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Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations

BACKGROUND: Treatment of intracranial arteriovenous malformations (AVMs) includes surgery, radiation therapy, endovascular occlusion, or a combination. Proton radiation therapy enables very focused radiation, minimizing dose to the surrounding brain. PURPOSE: To evaluate the presence of radiation-in...

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Autores principales: Correia de Verdier, Maria, Ronne-Engström, Elisabeth, Borota, Ljubisa, Nilsson, Kristina, Blomquist, Erik, Wikström, Johan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649916/
https://www.ncbi.nlm.nih.gov/pubmed/34888061
http://dx.doi.org/10.1177/20584601211050886
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author Correia de Verdier, Maria
Ronne-Engström, Elisabeth
Borota, Ljubisa
Nilsson, Kristina
Blomquist, Erik
Wikström, Johan
author_facet Correia de Verdier, Maria
Ronne-Engström, Elisabeth
Borota, Ljubisa
Nilsson, Kristina
Blomquist, Erik
Wikström, Johan
author_sort Correia de Verdier, Maria
collection PubMed
description BACKGROUND: Treatment of intracranial arteriovenous malformations (AVMs) includes surgery, radiation therapy, endovascular occlusion, or a combination. Proton radiation therapy enables very focused radiation, minimizing dose to the surrounding brain. PURPOSE: To evaluate the presence of radiation-induced changes on post-treatment MRI in patients with AVMs treated with proton radiation and to compare these with development of symptoms and nidus obliteration. MATERIAL AND METHODS: Retrospective review of pre- and post-treatment digital subtraction angiography and MRI and medical records in 30 patients with AVMs treated with proton radiation. Patients were treated with two or five fractions; total radiation dose was 20–35 physical Gy. Vasogenic edema (minimal, perinidal, or severe), contrast enhancement (minimal or annular), cavitation and nidus obliteration (total, partial, or none) were assessed. RESULTS: 26 of 30 patients (87%) developed MRI changes. Vasogenic edema was seen in 25 of 30 (83%), abnormal contrast enhancement in 18 of 26 (69%) and cavitation in 5 of 30 (17%). Time from treatment to appearance of MRI changes varied between 5 and 25 months (median 7, mean 10). Seven patients developed new or deteriorating symptoms that required treatment with corticosteroids; all these patients had extensive MRI changes (severe vasogenic edema and annular contrast enhancement). Not all patients with extensive MRI changes developed symptoms. We found no relation between MRI changes and nidus obliteration. CONCLUSION: Radiation-induced MRI changes are seen in a majority of patients after proton radiation treatment of AVMs. Extensive MRI changes are associated with new or deteriorating symptoms.
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spelling pubmed-86499162021-12-08 Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations Correia de Verdier, Maria Ronne-Engström, Elisabeth Borota, Ljubisa Nilsson, Kristina Blomquist, Erik Wikström, Johan Acta Radiol Open Original Article BACKGROUND: Treatment of intracranial arteriovenous malformations (AVMs) includes surgery, radiation therapy, endovascular occlusion, or a combination. Proton radiation therapy enables very focused radiation, minimizing dose to the surrounding brain. PURPOSE: To evaluate the presence of radiation-induced changes on post-treatment MRI in patients with AVMs treated with proton radiation and to compare these with development of symptoms and nidus obliteration. MATERIAL AND METHODS: Retrospective review of pre- and post-treatment digital subtraction angiography and MRI and medical records in 30 patients with AVMs treated with proton radiation. Patients were treated with two or five fractions; total radiation dose was 20–35 physical Gy. Vasogenic edema (minimal, perinidal, or severe), contrast enhancement (minimal or annular), cavitation and nidus obliteration (total, partial, or none) were assessed. RESULTS: 26 of 30 patients (87%) developed MRI changes. Vasogenic edema was seen in 25 of 30 (83%), abnormal contrast enhancement in 18 of 26 (69%) and cavitation in 5 of 30 (17%). Time from treatment to appearance of MRI changes varied between 5 and 25 months (median 7, mean 10). Seven patients developed new or deteriorating symptoms that required treatment with corticosteroids; all these patients had extensive MRI changes (severe vasogenic edema and annular contrast enhancement). Not all patients with extensive MRI changes developed symptoms. We found no relation between MRI changes and nidus obliteration. CONCLUSION: Radiation-induced MRI changes are seen in a majority of patients after proton radiation treatment of AVMs. Extensive MRI changes are associated with new or deteriorating symptoms. SAGE Publications 2021-11-01 /pmc/articles/PMC8649916/ /pubmed/34888061 http://dx.doi.org/10.1177/20584601211050886 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Article
Correia de Verdier, Maria
Ronne-Engström, Elisabeth
Borota, Ljubisa
Nilsson, Kristina
Blomquist, Erik
Wikström, Johan
Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations
title Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations
title_full Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations
title_fullStr Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations
title_full_unstemmed Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations
title_short Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations
title_sort magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649916/
https://www.ncbi.nlm.nih.gov/pubmed/34888061
http://dx.doi.org/10.1177/20584601211050886
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