value of NAA/Cr and Cho/Cralong with the ACE and MoCA Scores at the 4th week of RT, 1-month, 3-month and 6-month post-RT, compared to the previous timepoints and baseline pre-RT values. The star markers show significant differences to the base line, while the plus ones present the significant differences between any parameters to its previous time point.