Aims and objectives
To identify and evaluate distinct clinical scenarios that produce radiation necrosis in the brain.
To study imaging features of brain radiation necrosis and differentiation with radiation changes
Methods and materials
This study carried out at department of Cyberknife Robotic Radiosurgery at Jinnah post graduate Medical centre,
Karachi, Pakistan.
Data was reviewed for a period of 5 and half years from December 2012 till June 2018.
Patients with intracranial AVMs of less than 5cm were selected and treated with cyberknife Robotic Radiosurgery.
Follow up MRI brain with contrast was done after every three months to see the response of radiosurgery.
MRI brain perfusion and PET CT was also performed in some cases to evaluate radiation effects...
Results
225 patients with supra tentorial AVMs were selected and treated with 1 to 5 fractions as per indications,
with cyberknife Robotic Radiosurgery.
23 patients showed Radiation changes which on subsequent follow ups and additional imaging like MR Perfusion imaging and FDG PET CT imaging showed radiation necrosis in only 5 cases and the rest of the cases showed radiation changes which were radiologically and clinicaly improved on follow up imaging.
MRI typically reveal a ring-enhancing /swiss cheese like lesion with surrounding edema.Clinical history includes headache,...
Conclusion
Following radiation therapy of AVMs there are chances of radiation necrosis.
At conventional MR imaging,
there is a high degree of overlap between findings of radiation necrosis and radiation changes .This differentiation is important as Quick and accurate diagnosis,
followed by timely treatment may reduce morbidity.
Personal information
Dr.
Shazia Kadri
Consultant Radiologist
Cyberknife Robotic Radiosurgery
JPMC ,
Karachi
Pakistan
E mail : shaziaum
[email protected]
References
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Int J Radiat Oncol Biol...