Radiation‐induced cavernous hemangiomas of the brain

Heckl, Stefan; Aschoff, A.; Kunze, Stefan

doi:10.1002/cncr.10596

Cited by 171 publications

(138 citation statements)

References 16 publications

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“…mas following radiotherapy are believed to result from injury to vascular structures because radiotherapy stimulates the upregulation of angiogenesis factors such as vascular endothelial growth factor and basic fibroblast growth factor. Stimulation of such growth factors normally found in cavernomas may explain increased cavernoma formation following radiotherapy 6,7 . A peripheral rim of hemosiderin surrounding a reticulated core of heterogeneous signal intensity are typical MRI features of cavernomas:because of the high sensitivity of SWI to blood products cavernomas may appear only as black dots and their central components may be overwhelmed by susceptibility effects and may not be visible.…”

Section: Resultsmentioning

confidence: 98%

“…Different histologic manifestations of these vascular changes have been described, including endothelial injury and proliferation, fibrinoid necrosis, and induction of capillary telangiectasia and cavernomas 3,4,6 . Gaensler et al 3 described the appearance of hemorrhagic foci on MRI following central nervous system irradiation.…”

Section: Discussionmentioning

confidence: 99%

“…Different studies report that radiation can induce formation of cavernomas and that this occurs at a significantly higher rate when patients are irradiated as children 4,6,7 . Caverno-could represent metastases or lead to a search of other possible causes that may result in changes in management.…”

Section: Discussionmentioning

confidence: 99%

“…Common delayed effects of irradiation include diffuse white matter necrosis, focal or diffuse demyelination, reactive astrocytosis, brain atrophy, dystrophic mineralization, and radiation-induced vasculopathy 2 . Smallvessel injury is a prominent feature of delayed injury and different studies have shown that radiation can induce formation of capillary telangiectasias and cavernomas as a manifestation of vascular injury [3][4][5][6][7][8] . These vascular malformations could conceivably be confused with hemorrhagic metastases and their potential to bleed is unknown.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Brain Radiation-Related Black Dots on Susceptibility-Weighted Imaging

et al. 2014

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Brain Radiation-Related Black Dots on Susceptibility-Weighted Imaging

et al. 2014

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“…A large number of the radiotherapy secondary delayed effects have been well known. There are clear evidences of Glioma and Miningioma followed by radiation while radiation-induced cavernous angiomas (RICA) has been sporadic and even there has been reported few cases of early appearances of RICA (2,3). In 1994, Ciricillo et al propounded, for the first time, seven patients with brain cavernoma induced by radiotherapy (4).…”

Section: Introductionmentioning

confidence: 99%

Brain Cavernomas Induced By Radiotherapy in the Patient With Acute Lymphocytic Leukemia (ALL)

Alijani¹,

Saedi

Hadi

et al. 2015

Rep Radiother Oncol

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Introduction: Radiotherapy is considered the main part of the curative and preventive regimes in the pediatric cancer especially has been highly used in acute lymphocytic leukemia (ALL) as prophylaxis. A large number of the radiotherapy secondary delayed effects have been well known. Case Presentation: In present study, we has introduced a 15-year-old boy with ALL underwent chemotherapy and radiotherapy. Who had generalized tonic-colonic seizure which has been lasted 10 minutes (without any previous history). The patient with ALL ten years ago has been treated by chemotherapy and whole brain prophylactic radiotherapy with dose 1200 cGy/120 cGy/10. In his MRI a heterogeneous mass with the dimensions 3 × 2 cm in the left frontal lobe with the peripheral edema and after complete the diagnose process the final report of this mass was Cavernoma. Conclusions: There has been identified a clear link between radiotherapy and brain cavernoma; therefore, it should be considered in differential diagnosis of brain hemorrhagic lesions in each patient with the history of radiotherapy of the central nervous system. This risk is higher when the patient has the history of the brain radiotherapy in childhood.

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Susceptibility‐weighted imaging in malignant melanoma brain metastasis

Schwarz

Niederle

Münch

et al. 2019

Magnetic Resonance Imaging

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Background The value of cerebral susceptibility‐weighted imaging (SWI) in malignant melanoma (MM) patients remains controversial and the effect of melanin on SWI is not well understood. Purpose To systematically analyze the spectrum of intracerebral findings in MM brain metastases (BM) on SWI and to determine the diagnostic value of SWI. Study Type Retrospective. Population/Subjects In all, 100 patients with melanoma BM (69 having received radiotherapy [RT] and 31 RT‐naïve) and a control group of 100 melanoma patients without BM were included. For detailed analysis of signal characteristics, 175 metastases were studied. Field Strength/Sequence Gradient echo SWI sequence at 1.5, 3.0, and 9.4 T. Assessment Signal characteristics from melanotic and amelanotic BMs on SWI with a focus on blooming artifacts were analyzed, as well as the presence and longitudinal dynamics of isolated SWI blooming artifacts in patients with and without BM. Statistical Tests Chi‐squared and Student's t‐test were used for contingency table measures and group data of signal and clinical characteristics, respectively. Results Melanotic and amelanotic metastases did not show significant differences of SWI blooming artifacts (38% vs. 43%, P = 0.61). Most metastases without an initial SWI artifact developed a signal dropout during follow‐up (80%; 65/81). Isolated SWI artifacts were detected more frequently in patients with BM (20 vs. 9, P = 0.03), of which the majority were found in patients who had received RT (17 vs. 3, P = 0.08). None of these isolated SWI blooming artifacts turned into overt metastases over time (median follow‐up: 8.5 months). Similar findings persisted as remnants of successfully treated metastases (88%; 7/8). Data Conclusion We conclude that SWI provides little additional diagnostic benefit over standard T1‐weighted imaging, as melanin content alone does not cause diagnostically relevant SWI blooming. Signal transition of SWI may rather indicate secondary phenomena like microbleeding and/or metal scavenging. Our results suggest that isolated SWI artifacts do not constitute vital tumor tissue but represent unspecific microbleedings, RT‐related parenchymal changes or posttherapeutic remnants of former metastatic lesions. Level of Evidence: 3 Technical Efficacy Stage: 5 J. Magn. Reson. Imaging 2019;50:1251–1259.

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Radiation‐induced cavernous hemangiomas of the brain

Abstract: These results indicate a correlation between radiation and cavernoma, particularly in children under 10 years of age at the time of radiation therapy. In adults, cavernomas after radiation rarely occur, and then only after higher radiation dosages (3000 cGy or more).

Cited by 171 publications

References 16 publications

Brain Radiation-Related Black Dots on Susceptibility-Weighted Imaging

Brain Radiation-Related Black Dots on Susceptibility-Weighted Imaging

Brain Cavernomas Induced By Radiotherapy in the Patient With Acute Lymphocytic Leukemia (ALL)

Susceptibility‐weighted imaging in malignant melanoma brain metastasis

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