82fc7cb98dcad0ce0fc9714fb5029c8d pmc_10093348.pdf d711b76229a54719b730cf442eb8bf61fbb93511 pmc_10093348.pdf c28e59e838e14f5d375ab3119f074d18be54fef4a8a4e1302a1adbf7053451cc pmc_10093348.pdf Title: Normal Pressure Hydrocephalus Following Cranial Radiation: Identification of Shunting Responders Subject: Background: We examined cognitive, brain MRI, and lumbar infusion test (LIT) features to identify predictors of response to ventriculoperitoneal shunting (VPS) in long-term cancer survivors with suspected normal pressure hydrocephalus (NPH) following cranial radiotherapy (RT). Methods: Patients who completed cranial RT at least 2 years before with clinically suspected NPH and an Evans’ index (EI) 0.30 underwent a cognitive and a cerebrospinal fluid (CSF) volumetric (MRI) analysis (n = 36). For those in whom VPS was placed (n = 14), we explored whether adding a CSF volumetric analysis to classical MRI and LIT (Tap Test) features would better identify VPS responders. Results: Nearly 80% exhibited cognitive impairment. The CSF volume at NPH diagnoses was significantly larger in the group of VPS responders (p = 0.04). The addition of CSF volume to NPH diagnoses increased accuracy to 93%, with a positive and negative predictive value of 91% and 100%, respectively. Conclusion: The addition of a quantitative MRI analysis of CSF volume to classical MRI and LIT NPH criteria, along with a high clinical suspicion of NPH, may help to identify VPS responders, thus improving the clinical management and prognosis of long-term survivors. Keywords: cancer survivors; radiotherapy; normal pressure hydrocephalus; ventriculoperitoneal shunt; volumetric analysis Author: Nuria Cayuela, Manuel Domínguez-Lizarbe, Gerard Plans, Montserrat Alemany, Juan José Sánchez, Begoña Andrés, Anna Lucas, Jordi Bruna and Marta Simó Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Mar 24 06:32:33 2023 CET ModDate: Fri Mar 24 06:34:39 2023 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2117096 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- KORLVE+VnURWPalladioL Type 1 Custom yes yes no 10 0 YYUVUO+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 WMEWNN+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 WHLBRU+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 GQWIGS+CMSY10 Type 1 Builtin yes yes no 28 0 JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 51 0 LWLIVD+EURM10 Type 1 Builtin yes yes no 73 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 92 0 OIAEEB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 113 0 OIAEED+PalatinoLinotype TrueType WinAnsi yes yes no 116 0 OIAEEF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 119 0 OIAIAA+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 122 0 OIAEEB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 172 0 OIAEED+PalatinoLinotype TrueType WinAnsi yes yes no 175 0 OIAEEF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 178 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-07-29 02:31:55 CEST RepresentationInformation: pmc_10093348.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-07-27 02:24:39 CEST Size: 2117096 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 376 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Patients Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Neuropsychological Assessment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Lumbar Infusion Test and Data Acquisition Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: MRI Data and Image Processing for Volumetric CSF Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Demographic, Clinical, LIT and MRI Characteristics Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Neuropsychological Assessment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Ventriculoperitoneal Shunting Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Ventriculoperitoneal Shunting: Identification of Responders Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Info: Title: Normal Pressure Hydrocephalus Following Cranial Radiation: Identification of Shunting Responders Author: Nuria Cayuela, Manuel Domínguez-Lizarbe, Gerard Plans, Montserrat Alemany, Juan José Sánchez, Begoña Andrés, Anna Lucas, Jordi Bruna and Marta Simó Subject: Background: We examined cognitive, brain MRI, and lumbar infusion test (LIT) features to identify predictors of response to ventriculoperitoneal shunting (VPS) in long-term cancer survivors with suspected normal pressure hydrocephalus (NPH) following cranial radiotherapy (RT). Methods: Patients who completed cranial RT at least 2 years before with clinically suspected NPH and an Evans’ index (EI) 0.30 underwent a cognitive and a cerebrospinal fluid (CSF) volumetric (MRI) analysis (n = 36). For those in whom VPS was placed (n = 14), we explored whether adding a CSF volumetric analysis to classical MRI and LIT (Tap Test) features would better identify VPS responders. Results: Nearly 80% exhibited cognitive impairment. The CSF volume at NPH diagnoses was significantly larger in the group of VPS responders (p = 0.04). The addition of CSF volume to NPH diagnoses increased accuracy to 93%, with a positive and negative predictive value of 91% and 100%, respectively. Conclusion: The addition of a quantitative MRI analysis of CSF volume to classical MRI and LIT NPH criteria, along with a high clinical suspicion of NPH, may help to identify VPS responders, thus improving the clinical management and prognosis of long-term survivors. 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