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Role of resting-state functional MRI in detecting brain functional changes following radiotherapy for head and neck cancer: a systematic review and meta-analysis

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Abstract

Purpose

Increasing evidence implicates changes in brain function following radiotherapy for head and neck cancer as precursors for brain dysfunction. These changes may thus be used as biomarkers for early detection. This review aimed to determine the role of resting-state functional magnetic resonance imaging (rs-fMRI) in detecting brain functional changes.

Methods

A systematic search was performed in the PubMed, Scopus, and Web of Science (WoS) databases in June 2022. Patients with head and neck cancer treated with radiotherapy and periodic rs-fMRI assessments were included. A meta-analysis was performed to determine the potential of rs-fMRI for detecting brain changes.

Results

Ten studies with a total of 513 subjects (head and neck cancer patients, n = 437; healthy controls, n = 76) were included. A significance of rs-fMRI for detecting brain changes in the temporal and frontal lobes, cingulate cortex, and cuneus was demonstrated in most studies. These changes were reported to be associated with dose (6/10 studies) and latency (4/10 studies). A strong effect size (r = 0.71, p < 0.001) between rs-fMRI and brain changes was also reported, suggesting rs-fMRI’s capability for monitoring brain alterations.

Conclusion

Resting-state functional MRI is a promising tool for detecting brain functional changes following head and neck radiotherapy. These changes are correlated with latency and prescription dose.

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Funding

This work was funded by the Ministry of Higher Learning (Malaysia)—Fundamental Research Grant (FRGS/1/2021/SS03/UKM/02/1), and the National University of Malaysia under grants FF-2020-013 and GP-2021-K017963.

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Authors and Affiliations

  1. Diagnostic Imaging and Radiotherapy, Centre of Diagnostic, Therapeutic and Investigative Sciences, Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300, Kuala Lumpur, Malaysia

    Noor Shatirah Voon & Noorazrul Yahya

  2. Functional Image Processing Laboratory, Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia

    Hanani Abdul Manan

  3. Department of Radiotherapy & Oncology, National Cancer Institute, Putrajaya, Malaysia

    Noor Shatirah Voon

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  1. Noor Shatirah Voon
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Contributions

All authors contributed to the study conception and design. Material preparation, literature search, and data analysis were performed by Noor Shatirah Voon, Noorazrul Yahya, and Hanani A. Manan. The first draft of the manuscript was written by Noor Shatirah Voon and all authors commented on previous versions of the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Noorazrul Yahya.

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N.S. Voon, H.A. Manan, and N. Yahya declare that they have no competing interests.

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Voon, N.S., Manan, H.A. & Yahya, N. Role of resting-state functional MRI in detecting brain functional changes following radiotherapy for head and neck cancer: a systematic review and meta-analysis. Strahlenther Onkol 199, 706–717 (2023). https://doi.org/10.1007/s00066-023-02089-3

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