Magnetic resonance imaging patterns of treatment-related toxicity in the pediatric brain: an update and review of the literature.

Abstract:

: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.

journal_name

Pediatr Radiol

journal_title

Pediatric radiology

authors

Rossi Espagnet MC,Pasquini L,Napolitano A,Cacchione A,Mastronuzzi A,Caruso R,Tomà P,Longo D

doi

10.1007/s00247-016-3750-4

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

633-648

issue

6

eissn

0301-0449

issn

1432-1998

pii

10.1007/s00247-016-3750-4

journal_volume

47

pub_type

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