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- Title
MRI abnormalities in children following sequential chemotherapy, hyperfractionated accelerated radiotherapy and high-dose thiotepa for high-risk primitive neuroectodermal tumours of the central nervous system.
- Authors
Thust, Stefanie C; Blanco, Esther; Michalski, Antony J; Chong, WK; Gaze, Mark N; Phipps, Kim; Mankad, Kshitij
- Abstract
Introduction Intensive postsurgical therapies have improved survival in children with primitive neuroectodermal tumour, but there is concern that the combination of chemotherapy and radiotherapy may result in a compound injury to normal brain. The purposes of this analysis were to characterise what types of imaging abnormalities occur, identify risk factors and explore how treatment-related changes may be distinguished from tumour. Method One hundred fifty-three MRI studies in 14 children treated with sequential chemotherapy, hyperfractionated accelerated radiotherapy and high-dose thiotepa were retrospectively analysed at a paediatric national referral centre. Results We observed 11 episodes of new focal enhancing lesions, 5 of which were transient and judged to be treatment related. In addition, 7/14 (50%) of children demonstrated moderate to severe brain volume loss featuring a leukodystrophy pattern. Conclusion Treatment-related brain MRI abnormalities occurred frequently in this series with a risk of misdiagnosis as tumour. A proportion of patients suffer generalised white matter injury, which has not been appreciated as a side effect of this particular therapy.
- Subjects
MAGNETIC resonance imaging complications; TUMORS in children; RADIOTHERAPY; THIOTEPA; CENTRAL nervous system abnormalities; MEDULLOBLASTOMA; TUMOR treatment
- Publication
Journal of Medical Imaging & Radiation Oncology, 2014, Vol 58, Issue 6, p683
- ISSN
1754-9477
- Publication type
Article
- DOI
10.1111/1754-9485.12232