Treatment-Related MR Imaging Findings in Patients with Glioma after Radiotherapy, Chemotherapy, and Biological Therapy

Xiao Li and Fanny Morón

Department of Radiology, Baylor College of Medicine, USA

^*Correspondance to: Fanny Mor�n 

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Abstract:

Patients undergoing radiotherapy, chemotherapy, and biological therapy demonstrate treatmentrelated changes and characteristic magnetic resonance imaging findings. By understanding the various imaging findings, better clinical decisions can be made. Glioblastoma is the most common malignant primary brain tumor. Current standard of care involves surgical resection with first line radiation therapy and concomitant/adjuvant temozolomide chemotherapy and second line anti-angiogenic therapy, bevacizumab, for recurrent glioblastoma. Macdonald‘s criteria were commonly used for assessing treatment response to high-grade glioma therapy. Limitations to these criteria led to the more updated response assessment in neurooncology criteria. Intracranial and regional radiation to the brain often produces a number of significant changes that complicate the assessment of post-treatment outcomes. Leukoencephalopathy is often seen postradiation therapy because white matter is particularly vulnerable to radiation. Radiation necrosis and tumor reoccurrence can both present with contrast enhancement, mass effect and vasogenic edema. Other post-radiation therapy changes include radiation-induced meningioma, cavernous malformation, and micro bleeds. Chemotherapy and biological therapy treatments also create difficulty in post-treatment response interpretation. For example, pseudop rogression is non-tumoral enhancement likely associated with inflammatory local tissue reaction and edema caused by treatments such as temozolomide. On the other hand, pseudo response is post-treatment decrease in contrast enhancement not associated with true tumor reduction.

Keywords:

Abnormal regional wall motion; High sensitivity c-reactive Protein; Hematopoietic stem cell transplantation

Cite the Article:

Li X, Morón F. Treatment-Related MR Imaging Findings in Patients with Glioma after Radiotherapy, Chemotherapy, and Biological Therapy. Clin Oncol. 2016; 1: 1103.