ArticleRadiation oncology (London, England)2013
Magnetic resonance spectroscopic study of radiogenic changes after radiosurgery of cerebral arteriovenous malformations with implications for the differential diagnosis of radionecrosis.
Article in Radiation oncology (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Modern robot-assisted radiosurgery of cerebral angiomas-own experiences, system comparisons, and comprehensive literature overview.Neurosurgical review · 2018Review
- Radiation injury vs. recurrent brain metastasis: combining textural feature radiomics analysis and standard parameters may increaseEuropean radiology · 2017Article
- Management of unbled brain arteriovenous malformation study.Neurologic clinics · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe incidence of radionecrosis after radiosurgery is 5-20%. That radionecrosis after radiosurgery may be confused with a malignant tumor is a known phenomenon and problem.
methodsThree similarly treated patients with cAVM, 1 patient with symptomatic radionecrosis and 2 patients with normal post-radiation MRI changes, were selected and studied in detail with magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and magnetic resonance spectroscopy (MRS). 2 cAVM were located in eloquent locations and were classified as Spetzler-Martin grade (SM) III such that interdisciplinary radiosurgery was recommended; a third patient with a left frontal SM II cAVM refused surgery. 1 patient was male, and 2 were female. The patient's ages ranged from 38 to 62 years (median, 39 years). The nidus volume (= planning target volume = PTV) ranged from 2.75 to 6.89 ccm (median, 6.41 ccm). The single dose was 20 Gy at the isocenter of the PTV encompassing the 80 - 90% isodose. The median follow-up period was 20 months (range, 16 - 84 months). Toxicities were evaluated with the Common Terminology Criteria (CTC) for adverse events version 3.0.
resultsNo patient suffered a bleeding from cAVM during the study period. A complete nidus occlusion was shown in all patients with time-resolved MRA. All patients showed radiogenic MRI changes, 1 patient showed excessive radionecrosis. This patient was oligosymptomatic and under temporary corticoid therapy symptoms resolved completely.Following patterns associated with radionecrosis in the MRS studies were identified in our collective: 2D spectroscopic imaging (2D-SI) revealed much lower concentrations of metabolites in the lesion as compared to contralateral healthy tissue in all patients. Whereas regions with regular post-radiosurgery effects showed almost normal levels of Cho and a Cho/Cr ratio < 2.0, regions with radionecrosis were characterized by increased lipid levels and a Cho/Cr ratio > 2.0 in conjunction with decreased absolute levels of all metabolites, especially of Cr and NAA.
conclusionsMRS is an increasingly valuable tool for the differential diagnosis of radiation reactions. Specific patterns of MRS spectra in radionecrosis were identified; in synopsis with clinical parameters, these changes have to be taken into account to avoid misdiagnosis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.