Self-archiving version of the original published at the Journal of Magnetic Resonance Imaging Volume 27, Issue 6, pages 1250–1255, June 2008. DOI: 10.1002/jmri.21364 (The study was supported with a grant from the Kinderkrebsstiftung [Children Cancer Research Foundation] of Mainz for Paulo R. Dellani.) Late Structural Alterations of Cerebral White Matter in Long-Term Survivors of Childhood Leukaemia Paulo R. Dellani 1 , MSc, Stefan Eder 2 , MD, Joachim Gawehn 1 , MD, Goran Vucurevic 1 , MSc, Andreas Fellgiebel 3 , MD, Matthias J. Müller 3 , MD, Heinz Schmidberger 4 , MD , Peter Stoeter 1 , MD, Peter Gutjahr 2 , MD (1) Institute of Neuroradiology, (2) Department of Paediatrics, (3) Department of Psychiatry, (4) Department of Radiation Oncology, University Clinic of Mainz, Germany ABSTRACT Purpose: To look for presence and age-dependence of late structural alterations of otherwise normal-appearing cerebral gray and white matter after radiation and chemotherapy in adult survivors of acute lymphoblastic leukaemia (ALL) during childhood. Materials and Methods: In a group of 13 adult survivors 17–37 years old, who had been treated by total brain radiation (18-24 Gy) and chemotherapy 16-28 years ago, prospective MR examinations including diffusion tensor imaging were performed. Evaluation included volumetry, calculation of mean diffusivity (MD) and fractional anisotropy (FA), and comparison of results to an age-matched control group. Results: DTI showed significantly reduced FA values in the temporal lobes (difference of 0.069 units, p<0.001), hippocampi (difference of 0.033 units, p<0.001) and thalami (difference of 0.046 units, p=0.001), which were accompanied by significant white matter volume loss (difference of 92 cm³, p<0.001). Significant elevations of MD were limited to the temporal white matter (difference of 42 x 10-6 mm2/s, p=0.005). Global and frontal white matter MD correlated negatively to increasing age of the survivors (p<0.01). Conclusion: With regard to structural white matter alterations, adult long-term survivors of childhood ALL, who had received total brain radiation and chemotherapy, apparently show the same overall age dependence as controls. Follow-up studies are needed for confirmation.