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Detection of irreversible changes in susceptibility-weighted images after whole-brain irradiation of children

  • Diagnostic Neuroradiology
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Abstract

Introduction

Whole-brain irradiation is part of the therapy protocol for patients with medulloblastomas. Side effects and complications of radiation can be detected by follow-up magnetic resonance imaging (MRI). Susceptibility-weighted images (SWI) can detect even very small amounts of residual blood that cannot be shown with conventional MRI. The purpose of this study was to determine when and where SWI lesions appear after whole-brain irradiation.

Methods

MRI follow-up of seven patients with medulloblastoma who were treated with whole-brain irradiation were analyzed retrospectively. SWI were part of the initial and follow-up MRI protocol. De novo SWI lesions, localization, and development over time were documented.

Results

At time of irradiation, mean age of the patients was 13 years (±4 years). Earliest SWI lesions were detected 4 months after radiation treatment. In all patients, SWI lesions accumulated over time, although the individual number of SWI lesions varied. No specific dissemination of SWI lesions was observed.

Conclusion

Whole-brain irradiation can cause relatively early dot-like SWI lesions. The lesions are irreversible and accumulate over time. Histopathological correlation and clinical impact of these SWI lesions should be investigated.

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Abbreviations

SWI:

Susceptibility weighted imaging

WHO:

World Health Organization

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Institute of Neuroradiology, University of Schleswig-Holstein, Arnold-Heller-Straße 3-Haus 41, Campus Kiel, 24105, Kiel, Germany

    S. Peters & O. Jansen

  2. Clinic for Radiooncology, University of Schleswig-Holstein, Campus Kiel, Kiel, Germany

    R. Pahl

  3. Clinic for Paediatrics, University of Schleswig-Holstein, Campus Kiel, Kiel, Germany

    A. Claviez

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  1. S. Peters
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  2. R. Pahl
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  4. O. Jansen
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Correspondence to S. Peters.

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Peters, S., Pahl, R., Claviez, A. et al. Detection of irreversible changes in susceptibility-weighted images after whole-brain irradiation of children. Neuroradiology 55, 853–859 (2013). https://doi.org/10.1007/s00234-013-1185-2

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  • DOI: https://doi.org/10.1007/s00234-013-1185-2

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