Diffuse tensor imaging of lower extremities: a novel MR imaging technique for chemotherapy-induced peripheral neuropathy
- 1 December 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Breast Cancer Research and Treatment
- Vol. 184 (3), 771-778
- https://doi.org/10.1007/s10549-020-05897-8
Abstract
Purpose Chemotherapy-induced peripheral neuropathy (CIPN) is caused by drug-induced damage to the axons which is not detected easily due to lack of reliable, clinically applicable modalities. Diffuse tensor imaging (DTI) allows for quantitative measurements of fractional anisotropy (FA) and apparent diffusion coefficient (ADC), which have been shown to detect nerve injury by Magnetic Resonance Imaging (MRI). Methods We sought to evaluate if DTI could be used for detection of CIPN in patients with breast cancer treated with a taxane. Patients with h/o exposure to neurotoxic chemotherapy, diabetes, or peripheral neuropathy were excluded. Patients completed pre- and post-chemotherapy MRI of bilateral legs and FACT&GOG-Ntx. Genotyping of single-nucleotide variations (SNVs) was performed to detect known associations with CIPN. Results We had 14 evaluable patients in this prospective trial. Mean FA values post-chemotherapy were significantly lower than baseline at mid-calf (p < 0.0001) and ankle (p = 0.03). We did not find any significant change in mean ADC values. In patients without symptomatic neuropathy, mean FA values decreased more than symptomatic patients at mid-calf (p < 0.001). Of the 41 genotyped SNVs, only rs8110536 was found to be significantly associated with development of CIPN. Conclusions Our results show that FA values are indicative of CIPN and differential changes in FA values in symptomatic versus asymptomatic patients highlights its potential to be further studied as a predictive biomarker for CIPN. This is the first study to highlight a non-invasive, imaging based, objective biomarker which, if validated, can be translated into clinic easily.Keywords
Funding Information
- University of Arizona Cancer Center (5P30CA023074)
- Better Than Ever
This publication has 28 references indexed in Scilit:
- Chemotherapy-induced neuropathy: A comprehensive surveyCancer Treatment Reviews, 2014
- Replication of Genetic Polymorphisms Reported to Be Associated with Taxane-Related Sensory Neuropathy in Patients with Early Breast Cancer Treated with PaclitaxelClinical Cancer Research, 2014
- Falls and functional impairments in cancer survivors with chemotherapy-induced peripheral neuropathy (CIPN): a University of Rochester CCOP studySupportive Care in Cancer, 2013
- A Genome-Wide Association Study Identifies Novel Loci for Paclitaxel-Induced Sensory Peripheral Neuropathy in CALGB 40101Clinical Cancer Research, 2012
- Healthcare Costs and Workloss Burden of Patients with Chemotherapy-Associated Peripheral Neuropathy in Breast, Ovarian, Head and Neck, and Nonsmall Cell Lung CancerChemotherapy Research and Practice, 2012
- MR Neurography: Past, Present, and FutureAmerican Journal of Roentgenology, 2011
- Diffusion tensor imaging of peripheral nervesSkeletal Radiology, 2010
- Diffusion tensor imaging to assess axonal regeneration in peripheral nervesExperimental Neurology, 2009
- Diffusion-direction-dependent imaging: a novel MRI approach for peripheral nerve imagingMagnetic Resonance Imaging, 2006
- Understanding Diffusion MR Imaging Techniques: From Scalar Diffusion-weighted Imaging to Diffusion Tensor Imaging and BeyondRadioGraphics, 2006