title: MR Imaging Evaluation of Intracerebral Hemorrhages and T2 Hyperintense White Matter Lesions Appearing after Radiation Therapy in Adult Patients with Primary Brain Tumors.
abstract: The purpose of our study was to determine the frequency and severity of intracerebral hemorrhages and T2 hyperintense white matter lesions (WMLs) following radiation therapy for brain tumors in adult patients. Of 648 adult brain tumor patients who received radiation therapy at our institute, magnetic resonance (MR) image data consisting of a gradient echo (GRE) and FLAIR T2-weighted image were available three and five years after radiation therapy in 81 patients. Intracerebral hemorrhage was defined as a hypointense dot lesion appearing on GRE images after radiation therapy. The number and size of the lesions were evaluated. The T2 hyperintense WMLs observed on the FLAIR sequences were graded according to the extent of the lesion. Intracerebral hemorrhage was detected in 21 (25.9%) and 35 (43.2) patients in the three- and five-year follow-up images, respectively. The number of intracerebral hemorrhages per patient tended to increase as the follow-up period increased, whereas the size of the intracerebral hemorrhages exhibited little variation over the course of follow-up. T2 hyperintense WMLs were observed in 27 (33.3%) and 32 (39.5) patients in the three and five year follow-up images, respectively. The age at the time of radiation therapy was significantly higher (p < 0.001) in the patients with T2 hyperintense WMLs than in those without lesions. Intracerebral hemorrhages are not uncommon in adult brain tumor patients undergoing radiation therapy. The incidence and number of intracerebral hemorrhages increased over the course of follow-up. T2 hyperintense WMLs were observed in more than one-third of the study population.
authors: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors: Dong Hyun
authors: DH
authors: Yoo
authors: Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
authors: Sang Woo
authors: SW
authors: Song
authors: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors: Tae Jin
authors: TJ
authors: Yun
authors: Department of Internal Medicine, Cancer Research Institute, Seoul National University Hospital, Seoul, Korea.
authors: Tae Min
authors: TM
authors: Kim
authors: Department of Internal Medicine, Cancer Research Institute, Seoul National University Hospital, Seoul, Korea.
authors: Se-Hoon
authors: SH
authors: Lee
authors: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors: Ji-Hoon
authors: JH
authors: Kim
authors: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors: Chul-Ho
authors: CH
authors: Sohn
authors: Department of Pathology, Seoul National University Hospital, Seoul, Korea.
authors: Sung-Hye
authors: SH
authors: Park
authors: Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
authors: Chul-Kee
authors: CK
authors: Park
authors: Department of Radiation Oncology, Cancer Research Institute, Seoul National University Hospital, Seoul, Korea.
authors: Il Han
authors: IH
authors: Kim
authors: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors: Seung Hong
authors: SH
authors: Choi
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D002543:Cerebral Hemorrhage / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000473:pathology*; D011878:Radiotherapy / Q000009:adverse effects; D066127:White Matter / Q000473:pathology*; D055815:Young Adult