Evaluating growth failure with diffusion tensor imaging in pediatric survivors of high-risk neuroblastoma treated with high-dose cis-retinoic acid.
Background: The survival of patients with high-risk neuroblastoma has increased with multimodal therapy, but most survivors demonstrate growth failure.Objective: To assess physeal abnormalities in children with high-risk neuroblastoma in comparison to normal controls by using diffusion tensor imagin...
| Publicado en: | Pediatric Radiology Vol. 49; no. 8; pp. 1056 - 1066 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Jul2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=137229249&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 137229249 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03010449 O03 jtl: Pediatric Radiology issn: 03010449 maglogo: N pubinfo: dt: Jul2019 vid: 49 iid: 8 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 137229249 137229249 NLM31055614 10.1007/s00247-019-04409-1 NLM31055614 137229249 ppf: 1056 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Evaluating growth failure with diffusion tensor imaging in pediatric survivors of high-risk neuroblastoma treated with high-dose cis-retinoic acid. aug: au: Delgado, Jorge Jaramillo, Diego Chauvin, Nancy A. Guo, Michelle Stratton, Mackenzie S. Sweeney, Hannah E. Barrera, Christian A. Mostoufi-Moab, Sogol affil: Department of Radiology, Massachusetts General Hospital, Boston, MA, USA sug: subj: Tretinoin Therapeutic Use Neuroblastoma Magnetic Resonance Imaging Methods Growth Disorders Drug Therapy Neuroblastoma Drug Therapy Retrospective Design Sex Factors Risk Assessment Growth Disorders Etiology Female Tretinoin Adverse Effects Body Height Drug Effects Dose-Response Relationship, Drug Adolescence Femur Age Factors Neuroblastoma Mortality Child Multivariate Analysis Drug Administration Schedule Case Control Studies Survivors Male Femur Pathology Linear Regression Checklists Short Portable Mental Status Questionnaire Adolescent: 13-18 years Child: 6-12 years Female Male ab: Background: The survival of patients with high-risk neuroblastoma has increased with multimodal therapy, but most survivors demonstrate growth failure.Objective: To assess physeal abnormalities in children with high-risk neuroblastoma in comparison to normal controls by using diffusion tensor imaging (DTI) of the distal femoral physis and adjacent metaphysis.Materials and Methods: We prospectively obtained physeal DTI at 3.0 T in 20 subjects (mean age: 12.4 years, 7 females) with high-risk neuroblastoma treated with high-dose cis-retinoic acid, and 20 age- and gender-matched controls. We compared fractional anisotropy (FA), normalized tract volume (cm3/cm2) and tract concentration (tracts/cm2) between the groups, in relation to height Z-score and response to growth hormone therapy. Tractography images were evaluated qualitatively.Results: DTI parameters were significantly lower in high-risk neuroblastoma survivors compared to controls (P<0.01), particularly if the patients were exposed to both cis-retinoic acid and total body irradiation (P<0.05). For survivors and controls, DTI values were respectively [mean ± standard deviation]: tract concentration (tracts/cm2), 23.2±14.7 and 36.7±10.5; normalized tract volume (cm3/cm2), 0.44±0.27 and 0.70±0.21, and FA, 0.22±0.05 and 0.26±0.02. High-risk neuroblastoma survivors responding to growth hormone compared to non-responders had higher FA (0.25±0.04 and 0.18±0.03, respectively, P=0.02), and tract concentration (tracts/cm2) (31.4±13.7 and 14.8±7.9, respectively, P<0.05). FA, normalized tract volume and tract concentration were linearly related to height Z-score (R2>0.31; P<0.001). Qualitatively, tracts were nearly absent in all non-responders to growth hormone and abundant in all responders (P=0.02).Conclusion: DTI shows physeal abnormalities that correlate with short stature in high-risk neuroblastoma survivors and demonstrates response to growth hormone treatment. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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