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Asymptomatic cystic changes in the brain of children after cranial irradiation: frequency, latency, and relationship to age

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

Although radiation therapy plays an important role in the management of children with brain tumors, radiation-induced brain damage sometimes occurs after radiation therapy. In some pediatric patients who had undergone cranial radiation therapy, we noticed cystic changes in the brain on follow-up MRI. The purpose of this study was to determine the frequency, latency, relationship with patient age, radiation dose, and serial change in the cystic changes in children after cranial irradiation.

Methods

We retrospectively studied MRI in 33 children who had undergone cranial irradiation for their primary brain tumors. Postirradiation cystic change in the brain on follow-up MRI was defined as a well-demarcated, oval-shaped, CSF-like signal intensity area, and no contrast enhancement.

Results

Of the 33 patients, 6 (18.2%) had one or more cystic lesions. The latency of the cystic changes ranged from 1.5 to 7 years (mean 2.6 years). Cystic changes were found in the subcortical, periventricular and other deep white matter and the basal ganglia. The size of the lesions ranged from 1 to 10 mm at their first appearance; eight cystic lesions increased in size. None the cystic lesions reduced in size or resolved with time and none required intervention. All patients with cystic changes had received irradiation when they were 6 years of age or younger. The cystic changes occurred within the radiation field in patients treated with a radiation dose of 36 Gy or more.

Conclusion

Asymptomatic brain parenchymal cystic changes appear to occur in children who have undergone cranial irradiation at 6 years of age or younger.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Mika Kitajima, Toshinori Hirai, Natsuki Maruyama, Masayuki Yamura, Yoshiko Hayashida, Yuji Baba & Yasuyuki Yamashita

  2. Department of Radiation Oncology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Ryuji Murakami

  3. Department of Radiology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan

    Yukunori Korogi

  4. Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Hideo Nakamura & Jun-ichi Kuratsu

Authors
  1. Mika Kitajima
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  2. Toshinori Hirai
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  3. Natsuki Maruyama
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  4. Masayuki Yamura
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  5. Yoshiko Hayashida
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  6. Yuji Baba
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  7. Ryuji Murakami
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  8. Yasuyuki Yamashita
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  9. Yukunori Korogi
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  10. Hideo Nakamura
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  11. Jun-ichi Kuratsu
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Correspondence to Mika Kitajima.

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Kitajima, M., Hirai, T., Maruyama, N. et al. Asymptomatic cystic changes in the brain of children after cranial irradiation: frequency, latency, and relationship to age. Neuroradiology 49, 411–417 (2007). https://doi.org/10.1007/s00234-006-0199-4

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  • DOI: https://doi.org/10.1007/s00234-006-0199-4

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