ArticleNeuro-oncology2023
Whole-brain radiotherapy associated with structural changes resembling aging as determined by anatomic surface-based deep learning.
Article in Neuro-oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Performance of artificial intelligence for brain tumor segmentation, treatment planning, and outcome prediction: a comprehensive systematic review and meta-analysis.Journal of neuro-oncology · 2025Pooled it
- Isocenter Optimization in WBRT: Concurrent Sparing of Lens and Lacrimal Gland via Anterior Penumbra Sharpening.Journal of applied clinical medical physics · 2026Article
- Radiation-Induced Neurodegeneration.Biomedicines · 2026Review
- [Association between age-typical structural brain changes and whole brain irradiation].Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Article
- Review
- AI-driven immunotherapy: synergizing with radiotherapy to reconfigure the tumor microenvironment and treatment landscape.Frontiers in pharmacology · 2025Review
- Radiation-Induced Brain Injury: Mechanistic Insights and the Promise of Gut-Brain Axis Therapies.Brain sciences · 2024Review
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundBrain metastases are the most common intracranial tumors in adults and are associated with significant morbidity and mortality. Whole-brain radiotherapy (WBRT) is used frequently in patients for palliation, but can result in neurocognitive deficits. While dose-dependent injury to individual areas such as the hippocampus has been demonstrated, global structural shape changes after WBRT remain to be studied.
methodsWe studied healthy controls and patients with brain metastases and examined MRI brain anatomic surface data before and after WBRT. We implemented a validated graph convolutional neural network model to estimate patient's "brain age". We further developed a mixed-effects linear model to compare the estimated age of the whole brain and substructures before and after WBRT.
results4220 subjects were analyzed (4148 healthy controls and 72 patients). The median radiation dose was 30 Gy (range 25-37.5 Gy). The whole brain and substructures underwent structural change resembling rapid aging in radiated patients compared to healthy controls; the whole brain "aged" 9.32 times faster, the cortex 8.05 times faster, the subcortical structures 12.57 times faster, and the hippocampus 10.14 times faster. In a subset analysis, the hippocampus "aged" 8.88 times faster in patients after conventional WBRT versus after hippocampal avoidance (HA)-WBRT.
conclusionsOur findings suggest that WBRT causes the brain and its substructures to undergo structural changes at a pace up to 13x of the normal aging pace, where hippocampal avoidance offers focal structural protection. Correlating these structural imaging changes with neurocognitive outcomes following WBRT or HA-WBRT would benefit from future analysis.
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