ESTRO 2024 - Abstract Book

S769

Clinical - CNS

ESTRO 2024

Keywords: postsurgical irradiation; brain metastases

630

Mini-Oral

Connectome analysis & cognitive outcomes post Whole-brain RT: Prospective registry's first analysis

Sreenija Yarlagadda 1 , Starlie C Belnap 2 , Tugce Kutuk 1 , John Candela 2 , Thailin Companioni Reyes 1 , Miguel A Ramirez Menendez 1 , Matthew D Hall 1,3 , Robert H Press 1 , Minesh P Mehta 1,3 , Michael W McDermott 4 , Rupesh Kotecha 1,3 1 Miami Cancer Institute, Baptist Health South Florida, Department of Radiation Oncology, Miami, USA. 2 Miami Neuroscience Institute, Baptist Health South Florida, Department of Neuroscience, Miami, USA. 3 Herbert Wertheim College of Medicine, Florida International University, Department of Radiation Oncology, Miami, USA. 4 Miami Neuroscience Institute, Baptist Health South Florida, Department of Neurosurgery, Miami, USA

Purpose/Objective:

Connectomics is an evolving branch of neuroscience that evaluates structural and functional connectivity in the brain. Whole brain radiation therapy (WBRT) is used in patients with multiple brain metastases but is known to cause post-treatment neurocognitive changes. The objective of this prospective imaging study is to evaluate the effect of WBRT on the human connectome; this analysis represents the first 10 patients evaluated enrolled in an ongoing registry trial.

Material/Methods:

Ten patients treated with WBRT were enrolled onto a prospective imaging registry trial where a combination of diffusion tensor imaging and functional magnetic resonance imaging (MRI) was obtained to study the structural and functional connectivity of the brain. A machine learning algorithm trained to analyze subject-specific data was applied to create individualized brain maps of neuronal networks for each patient at each time point. These brain maps were then compared to normal brains from the connectome project, with results displayed as an anomaly matrix (Figure 1). The anomaly matrix indicates if the functional relationship of two brain parcellations (359 known parcellations) is significantly different compared to normal brains and organizes them into 15 known functional brain networks. Human connectome analysis was performed at baseline and at 3 months post-WBRT and the anomaly frequencies in the individualized brain maps were compared in each network. Multi-dimensional neurocognitive testing was also performed on an app-based platform at the same intervals. The change in anomaly frequency was co-related with neurocognitive outcomes.

Figure 1: Anomaly matrix of a single network (red and blue indicate anomalies)