TY - JOUR
T1 - The impact of brain lesions on health-related quality of life in patients with WHO CNS grade 3 or 4 glioma: a lesion-function and resting-state fMRI analysis
AU - Heinzel, A.
AU - Mottaghy, F.M.
AU - Filss, C.
AU - Stoffels, G.
AU - Lohmann, P.
AU - Friedrich, M.
AU - Shah, N.J.
AU - Caspers, S.
AU - Lucas, C.W.
AU - Ruge, M.I.
AU - Galldiks, N.
AU - Fink, G.R.
AU - Langen, K.J.
AU - Kocher, M.
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/2
Y1 - 2023/2
N2 - PurposeIn glioma patients, tumor development and multimodality therapy are associated with changes in health-related quality of life (HRQoL). It is largely unknown how different types and locations of tumor- and treatment-related brain lesions, as well as their relationship to white matter tracts and functional brain networks, affect HRQoL.MethodsIn 121 patients with pretreated gliomas of WHO CNS grades 3 or 4, structural MRI, O-(2-[F-18]fluoroethyl)-L-tyrosine (FET) PET, resting-state functional MRI (rs-fMRI) and self-reported HRQoL questionnaires (EORTC QLQ-C30/BN20) were obtained. Resection cavities, T1-enhancing lesions, T2/FLAIR hyperintensities, and lesions with pathologically increased FET uptake were delineated. Effects of tumor lateralization, involvement of white matter tracts or resting-state network nodes by different types of lesions and within-network rs-fMRI connectivity were analyzed in terms of their interaction with HRQoL scores.ResultsRight hemisphere gliomas were associated with significantly less favorable outcomes in physical, role, emotional and social functioning, compared with left-sided tumors. Most functional HRQoL scores correlated significantly with right-sided white-matter tracts involvement by T2/FLAIR hyperintensities and with loss of within-network functional connectivity of right-sided nodes. Tumors of the left hemisphere caused significantly more communication deficits.ConclusionIn pretreated high-grade gliomas, right hemisphere lesions are associated with reduced HRQoL scores in most functional domains except communication ability, compared to tumors of the left hemisphere. These relationships are mainly observed for T2/FLAIR lesions involving structural and functional networks in the right hemisphere. The data suggest that sparing the right hemisphere from treatment-related tissue damage may improve HRQoL in glioma patients.
AB - PurposeIn glioma patients, tumor development and multimodality therapy are associated with changes in health-related quality of life (HRQoL). It is largely unknown how different types and locations of tumor- and treatment-related brain lesions, as well as their relationship to white matter tracts and functional brain networks, affect HRQoL.MethodsIn 121 patients with pretreated gliomas of WHO CNS grades 3 or 4, structural MRI, O-(2-[F-18]fluoroethyl)-L-tyrosine (FET) PET, resting-state functional MRI (rs-fMRI) and self-reported HRQoL questionnaires (EORTC QLQ-C30/BN20) were obtained. Resection cavities, T1-enhancing lesions, T2/FLAIR hyperintensities, and lesions with pathologically increased FET uptake were delineated. Effects of tumor lateralization, involvement of white matter tracts or resting-state network nodes by different types of lesions and within-network rs-fMRI connectivity were analyzed in terms of their interaction with HRQoL scores.ResultsRight hemisphere gliomas were associated with significantly less favorable outcomes in physical, role, emotional and social functioning, compared with left-sided tumors. Most functional HRQoL scores correlated significantly with right-sided white-matter tracts involvement by T2/FLAIR hyperintensities and with loss of within-network functional connectivity of right-sided nodes. Tumors of the left hemisphere caused significantly more communication deficits.ConclusionIn pretreated high-grade gliomas, right hemisphere lesions are associated with reduced HRQoL scores in most functional domains except communication ability, compared to tumors of the left hemisphere. These relationships are mainly observed for T2/FLAIR lesions involving structural and functional networks in the right hemisphere. The data suggest that sparing the right hemisphere from treatment-related tissue damage may improve HRQoL in glioma patients.
KW - Glioma
KW - Quality of life
KW - Brain networks
KW - Functional magnetic resonance tomography
KW - Positron emission tomography
KW - Radiotherapy
KW - PSYCHOMETRIC VALIDATION
KW - TUMOR LATERALITY
KW - GLIOBLASTOMA
KW - QUESTIONNAIRE
KW - DIAGNOSIS
U2 - 10.1007/s11060-023-04254-1
DO - 10.1007/s11060-023-04254-1
M3 - Article
C2 - 36750534
SN - 0167-594X
VL - 161
SP - 643
EP - 654
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
IS - 3
ER -