Abstract
Objective
The aim of the study was to evaluate the incidence of postirradiation imaging changes after stereotactic radiosurgery for arteriovenous malformations (AVM) and cerebral cavernous malformations (CCM).
Material and Methods
A group of 85 patients treated for arteriovenous malformations (62 patients, 73%) and cavernomas (23 patients, 27%) between October 2001 and December 2005 was analyzed.
All patients were treated with stereotactic radiosurgery with doses ranging from 8-28 Gy. After the irradiation, magnetic resonance imaging (MRI) or computed tomography (CT) was performed at 6 to 12-month intervals to assess the effects of the treatment. The mean follow-up time for the whole group was 27.3 months; AVM group – 26 months; CCM group – 30.9 months.
All the imaging data were carefully reviewed to identify the radiological symptoms of postradiosurgical damage. T2 or FLAIR hyperintensity, T1-hypointensity and contrast enhancement on MRI and the presence of hypodense areas and contrast enhancement on CT examinations were assessed.
Results
Imaging abnormalities were found in 28 (33%) patients. The symptoms of postradiosurgical damage were observed in 21 (33.9%) patients in the AVM group and 7 (30.4%) patients in the CCM group. Radiological symptoms of radiation necrosis associated with neurological deterioration were identified in two patients with cavernomas, while no radiation necrosis was found in the AVM group. Patients in whom radiological signs of focal brain edema or gliosis existed were asymptomatic.
Conclusions
Radiological symptoms of postradiosurgical damage affected about one third of the irradiated patients, typically without any clinical manifestations. Patients irradiated for CCMs seem to be more prone to develop symptomatic postradiosurgical necrosis; this observation, however, requires further investigation.
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References
Flickinger JC, Kondziolka D, Kalend AM, Maitz AH, Lunsford LD (1996) Radiosurgery-related imaging changes in surrounding brain: multivariate analysis and model evaluation. Radiosurgery 1:229–236
Flickinger JC, Kondziolka D, Maitz AH, Lunsford LD (1998) Analysis of neurological sequelae from radiosurgery of arteriovenous malformations: how location affects outcome. Int J Radiat Oncol Biol Phys 40(2):273–278
Flickinger JC, Kondziolka D, Pollock BE, Maitz AH, Lunsford LD (1997) Complications from arteriovenous malformation radiosurgery: multivariate analysis and risk modeling. Int J Radiat Oncol Biol Phys 38(3):485–490
Hasegawa T, McInerney J, Kondziolka D, Lee JYK, Flickinger JC, Lunsford D (2002) Long-term results after stereotactic radiosurgery for patients with cavernous malformations. Neurosurgery 50(6):1190–1197
Huang YC, Tseng CK, Chang CN, Wei KC, Liao CC, Hsu PW (2006) LINAC radiosurgery for intracranial cavernous malformation: 10-year experience. Clin Neurol Neurosurg 108(8):750–756
Karlsson B, Kihlström L, Lindquist C, Ericson K, Steiner L (1998) Radiosurgery for cavernous malformations. J Neurosurg 88(2):293–297
Kim DG, Choe WJ, Paek SH, Chung HT, Kim IH, Han DH (2002) Radiosurgery of intracranial cavernous malformations. Acta Neurochir (Wien) 144(9):869–878
Kondziolka D, Lunsford LD, Flickinger JC (2003) Gamma knife radiosurgery for brain arteriovenous malformations. Oper Tech Neurosurg 2(6):75–82
Levegrün S, Hof H, Essig M, Schlegel W, Debus J (2004) Radiation-induced changes of brain tissue after radiosurgery in patients with arteriovenous malformations: Correlation with dose distribution parameters. Int J Radiat Oncol Biol Phys 59(3):796–808
Pollock BE, Flickinger JC (2002) A proposed radiosurgery-based grading system for arteriovenous malformations. J Neurosurg 96:79–85
Pollock BE, Garces YI, Stafford SL, Foote RL, Schomberg PJ, Link MJ (2000) Stereotactic radiosurgery for cavernous malformations. J Neurosurg 93(6):987–991
Spetzler RF, Martin NA (1986) A proposed grading system for arteriovenous malformations. J Neurosurg 65:476–483
Tomura N, Izumi J, Sakuma I, Takahashi S, Omachi K, Otani T, Anbai A, Watarai J, Suzuki A, Mizoi K (2004) Radiation-induced changes in the brain following stereotactic irradiation evaluated by sequential MRI. Comp Med Imag Graph (28):73–79
Voges J, Treuer H, Sturm V, Büchner C, Lehrke R, Kocher M, Staar S, Kuchta J, Müller RP (1996) Risk analysis of linear accelerator radiosurgery. Int J Radiat Oncol Biol Phys 36(5):1055–1063
Yamamoto M, Hara M, Ide M, Ono Y, Jimbo M, Saito I (1998) Radiation-related adverse effects observed on neuro-imaging several years after radiosurgery for cerebral arteriovenous malformations. Surg Neurol 49(4):385–397
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Blamek, S. et al. (2010). The Incidence of Imaging Abnormalities after Stereotactic Radiosurgery for Cerebral Arteriovenous and Cavernous Malformations. In: Czernicki, Z., Baethmann, A., Ito, U., Katayama, Y., Kuroiwa, T., Mendelow, D. (eds) Brain Edema XIV. Acta Neurochirurgica Supplementum, vol 106. Springer, Vienna. https://doi.org/10.1007/978-3-211-98811-4_34
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