Effect of Whole Brain Radiation on Local Cerebral Glucose Utilization in the Rat

Neurosurgery ◽  
1991 ◽  
Vol 28 (4) ◽  
pp. 491-495 ◽  
Author(s):  
Domenico d'Avella ◽  
Rocco Cicciarello ◽  
Francesca Albiero ◽  
Mario Mesiti ◽  
Maria Ester Gagliardi ◽  
...  
Keyword(s):  
Metabolic Activity ◽  
Glucose Utilization ◽  
Whole Brain Radiotherapy ◽  
Brain Regions ◽  
Local Cerebral Glucose Utilization ◽  
Whole Brain ◽  
Conventional Fractionation ◽  
Cerebral Glucose Utilization ◽  
Brain Radiotherapy ◽  
Whole Brain Radiation

Abstract We assessed, by means of the [14C]-2-deoxy-D-glucose autoradiography method, the effect of whole-brain x-radiation on local cerebral glucose utilization in the rat brain. Animals were exposed to conventional fractionation (200 ± 4 cGy/day, 5 days/week; total dose, 4000 cGy);. Metabolic experiments were made 2 to 3 weeks after completion of the radiation exposure. In comparison with control and sham-irradiated animals, cerebral metabolic activity was diffusely decreased after irradiation. Statistically significant decreases in metabolic activity were observed in 13 of 27 brain regions studied. In general, the brain areas with the highest basal metabolic rates showed the greatest percentage of decrease in glucose utilization. The concept that radiation suppresses glucose utilization before any morphological change takes place in the cell structures was the basis of this study. Metabolic alterations after irradiation may explain the syndrome of early delayed deterioration observed in humans after whole-brain radiotherapy. These studies have applications to observations made with the [18F]-fluorodeoxyglucose method in conjunction with positron emission tomographic scans in patients receiving radiation therapy for intracranial malignancies. The data reported here also have potential clinical implications for the evaluation of a risk/benefit ratio for radiotherapy in patients with benign neurosurgical diseases or children undergoing prophylactic treatment of the central nervous system.

Effect of whole brain radiation on local cerebral glucose utilization in the rat

Neurosurgery ◽  
1991 ◽  
pp. 491 ◽  
Author(s):  
D d??Avella ◽  
R Cicciarello ◽  
F Albiero ◽  
M Mesiti ◽  
M E Gagliardi ◽  
...  
Keyword(s):  
Glucose Utilization ◽  
Local Cerebral Glucose Utilization ◽  
Whole Brain ◽  
Cerebral Glucose Utilization ◽  
Whole Brain Radiation ◽  
Brain Radiation

Local Cerebral Blood Flow, Local Cerebral Glucose Utilization, and Flow-Metabolism Coupling during Sevoflurane versus Isoflurane Anesthesia in Rats 

1998 ◽  
Vol 89 (6) ◽  
pp. 1480-1488 ◽  
Author(s):  
Christian Lenz ◽  
Annette Rebel ◽  
Klaus van Ackern ◽  
Wolfgang Kuschinsky ◽  
Klaus F. Waschke
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Glucose Utilization ◽  
Brain Regions ◽  
Local Analysis ◽  
Sprague Dawley ◽  
Local Cerebral Blood Flow ◽  
Local Cerebral Glucose Utilization ◽  
Isoflurane Anesthesia ◽  
Cerebral Glucose Utilization

Background Compared to isoflurane, knowledge of local cerebral glucose utilization (LCGU) and local cerebral blood flow (LCBF) during sevoflurane anesthesia is limited. Methods LCGU, LCBF, and their overall means were measured in Sprague-Dawley rats (8 groups, n=6 each) during sevoflurane and isoflurane anesthesia, 1 and 2 MAC, and in conscious control animals (2 groups, n=6 each) using the autoradiographic 2-[14C]deoxy-D-glucose and 4-iodo-N-methyl-[14C]antipyrine methods. Results During anesthesia, mean cerebral glucose utilization was decreased: control, 56+/-5 micronmol x 100 g(-1) x min(-1); 1 MAC isoflurane, 32+/-4 micromol x 100 g(-1) x min(-1) (-43%); 1 MAC sevoflurane, 37+/-5 micromol x 100 g(-1) x min(-1) (-34%); 2 MAC isoflurane, 23+/-3 micromol x 100 g(-1) x min(-1) (-58%); 2 MAC sevoflurane, 23+/-5 micromol x 100 g(-1) x min(-1) (-59%). Local analysis showed a reduction in LCGU in the majority of the 40 brain regions analyzed. Mean cerebral blood flow was increased as follows: control 93+/-8 ml x 100 g(-1) x min(-1); 1 MAC isofurane, 119+/-19 ml x 100 g(-1) x min(-1) (+28%); 1 MAC sevoflurane, 104+/-15 ml x 100 g(-1) x min(-1) (+12%); 2 MAC isoflurane, 149+/-17 ml x 100 g(-1) x min(-1) (+60%); 2 MAC sevoflurane, 118+/-21 ml x 100 g(-1) min(-1) (+27%). LCBF was increased in most brain structures investigated. Correlation coefficients obtained for the relationship between LCGU and LCBF were as follows: control 0.93; 1 MAC isoflurane, 0.89; 2 MAC isoflurane, 0.71; 1 MAC sevoflurane, 0.83; 2 MAC sevoflurane, 0.59). Conclusion Mean and local cerebral blood flows were lower during sevoflurane than during isoflurane anesthesia. This difference cannot be explained by differing changes in glucose utilization because glucose utilization was decreased to the same extent in both groups.

scholarly journals Individual 3D-printed fixation masks for radiotherapy: first clinical experiences

2021 ◽  
Author(s):  
M. Mattke ◽  
D. Rath ◽  
M. F. Häfner ◽  
R. Unterhinninghofen ◽  
F. Sterzing ◽  
...  
Keyword(s):  
Whole Brain Radiotherapy ◽  
The Body ◽  
Whole Brain Irradiation ◽  
Whole Brain ◽  
Brain Irradiation ◽  
Brain Radiotherapy ◽  
Whole Brain Radiation ◽  
Thermoplastic Mask ◽  
Position Correction ◽  
3D Printed

Abstract Purpose To show the feasibility of 3D-printed fixation masks for whole brain radiation therapy in a clinical setting and perform a first comparison to an established thermoplastic mask system. Methods Six patients were irradiated with whole brain radiotherapy using individually 3D-printed masks. Daily image guidance and position correction were performed prior to each irradiation fraction. The vectors of the daily position correction were compared to two collectives of patients, who were irradiated using the standard thermoplastic mask system (one cohort with head masks; one cohort with head and neck masks). Results The mean systematic errors in the experimental cohort ranged between 0.59 and 2.10 mm which is in a comparable range to the control groups (0.18 mm–0.68 mm and 0.34 mm–2.96 mm, respectively). The 3D-printed masks seem to be an alternative to the established thermoplastic mask systems. Nevertheless, further investigation will need to be performed. Conclusion The prevailing study showed a reliable and reproducible interfractional positioning accuracy using individually 3D-printed masks for whole brain irradiation in a clinical routine. Further investigations, especially concerning smaller target volumes or other areas of the body, need to be performed before using the system on a larger basis.

Progressive perturbations in cerebral energy metabolism after experimental whole-brain radiation in the therapeutic range

1994 ◽  
Vol 81 (5) ◽  
pp. 774-779 ◽  
Author(s):  
Domenico D'Avella ◽  
Rocco Cicciarello ◽  
Maria E. Gagliardi ◽  
Francesca Albiero ◽  
Mario Mesiti ◽  
...  
Keyword(s):  
Metabolic Activity ◽  
Average Rate ◽  
Weighted Average ◽  
Whole Brain ◽  
Content Type ◽  
Conventional Fractionation ◽  
Whole Brain Radiation ◽  
X Irradiation ◽  
The Difference ◽  
Fine Print

✓ Basic mechanisms underlying the tolerance and reaction of the central nervous system to ionizing radiation have not been fully elucidated in the literature. The authors employed the [14C]-2-deoxy-D-glucose autoradiography method to investigate the effect of whole-brain x-irradiation on local cerebral glucose utilization in the rat brain. The animals were exposed to conventional fractionation (200 ± 4 cGy/day, 5 days/week for a total dose of 4000 cGy), and the effects of this regimen were assessed at 2 weeks and 3 months postirradiation. In rats evaluated 2 weeks after treatment, statistically significant decreases in cerebral metabolic activity were found in 13 of the 27 regions studied, compared to control animals. In rats studied 3 months after treatment, additional metabolic suppression and statistically significant decreases in cerebral metabolic activity were found in 11 of the 27 regions, compared to rats studied 2 weeks after treatment. A weighted-average rate for the brain as a whole was approximately 15% and approximately 25% below that of control animals 2 weeks and 3 months after exposure, respectively. Although the difference in species is significant enough so that direct extrapolation to humans may not be appropriate, the data reported here may have potential clinical implications for the evaluation of the risk-benefit ratio for radiotherapy. This model can be used reproducibly for further investigations, including evaluation of therapies that may reduce irradiation-induced brain injury.

Local cerebral glucose utilization in the beagle puppy model of intraventricular hemorrhage

1982 ◽  
Vol 57 (3) ◽  
pp. 384-389 ◽  
Author(s):  
Laura R. Ment ◽  
William B. Stewart ◽  
Charles C. Duncan
Keyword(s):  
Intraventricular Hemorrhage ◽  
Animal Studies ◽  
Glucose Utilization ◽  
Adult Animal ◽  
Brain Regions ◽  
Local Cerebral Glucose Utilization ◽  
Content Type ◽  
Carbon 14 ◽  
Cerebral Glucose Utilization ◽  
Fine Print

✓ Local cerebral glucose utilization has been measured by means of carbon-14 (14C)-autoradiography with 2-deoxyglucose in the newborn beagle puppy model of intraventricular hemorrhage. Our studies demonstrate gray matter/white matter differentiation of uptake of 14C-2-deoxyglucose in the control pups, as would be expected from adult animal studies. However, there is a marked homogeneity of 14C-2-deoxyglucose uptake in all brain regions in the puppies with intraventricular hemorrhage, possibly indicating a loss of the known coupling between cerebral blood flow and metabolism in this neuropathological condition.

scholarly journals RADI-16. Efficacy of WBRT among the Sub-types of Metastatic Breast Cancer

2021 ◽  
Vol 3 (Supplement_3) ◽  
pp. iii21-iii21
Author(s):  
Shija Mathew ◽  
A S Udaykrishna ◽  
V Lokesh
Keyword(s):  
Brain Metastases ◽  
Metastatic Breast ◽  
Whole Brain Radiotherapy ◽  
Luminal A ◽  
Whole Brain ◽  
Metastatic Breast Carcinoma ◽  
Luminal B ◽  
Brain Radiotherapy ◽  
Whole Brain Radiation ◽  
Her 2

Abstract Objectives To understand the effect of Whole Brain Radiation (WBRT) in terms of Age, Neurological performance, Radiological Improvement and the Overall Survival. Methods 34 Patients [Median Age: 45 years (31- 65)] with Metastatic Breast Carcinoma who presented with Brain metastasis to the Department of Radiation Oncology at Kidwai Memorial Institute of Oncology and subjected to Whole Brain Radiotherapy/ Focal RT were taken into the study. The efficacy of WBRT was assessed among the four subtypes of MBC. Results 39% of the patients belonged to Luminal A, 25%, 22% and 14% belonged to Luminal B, Her2 amplified and Basal respectively. Patients under Luminal A, presented with brain metastases by 25 months after the diagnosis of the primary. 60% presented with single lesion, amenable to resection and 58% underwent surgery followed by WBRT and OS fared better as compared to patients with WBRT alone with no distant recurrences on imaging and improvement in KPS. Patients with Luminal B/ HER2 amplified subgroup had predominantly oligometastatic lesions (65%), presented with brain metastases at 15 months after diagnosis of Carcinoma Breast,18% received Herceptin and Lapatinib and 33% and 22% received Herceptin and Lapatinib alone. OS was superior over WBRT alone with exaggerated radiation necrosis in those who took concurrent biological therapy and RT.In patients with Basal subtype,75%had multiple metastatic brain lesions, presented with symptoms by 10 months of diagnosis of the primary with poor KPS and OS remained poor despite WBRT. Conclusions Lesions being amenable for surgery, focal RT to post op cavity alone may be considered in patients with Luminal A. WBRT plus boost for those unfit for surgery. Addition of TKI +/- oral chemo for all patients with Luminal B and HER 2 amplified to Focal RT or WBRT. Triple Negative patients present with poor KPS can be considered for BSC/WBRT on case basis.

scholarly journals Use of a Head-Tilting Baseplate During Tomotherapy to Shorten the Irradiation Time and Protect the Hippocampus and Lens in Hippocampal Sparing-Whole Brain Radiotherapy

2021 ◽  
Vol 20 ◽  
pp. 153303382098682
Author(s):  
Kosei Miura ◽  
Hiromasa Kurosaki ◽  
Nobuko Utsumi ◽  
Hideyuki Sakurai
Keyword(s):  
At Risk ◽  
Planning Target Volume ◽  
Irradiation Time ◽  
Organs At Risk ◽  
Absorbed Dose ◽  
Whole Brain Radiotherapy ◽  
Target Volume ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Hippocampal Sparing

Purpose: The aim of this study is to comparatively examine the possibility of reducing the exposure dose to organs at risk, such as the hippocampus and lens, and improving the dose distribution of the planned target volume with and without the use of a head-tilting base plate in hippocampal-sparing whole-brain radiotherapy using tomotherapy. Methods: Five paired images of planned head computed tomography without and with tilt were analyzed. The hippocampus and planning target volume were contoured according to the RTOG 0933 contouring atlas protocol. The hippocampal zone to be avoided was delineated using a 5-mm margin. The prescribed radiation dose was 30 Gy in 10 fractions. The absorbed dose to planning target volume dose, absorbed dose to the organ at risk, and irradiation time were evaluated. The paired t-test was used to analyze the differences between hippocampal-sparing whole-brain radiotherapy with head tilts and without head tilts. Results: Hippocampal-sparing whole-brain radiotherapy with tilt was not superior in planning target volume doses using the homogeneity index than that without tilt; however, it showed better values, and for Dmean and D2%, the values were closer to 30 Gy. Regarding the hippocampus, dose reduction with tilt was significantly greater at Dmax, Dmean, and Dmin, whereas regarding the lens, it was significantly greater at Dmax and Dmin. The irradiation time was also predominantly shorter. Conclusion: In our study, a tilted hippocampal-sparing whole-brain radiotherapy reduced the irradiation time by >10%. Therefore, our study indicated that hippocampal-sparing whole-brain radiotherapy with tomotherapy should be performed with a tilt. The head-tilting technique might be useful during hippocampal-sparing whole-brain radiotherapy. This method could decrease the radiation exposure time, while sparing healthy organs, including the hippocampus and lens.

scholarly journals A Dutch phase III randomized multicenter trial: whole brain radiotherapy vs. stereotactic radiotherapy for 4-10 brain metastases

2021 ◽  
Author(s):  
Dianne Hartgerink ◽  
Anna Bruynzeel ◽  
Danielle Eekers ◽  
Ans Swinnen ◽  
Coen Hurkmans ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Brain Metastases ◽  
Survival Rates ◽  
Whole Brain Radiotherapy ◽  
Phase Iii ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
One Year

Abstract Background The clinical value of whole brain radiotherapy (WBRT) for brain metastases (BM) is a matter of debate due to the significant side effects involved. Stereotactic radiosurgery (SRS) is an attractive alternative treatment option that may avoid these side effects and improve local tumor control. We initiated a randomized trial (NCT02353000) to investigate whether quality of life is better preserved after SRS compared with WBRT in patients with multiple brain metastases. Methods Patients with 4 to 10 BM were randomized between the standard arm WBRT (total dose 20 Gy in 5 fractions) or SRS (single fraction or 3 fractions). The primary endpoint was the difference in quality of life (QOL) at three months post-treatment. Results The study was prematurely closed due to poor accrual. A total of 29 patients (13%) were randomized, of which 15 patients have been treated with SRS and 14 patients with WBRT. The median number of lesions were 6 (range, 4-9) and the median total treatment volume was 13.0 cc 3 (range, 1.8-25.9 cc 3). QOL at three months decreased in the SRS group by 0.1 (SD=0.2), compared to 0.2 (SD=0.2) in the WBRT group (p=0.23). The actuarial one-year survival rates were 57% (SRS) and 31% (WBRT) (p=0.52). The actuarial one-year brain salvage-free survival rates were 50% (SRS) and 78% (WBRT) (p=0.22). Conclusion In patients with 4 to 10 BM, SRS alone resulted in one-year survival for 57% of patients while maintaining quality of life. Due to the premature closure of the trial, no statistically significant differences could be determined.

scholarly journals Whole-brain radiotherapy in patients with brain metastases from melanoma

CNS Oncology ◽  
2014 ◽  
Vol 3 (6) ◽  
pp. 401-406 ◽  
Author(s):  
Macarena de la Fuente ◽  
Kathryn Beal ◽  
Richard Carvajal ◽  
Thomas J Kaley
Keyword(s):  
Brain Metastases ◽  
Whole Brain Radiotherapy ◽  
Whole Brain ◽  
Brain Radiotherapy
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