Skip to main content
Erschienen in: European Radiology 10/2018

12.04.2018 | Neuro

Remote brain microhaemorrhages may predict haematoma in glioma patients treated with radiation therapy

verfasst von: Augustin Lecler, Frédérique Charbonneau, Dimitri Psimaras, Marie-Astrid Metten, Antoine Gueguen, Khe Hoang Xuan, Loic Feuvret, Julien Savatovsky

Erschienen in: European Radiology | Ausgabe 10/2018

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To evaluate the prevalence of cerebral remote microhaemorrhages (RMH) and remote haematomas (RH) using magnetic resonance susceptibility-weighted imaging (SWI) among patients treated for gliomas during follow-up.

Methods

We conducted a retrospective single centre longitudinal study on 58 consecutive patients treated for gliomas from January 2009 through December 2010. Our institutional review board approved this study. We evaluated the presence and number of RMH and RH found outside the brain tumour on follow-up MR imaging. We performed univariate and bivariate analyses to identify predictors for RMH and RH and Kaplan–Meier survival analysis techniques.

Results

Twenty-five (43%) and four patients (7%) developed at least one RMH or RH, respectively, during follow-up. The risk was significantly higher for patients who received radiation therapy (49% and 8% versus 0%) (p = 0.02). The risk of developing RH was significantly higher in patients with at least one RMH and a high burden of RMH. The mean age of those presenting with at least one RMH or RH was significantly lower.

Conclusions

RMH were common in adult survivors of gliomas who received radiation therapy and may predict the onset of RH during follow-up, mainly in younger patients.

Key Points

• Brain RMH and RH are significantly more likely to occur after RT.
• RMH occur in almost half of the patients treated with RT.
• RMH and RH are significantly more frequent in younger patients.
• RH occur only in patients with RMH.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Shinohara C, Muragaki Y, Maruyama T et al (2008) Long-term prognostic assessment of 185 newly diagnosed gliomas: grade III glioma showed prognosis comparable to that of Grade II glioma. Jpn J Clin Oncol 38:730–733CrossRef Shinohara C, Muragaki Y, Maruyama T et al (2008) Long-term prognostic assessment of 185 newly diagnosed gliomas: grade III glioma showed prognosis comparable to that of Grade II glioma. Jpn J Clin Oncol 38:730–733CrossRef
2.
Zurück zum Zitat Stupp R, Mason WP, van den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996CrossRef Stupp R, Mason WP, van den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996CrossRef
3.
Zurück zum Zitat Douw L, Klein M, Fagel SS et al (2009) Cognitive and radiological effects of radiotherapy in patients with low-grade glioma: long-term follow-up. Lancet Neurol 8:810–8182CrossRef Douw L, Klein M, Fagel SS et al (2009) Cognitive and radiological effects of radiotherapy in patients with low-grade glioma: long-term follow-up. Lancet Neurol 8:810–8182CrossRef
4.
Zurück zum Zitat Peters S, Pahl R, Claviez A, Jansen O (2013) Detection of irreversible changes in susceptibility-weighted images after whole-brain irradiation of children. Neuroradiology 55:853–859CrossRef Peters S, Pahl R, Claviez A, Jansen O (2013) Detection of irreversible changes in susceptibility-weighted images after whole-brain irradiation of children. Neuroradiology 55:853–859CrossRef
5.
Zurück zum Zitat Lupo JM, Chuang CF, Chang SM et al (2012) 7-Tesla susceptibility-weighted imaging to assess the effects of radiotherapy on normal-appearing brain in patients with glioma. Int J Radiat Oncol Biol Phys 82:e493–e500CrossRef Lupo JM, Chuang CF, Chang SM et al (2012) 7-Tesla susceptibility-weighted imaging to assess the effects of radiotherapy on normal-appearing brain in patients with glioma. Int J Radiat Oncol Biol Phys 82:e493–e500CrossRef
6.
Zurück zum Zitat Jain R, Robertson PL, Gandhi D et al (2005) Radiation-induced cavernomas of the brain. AJNR Am J Neuroradiol 26:1158–1162PubMed Jain R, Robertson PL, Gandhi D et al (2005) Radiation-induced cavernomas of the brain. AJNR Am J Neuroradiol 26:1158–1162PubMed
7.
Zurück zum Zitat Bian W, Hess CP, Chang SM et al (2014) Susceptibility-weighted MR imaging of radiation therapy-induced cerebral microbleeds in patients with glioma: a comparison between 3T and 7T. Neuroradiology 56:91–96CrossRef Bian W, Hess CP, Chang SM et al (2014) Susceptibility-weighted MR imaging of radiation therapy-induced cerebral microbleeds in patients with glioma: a comparison between 3T and 7T. Neuroradiology 56:91–96CrossRef
8.
Zurück zum Zitat Zeng Q-S, Kang X-S, Li C-F, Zhou G-Y (2011) Detection of hemorrhagic hypointense foci in radiation injury region using susceptibility-weighted imaging. Acta Radiol 52:115–119CrossRef Zeng Q-S, Kang X-S, Li C-F, Zhou G-Y (2011) Detection of hemorrhagic hypointense foci in radiation injury region using susceptibility-weighted imaging. Acta Radiol 52:115–119CrossRef
9.
Zurück zum Zitat Lupo JM, Molinaro AM, Essock-Burns E et al (2016) The effects of anti-angiogenic therapy on the formation of radiation-induced microbleeds in normal brain tissue of patients with glioma. Neuro Oncol 18:87–95CrossRef Lupo JM, Molinaro AM, Essock-Burns E et al (2016) The effects of anti-angiogenic therapy on the formation of radiation-induced microbleeds in normal brain tissue of patients with glioma. Neuro Oncol 18:87–95CrossRef
10.
Zurück zum Zitat Walker MD, Alexander E, Hunt WE et al (1978) Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J Neurosurg 49:333–343PubMed Walker MD, Alexander E, Hunt WE et al (1978) Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J Neurosurg 49:333–343PubMed
11.
Zurück zum Zitat Valk PE, Dillon WP (1991) Radiation injury of the brain. AJNR Am J Neuroradiol 12:45–62PubMed Valk PE, Dillon WP (1991) Radiation injury of the brain. AJNR Am J Neuroradiol 12:45–62PubMed
12.
Zurück zum Zitat Roddy E, Sear K, Felton E et al (2016) Presence of cerebral microbleeds is associated with worse executive function in pediatric brain tumor survivors. Neuro-Oncol 18:1548–1558CrossRef Roddy E, Sear K, Felton E et al (2016) Presence of cerebral microbleeds is associated with worse executive function in pediatric brain tumor survivors. Neuro-Oncol 18:1548–1558CrossRef
13.
Zurück zum Zitat Charidimou A, Werring DJ (2012) Cerebral microbleeds and cognition in cerebrovascular disease: an update. J Neurol Sci 322:50–55CrossRef Charidimou A, Werring DJ (2012) Cerebral microbleeds and cognition in cerebrovascular disease: an update. J Neurol Sci 322:50–55CrossRef
14.
Zurück zum Zitat Valenti R, Del Bene A, Poggesi A et al (2016) Cerebral microbleeds in patients with mild cognitive impairment and small vessel disease: The Vascular Mild Cognitive Impairment (VMCI)-Tuscany study. J Neurol Sci 368:195–202CrossRef Valenti R, Del Bene A, Poggesi A et al (2016) Cerebral microbleeds in patients with mild cognitive impairment and small vessel disease: The Vascular Mild Cognitive Impairment (VMCI)-Tuscany study. J Neurol Sci 368:195–202CrossRef
15.
Zurück zum Zitat Ayaz M, Boikov AS, Haacke EM et al (2010) Imaging cerebral microbleeds using susceptibility weighted imaging: one step toward detecting vascular dementia. J Magn Reson Imaging JMRI 31:142–148CrossRef Ayaz M, Boikov AS, Haacke EM et al (2010) Imaging cerebral microbleeds using susceptibility weighted imaging: one step toward detecting vascular dementia. J Magn Reson Imaging JMRI 31:142–148CrossRef
16.
Zurück zum Zitat Werring DJ, Gregoire SM, Cipolotti L (2010) Cerebral microbleeds and vascular cognitive impairment. J Neurol Sci 299:131–135CrossRef Werring DJ, Gregoire SM, Cipolotti L (2010) Cerebral microbleeds and vascular cognitive impairment. J Neurol Sci 299:131–135CrossRef
17.
Zurück zum Zitat Landis JR, Koch GG (1977) An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. Biometrics 33:363–374CrossRef Landis JR, Koch GG (1977) An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. Biometrics 33:363–374CrossRef
19.
Zurück zum Zitat Reinhold HS, Hopewell JW (1980) Late changes in the architecture of blood vessels of the rat brain after irradiation. Br J Radiol 53:693–696CrossRef Reinhold HS, Hopewell JW (1980) Late changes in the architecture of blood vessels of the rat brain after irradiation. Br J Radiol 53:693–696CrossRef
20.
Zurück zum Zitat Cutsforth-Gregory JK, Lanzino G, Link MJ et al (2015) Characterization of radiation-induced cavernous malformations and comparison with a nonradiation cavernous malformation cohort. J Neurosurg 122:1214–1222CrossRef Cutsforth-Gregory JK, Lanzino G, Link MJ et al (2015) Characterization of radiation-induced cavernous malformations and comparison with a nonradiation cavernous malformation cohort. J Neurosurg 122:1214–1222CrossRef
21.
Zurück zum Zitat Smart D (2017) Radiation toxicity in the central nervous system: mechanisms and strategies for injury reduction. Semin Radiat Oncol 27:332–339CrossRef Smart D (2017) Radiation toxicity in the central nervous system: mechanisms and strategies for injury reduction. Semin Radiat Oncol 27:332–339CrossRef
22.
Zurück zum Zitat Vinchon M, Leblond P, Caron S et al (2011) Radiation-induced tumors in children irradiated for brain tumor: a longitudinal study. Childs Nerv Syst 27:445–453CrossRef Vinchon M, Leblond P, Caron S et al (2011) Radiation-induced tumors in children irradiated for brain tumor: a longitudinal study. Childs Nerv Syst 27:445–453CrossRef
23.
Zurück zum Zitat Mirimanoff R-O, Gorlia T, Mason W et al (2006) Radiotherapy and temozolomide for newly diagnosed glioblastoma: recursive partitioning analysis of the EORTC 26981/22981-NCIC CE3 phase III randomized trial. J Clin Oncol 24:2563–2569CrossRef Mirimanoff R-O, Gorlia T, Mason W et al (2006) Radiotherapy and temozolomide for newly diagnosed glioblastoma: recursive partitioning analysis of the EORTC 26981/22981-NCIC CE3 phase III randomized trial. J Clin Oncol 24:2563–2569CrossRef
24.
Zurück zum Zitat Cairncross G, Wang M, Shaw E et al (2013) Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. J Clin Oncol 31:337–343CrossRef Cairncross G, Wang M, Shaw E et al (2013) Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. J Clin Oncol 31:337–343CrossRef
25.
Zurück zum Zitat Ducray F, Idbaih A (2013) Neuro-oncology: anaplastic oligodendrogliomas-value of early chemotherapy. Nat Rev Neurol 9:7–8CrossRef Ducray F, Idbaih A (2013) Neuro-oncology: anaplastic oligodendrogliomas-value of early chemotherapy. Nat Rev Neurol 9:7–8CrossRef
26.
Zurück zum Zitat Jastaniyah N, Murtha A, Pervez N et al (2013) Phase I study of hypofractionated intensity modulated radiation therapy with concurrent and adjuvant temozolomide in patients with glioblastoma multiforme. Radiat Oncol Lond Engl 8:38CrossRef Jastaniyah N, Murtha A, Pervez N et al (2013) Phase I study of hypofractionated intensity modulated radiation therapy with concurrent and adjuvant temozolomide in patients with glioblastoma multiforme. Radiat Oncol Lond Engl 8:38CrossRef
27.
Zurück zum Zitat Combs SE (2017) Does proton therapy have a future in CNS tumors? Curr Treat Options Neurol 19:12CrossRef Combs SE (2017) Does proton therapy have a future in CNS tumors? Curr Treat Options Neurol 19:12CrossRef
28.
Zurück zum Zitat Floyd NS, Woo SY, Teh BS et al (2004) Hypofractionated intensity-modulated radiotherapy for primary glioblastoma multiforme. Int J Radiat Oncol Biol Phys 58:721–726CrossRef Floyd NS, Woo SY, Teh BS et al (2004) Hypofractionated intensity-modulated radiotherapy for primary glioblastoma multiforme. Int J Radiat Oncol Biol Phys 58:721–726CrossRef
29.
Zurück zum Zitat Chen Y-D, Feng J, Fang T et al (2013) Effect of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy on clinical outcomes in patients with glioblastoma multiforme. Chin Med J (Engl) 126:2320–2324 Chen Y-D, Feng J, Fang T et al (2013) Effect of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy on clinical outcomes in patients with glioblastoma multiforme. Chin Med J (Engl) 126:2320–2324
30.
Zurück zum Zitat Zach L, Stall B, Ning H et al (2009) A dosimetric comparison of four treatment planning methods for high grade glioma. Radiat Oncol Lond Engl 4:45CrossRef Zach L, Stall B, Ning H et al (2009) A dosimetric comparison of four treatment planning methods for high grade glioma. Radiat Oncol Lond Engl 4:45CrossRef
31.
Zurück zum Zitat Letarte N, Bressler LR, Villano JL (2013) Bevacizumab and central nervous system (CNS) hemorrhage. Cancer Chemother Pharmacol 71:1561–1565CrossRef Letarte N, Bressler LR, Villano JL (2013) Bevacizumab and central nervous system (CNS) hemorrhage. Cancer Chemother Pharmacol 71:1561–1565CrossRef
32.
Zurück zum Zitat Zuo P-Y, Chen X-L, Liu Y-W et al (2014) Increased risk of cerebrovascular events in patients with cancer treated with bevacizumab: a meta-analysis. PLoS One 9:e102484CrossRef Zuo P-Y, Chen X-L, Liu Y-W et al (2014) Increased risk of cerebrovascular events in patients with cancer treated with bevacizumab: a meta-analysis. PLoS One 9:e102484CrossRef
33.
Zurück zum Zitat Hapani S, Sher A, Chu D, Wu S (2010) Increased risk of serious hemorrhage with bevacizumab in cancer patients: a meta-analysis. Oncology 79:27–38CrossRef Hapani S, Sher A, Chu D, Wu S (2010) Increased risk of serious hemorrhage with bevacizumab in cancer patients: a meta-analysis. Oncology 79:27–38CrossRef
34.
Zurück zum Zitat Kamba T, McDonald DM (2007) Mechanisms of adverse effects of anti-VEGF therapy for cancer. Br J Cancer 96:1788–1795CrossRef Kamba T, McDonald DM (2007) Mechanisms of adverse effects of anti-VEGF therapy for cancer. Br J Cancer 96:1788–1795CrossRef
35.
Zurück zum Zitat de Souza JM, Domingues RC, Cruz LCH et al (2008) Susceptibility-weighted imaging for the evaluation of patients with familial cerebral cavernous malformations: a comparison with t2-weighted fast spin-echo and gradient-echo sequences. AJNR Am J Neuroradiol 29:154–158CrossRef de Souza JM, Domingues RC, Cruz LCH et al (2008) Susceptibility-weighted imaging for the evaluation of patients with familial cerebral cavernous malformations: a comparison with t2-weighted fast spin-echo and gradient-echo sequences. AJNR Am J Neuroradiol 29:154–158CrossRef
36.
Zurück zum Zitat de Champfleur NM, Langlois C, Ankenbrandt WJ et al (2011) Magnetic resonance imaging evaluation of cerebral cavernous malformations with susceptibility-weighted imaging. Neurosurgery 68:641–647 discussion 647-648CrossRef de Champfleur NM, Langlois C, Ankenbrandt WJ et al (2011) Magnetic resonance imaging evaluation of cerebral cavernous malformations with susceptibility-weighted imaging. Neurosurgery 68:641–647 discussion 647-648CrossRef
37.
Zurück zum Zitat Bian W, Banerjee S, Kelly DAC et al (2015) Simultaneous imaging of radiation-induced cerebral microbleeds, arteries and veins, using a multiple gradient echo sequence at 7 Tesla. J Magn Reson Imaging JMRI 42:269–279CrossRef Bian W, Banerjee S, Kelly DAC et al (2015) Simultaneous imaging of radiation-induced cerebral microbleeds, arteries and veins, using a multiple gradient echo sequence at 7 Tesla. J Magn Reson Imaging JMRI 42:269–279CrossRef
38.
Zurück zum Zitat Jeerakathil T, Wolf PA, Beiser A et al (2004) Cerebral microbleeds: prevalence and associations with cardiovascular risk factors in the Framingham Study. Stroke 35:1831–1835CrossRef Jeerakathil T, Wolf PA, Beiser A et al (2004) Cerebral microbleeds: prevalence and associations with cardiovascular risk factors in the Framingham Study. Stroke 35:1831–1835CrossRef
39.
Zurück zum Zitat Tsushima Y, Tanizaki Y, Aoki J, Endo K (2002) MR detection of microhemorrhages in neurologically healthy adults. Neuroradiology 44:31–36CrossRef Tsushima Y, Tanizaki Y, Aoki J, Endo K (2002) MR detection of microhemorrhages in neurologically healthy adults. Neuroradiology 44:31–36CrossRef
Metadaten
Titel
Remote brain microhaemorrhages may predict haematoma in glioma patients treated with radiation therapy
verfasst von
Augustin Lecler
Frédérique Charbonneau
Dimitri Psimaras
Marie-Astrid Metten
Antoine Gueguen
Khe Hoang Xuan
Loic Feuvret
Julien Savatovsky
Publikationsdatum
12.04.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 10/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5356-8

Weitere Artikel der Ausgabe 10/2018

European Radiology 10/2018 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.