TY - JOUR
T1 - Magnetic resonance imaging patterns of treatment-related toxicity in the pediatric brain
T2 - an update and review of the literature
AU - Rossi Espagnet, Maria Camilla
AU - Pasquini, Luca
AU - Napolitano, Antonio
AU - Cacchione, Antonella
AU - Mastronuzzi, Angela
AU - Caruso, Roberta
AU - Tomà, Paolo
AU - Longo, Daniela
PY - 2016/12/9
Y1 - 2016/12/9
N2 - Treatment-related neurotoxicity is a potentially life-threatening clinical condition that can represent a diagnostic challenge. Differentiating diagnoses between therapy-associated brain injury and recurrent disease can be difficult, and the immediate recognition of neurotoxicity is crucial to providing correct therapeutic management, ensuring damage reversibility. For these purposes, the knowledge of clinical timing and specific treatment protocols is extremely important for interpreting MRI patterns. Neuroradiologic findings are heterogeneous and sometimes overlapping, representing the compounding effect of the different treatments. Moreover, MRI patterns can be acute, subacute or delayed and involve different brain regions, depending on (1) the mechanism of action of the specific medication and (2) which brain regions are selectively vulnerable to specific toxic effects. This review illustrates the most common radiologic appearance of radiotherapy, chemotherapy and medication-associated brain injury in children, with special focus on the application of advanced MRI techniques (diffusion, perfusion and proton spectroscopy) in the diagnosis of the underlying processes leading to brain toxicity.
AB - Treatment-related neurotoxicity is a potentially life-threatening clinical condition that can represent a diagnostic challenge. Differentiating diagnoses between therapy-associated brain injury and recurrent disease can be difficult, and the immediate recognition of neurotoxicity is crucial to providing correct therapeutic management, ensuring damage reversibility. For these purposes, the knowledge of clinical timing and specific treatment protocols is extremely important for interpreting MRI patterns. Neuroradiologic findings are heterogeneous and sometimes overlapping, representing the compounding effect of the different treatments. Moreover, MRI patterns can be acute, subacute or delayed and involve different brain regions, depending on (1) the mechanism of action of the specific medication and (2) which brain regions are selectively vulnerable to specific toxic effects. This review illustrates the most common radiologic appearance of radiotherapy, chemotherapy and medication-associated brain injury in children, with special focus on the application of advanced MRI techniques (diffusion, perfusion and proton spectroscopy) in the diagnosis of the underlying processes leading to brain toxicity.
KW - Adverse effects
KW - Anti-neoplastic therapy
KW - Brain
KW - Children
KW - Magnetic resonance imaging
KW - Neuroradiology
KW - Toxicity
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U2 - 10.1007/s00247-016-3750-4
DO - 10.1007/s00247-016-3750-4
M3 - Article
SP - 1
EP - 16
JO - Pediatric Radiology
JF - Pediatric Radiology
SN - 0301-0449
ER -