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Open Access 01-12-2019 | Magnetic Resonance Imaging | Educational Review

Brain MR findings in patients treated with particle therapy for skull base tumors

Authors: Gisela Viselner, Lisa Farina, Federica Lucev, Elena Turpini, Luca Lungarotti, Ana Bacila, Alberto Iannalfi, Emma D’Ippolito, Barbara Vischioni, Sara Ronchi, Enrico Marchioni, Francesca Valvo, Stefano Bastianello, Lorenzo Preda

Published in: Insights into Imaging | Issue 1/2019

Abstract

Nowadays, hadrontherapy is increasingly used for the treatment of various tumors, in particular of those resistant to conventional radiotherapy. Proton and carbon ions are characterized by physical and biological features that allow a high radiation dose to tumors, minimizing irradiation to adjacent normal tissues. For this reason, radioresistant tumors and tumors located near highly radiosensitive critical organs, such as skull base tumors, represent the best target for this kind of therapy. However, also hadrontherapy can be associated with radiation adverse effects, generally referred as acute, early-delayed and late-delayed. Among late-delayed effects, the most severe form of injury is radiation necrosis. There are various underlying mechanisms involved in the development of radiation necrosis, as well as different clinical presentations requiring specific treatments. In most cases, radiation necrosis presents as a single focal lesion, but it can be multifocal and involve a single or multiple lobes simulating brain metastasis, or it can also involve both cerebral hemispheres. In every case, radiation necrosis results always related to the extension of radiation delivery field. Multiple MRI techniques, including diffusion, perfusion imaging, and spectroscopy, are important tools for the radiologist to formulate the correct diagnosis. The aim of this paper is to illustrate the possible different radiologic patterns of radiation necrosis that can be observed in different MRI techniques in patients treated with hadrontherapy for tumors involving the skull base. The images of exemplary cases of radiation necrosis are also presented.

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Title: Brain MR findings in patients treated with particle therapy for skull base tumors
Authors: Gisela Viselner
Lisa Farina
Federica Lucev
Elena Turpini
Luca Lungarotti
Ana Bacila
Alberto Iannalfi
Emma D’Ippolito
Barbara Vischioni
Sara Ronchi
Enrico Marchioni
Francesca Valvo
Stefano Bastianello
Lorenzo Preda
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: Insights into Imaging / Issue 1/2019
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-019-0784-9

At a glance: The STEP trials

Springer Medicine

Brain MR findings in patients treated with particle therapy for skull base tumors

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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