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cancers-15-01949.pdf (2.02 MB)

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Data de publicació

2023-03-24

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cc by (c) Cayuela, Nuria et al, 2023
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/209741

Normal Pressure Hydrocephalus Following Cranial Radiation: Identification of Shunting Responders

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Recurs relacionat

https://doi.org/10.3390/cancers15071949

Resum

Simple Summary: Up to 50-90% of long-term cancer survivors will exhibit moderate to severe cognitive impairment following cranial radiotherapy (RT). It is common in this population to observe a ventricular dilatation disproportionate to the cerebral atrophy, which clinically manifests similar to normal pressure hydrocephalus (NPH). Previous studies demonstrated that early placement of a ventriculoperitoneal shunt (VPS) may be beneficial. Our study aimed to describe the cognitive, neuroimaging-MRI (cerebrospinal fluid-CSF volumetric analysis), and lumbar infusion test features of a cohort of cancer survivors (n = 36) with suspected post-RT NPH and identify which patients may benefit from a VPS. It was revealed that up to 81% of our cohort met the criteria for cognitive impairment. Additionally, we observed that the addition of a CSF volumetric analysis improved the identification of VPS responders (accuracy of 93%), thus enhancing the management and prognosis of long-term cancer survivors. Background: We examined cognitive, brain MRI, and lumbar infusion test (LIT) features to identify predictors of response to ventriculoperitoneal shunting (VPS) in long-term cancer survivors with suspected normal pressure hydrocephalus (NPH) following cranial radiotherapy (RT). Methods: Patients who completed cranial RT at least 2 years before with clinically suspected NPH and an Evans' index (EI) >= 0.30 underwent a cognitive and a cerebrospinal fluid (CSF) volumetric (MRI) analysis (n = 36). For those in whom VPS was placed (n = 14), we explored whether adding a CSF volumetric analysis to classical MRI and LIT (Tap Test) features would better identify VPS responders. Results: Nearly 80% exhibited cognitive impairment. The CSF volume at NPH diagnoses was significantly larger in the group of VPS responders (p = 0.04). The addition of CSF volume to NPH diagnoses increased accuracy to 93%, with a positive and negative predictive value of 91% and 100%, respectively. Conclusion: The addition of a quantitative MRI analysis of CSF volume to classical MRI and LIT NPH criteria, along with a high clinical suspicion of NPH, may help to identify VPS responders, thus improving the clinical management and prognosis of long-term survivors.

Matèries

Radioteràpia, Trastorns de la cognició

Matèries (anglès)

Radiotherapy, Cognition disorders

Citació

Col·leccions

Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

CAYUELA, Nuria, et al. Normal Pressure Hydrocephalus Following Cranial Radiation: Identification of Shunting Responders. Cancers. 2023. Vol. 15, num. 7. ISSN 2072-6694. [consulted: 4 of August of 2026]. Available at: https://hdl.handle.net/2445/209741

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