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Correia de Verdier M, Ronne-Engström E, Borota L, et al. Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations. Acta Radiol Open. 2021;10(10):20584601211050886doi: 10.1177/20584601211050886.
Correia de Verdier, M., Ronne-Engström, E., Borota, L., Nilsson, K., Blomquist, E., & Wikström, J. (2021). Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations. Acta radiologica open, 10(10), 20584601211050886. https://doi.org/10.1177/20584601211050886
Correia de Verdier, Maria, et al. "Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations." Acta radiologica open vol. 10,10 (2021): 20584601211050886. doi: https://doi.org/10.1177/20584601211050886
Correia de Verdier M, Ronne-Engström E, Borota L, Nilsson K, Blomquist E, Wikström J. Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations. Acta Radiol Open. 2021 Nov 01;10(10):20584601211050886. doi: 10.1177/20584601211050886. eCollection 2021 Oct. PMID: 34888061; PMCID: PMC8649916.
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Acta Radiol Open. 2021 Nov 01;10(10):20584601211050886. doi: 10.1177/20584601211050886. eCollection 2021 Oct.

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

Acta radiologica open

Maria Correia de Verdier, Elisabeth Ronne-Engström, Ljubisa Borota, Kristina Nilsson, Erik Blomquist, Johan Wikström

Affiliations

  1. Department of Surgical Sciences, Section of Neuroradiology, Uppsala University, Uppsala, Sweden.
  2. Department of Neuroscience, Section of Neurosurgery, Uppsala University, Uppsala, Sweden.
  3. Department of Immunology, Genetics and Pathology, Section of Oncology, Uppsala University, Uppsala, Sweden.

PMID: 34888061 PMCID: PMC8649916 DOI: 10.1177/20584601211050886

Abstract

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.

© The Author(s) 2021.

Keywords: Magnetic resonance imaging; intracranial arteriovenous malformations; proton therapy

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

  1. Int J Radiat Oncol Biol Phys. 2014 Jun 1;89(2):338-46 - PubMed
  2. Prog Neurol Surg. 2013;27:5-21 - PubMed
  3. Acta Oncol. 2016;55(1):105-12 - PubMed
  4. J Neurosurg. 1997 Apr;86(4):589-93 - PubMed
  5. J Neurosurg. 2015 Oct;123(4):945-53 - PubMed
  6. Stroke. 2003 May;34(5):e29-33 - PubMed
  7. Acta Neurol Scand. 2004 Feb;109(2):85-90 - PubMed
  8. Int J Radiat Oncol Biol Phys. 1992;23(1):19-26 - PubMed
  9. Neurosurgery. 2018 Sep 1;83(3):365-376 - PubMed
  10. Int J Radiat Oncol Biol Phys. 2004 Jul 1;59(3):796-808 - PubMed
  11. Stereotact Funct Neurosurg. 1999;73(1-4):50-9 - PubMed
  12. J Neurosurg. 2013 Jan;118(1):63-73 - PubMed
  13. Brain. 2001 Oct;124(Pt 10):1900-26 - PubMed
  14. J Neurosurg. 2017 Jan;126(1):36-44 - PubMed
  15. Neurosurgery. 2008 Dec;63(6):1064-9; discussion 1069-70 - PubMed
  16. J Neurosurg. 1997 Sep;87(3):352-7 - PubMed
  17. J Neurol Surg A Cent Eur Neurosurg. 2019 May;80(3):187-197 - PubMed
  18. Neuroradiology. 2013 Mar;55(4):405-12 - PubMed
  19. Int J Radiat Oncol Biol Phys. 2012 Jun 1;83(2):533-41 - PubMed
  20. Int J Radiat Oncol Biol Phys. 2005 May 1;62(1):44-52 - PubMed
  21. J Neurosurg. 2005 Jan;102 Suppl:124-7 - PubMed
  22. Stereotact Funct Neurosurg. 1997;69(1-4 Pt 2):143-6 - PubMed
  23. Neurochirurgie. 2001 May;47(2-3 Pt 2):355-68 - PubMed
  24. World Neurosurg. 2020 Feb;134:e799-e807 - PubMed
  25. J Neurosurg. 1986 Oct;65(4):476-83 - PubMed
  26. Stroke. 2017 Aug;48(8):e200-e224 - PubMed
  27. Clin Neurosurg. 1983;31:248-90 - PubMed
  28. Neurocirugia (Astur). 2009 Apr;20(2):97-102 - PubMed

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