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Neurocognitive function in patients undergoing stereotactic radiosurgery for brain metastases

Iqbal, Najmus 2023. Neurocognitive function in patients undergoing stereotactic radiosurgery for brain metastases. PhD Thesis, Cardiff University.
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National Institute of Clinical Excellence (NICE) recommends Stereotactic radiosurgery (SRS) as the treatment of choice for patients with limited brain metastases, which is defined as volume <20 cc, with performance status 0-2, controlled or controllable extracranial disease and expected prognosis of greater than 6 months. Despite its precision, studies have reported 24-60% of patients can develop neurocognitive impairment following SRS alone. Dose to the hippocampus is thought to be related to development of neurocognitive impairment following fractionated radiotherapy for primary brain tumours and whole brain radiotherapy for brain metastases. However, this has not been studied in patients undergoing SRS. This thesis investigates the importance of hippocampus delineation and dose delivered to this organ in patients undergoing SRS and its impact on neurocognitive decline following treatment. Multi-parametric MRI imaging identifies changes in the hippocampus structure, blood flow, metabolites, and diffusion tensor imaging of the tracts involved in the limbic system. We utilised this opportunity to perform novel microstructure MRI imaging of the metastases to understand the tumour microenvironment and oxygenation.

Item Type: Thesis (PhD)
Date Type: Completion
Status: Unpublished
Schools: Medicine
Date of First Compliant Deposit: 8 January 2024
Last Modified: 08 Jan 2024 16:18

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