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Detection of cavernous malformations after whole-brain radiotherapy in primitive neuroectodermal tumor patients—comparing susceptibility-weighted imaging and T2 gradient-echo sequences

  • Diagnostic Neuroradiology
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Abstract

Purpose

The aim of this retrospective study is to investigate the value of the susceptibility-weighted imaging (SWI) sequence compared to gradient echo (GRE) in the detection and follow-up of cavernous malformations in patients who underwent whole-brain irradiation as part of their medulloblastoma treatment.

Methods

We retrospectively examined MRI studies of 28 subjects (16 males, 12 females) who received whole-brain irradiation as part of their treatment. Ages at irradiation ranged from 2 to 38 years. All patients were periodically followed up with MR imaging (ranging from 9 to 336 months). Two neuroradiologists reviewed studies of the same patients, comparing the number of suspected cavernomas detected on GRE and SWI sequences performed at different times (median time between studies, 10 months).

Results

Hypointense lesions were detected in 24 subjects on SWI sequences and in 19 subjects on GRE sequences. More lesions were seen on SWI than on GRE (p = 0.006). Four patients had no detectable lesions. The minimal period from irradiation to first lesion detection was 14 months. Cavernomas larger than 3 mm were detected in 14 subjects by both GRE and SWI. None of the subjects had symptoms related to cavernomas.

Conclusions

The sensitivity of SWI in the detection of hypointense lesions in patients after whole-brain irradiation is significantly higher than that of the GRE sequence. It appears that almost all subjects eventually develop small hypointense lesions after radiotherapy, and some of them progress to cavernous malformations. The clinical significance of the increased sensitivity of SWI in this group of patients is not entirely certain.

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Abbreviations

WBRT:

Whole-brain radiation therapy

CM:

Cavernous malformation

PNET:

Primitive neuroectodermal tumor

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Authors and Affiliations

  1. Department of Diagnostic Imaging, Rabin Medical Center, Jabotinsky 39, Petah Tikva, Israel

    Vadim Khasminsky

  2. Department of Pediatric Hemato-Oncology, Sheba Medical Center, Derech Sheba 2, Ramat Gan, Israel

    Michal Yalon

  3. Department of Diagnostic Imaging, Sheba Medical Center, Derech Sheba 2, Ramat Gan, Israel

    Gahl Greenberg, Galia Tsarfaty, Eli Atar & Chen Hoffmann

Authors
  1. Vadim Khasminsky
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  2. Michal Yalon
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  3. Gahl Greenberg
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  4. Galia Tsarfaty
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  5. Eli Atar
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  6. Chen Hoffmann
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Correspondence to Vadim Khasminsky.

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No funding was received for this study.

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The authors declare that they have no conflict of interest.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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For this type of retrospective study formal consent is not required.

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Khasminsky, V., Yalon, M., Greenberg, G. et al. Detection of cavernous malformations after whole-brain radiotherapy in primitive neuroectodermal tumor patients—comparing susceptibility-weighted imaging and T2 gradient-echo sequences. Neuroradiology 60, 913–919 (2018). https://doi.org/10.1007/s00234-018-2055-8

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  • DOI: https://doi.org/10.1007/s00234-018-2055-8

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