Challenges in radiological evaluation of brain metastases, beyond progression.

Ortiz de Mendivil, A; Martín-Medina, P; García-Cañamaque, L; Jiménez-Munarriz, B; Ciérvide, R; Diamantopoulos, J

Ortiz de Mendivil, A; Martín-Medina, P; García-Cañamaque, L; Jiménez-Munarriz, B; Ciérvide, R; Diamantopoulos, J.

Afiliación

Ortiz de Mendivil A; Servicio de Radiodiagnóstico, Sección de Neurorradiología, Hospital Universitario HM Sanchinarro, Madrid, Spain. Electronic address: aomendivil@hmhospitales.com.
Martín-Medina P; Servicio de Radiodiagnóstico, Sección de Neurorradiología, Hospital Universitario HM Sanchinarro, Madrid, Spain.
García-Cañamaque L; Servicio de Medicina Nuclear, HM Hospitales, Madrid, Spain.
Jiménez-Munarriz B; Servicio de Oncología Médica, Hospital Universitario HM Sanchinarro, Madrid, Spain.
Ciérvide R; Servicio de Oncología Radioterápica, Hospital Universitario HM Sanchinarro, Madrid, Spain.
Diamantopoulos J; Servicio de Neurocirugía, HM Hospitales, Madrid, Spain.

Radiologia (Engl Ed) ; 66(2): 166-180, 2024.

Article en En | MEDLINE | ID: mdl-38614532

ABSTRACT

ABSTRACT

MRI is the cornerstone in the evaluation of brain metastases. The clinical challenges lie in discriminating metastases from mimickers such as infections or primary tumors and in evaluating the response to treatment. The latter sometimes leads to growth, which must be framed as pseudo-progression or radionecrosis, both inflammatory phenomena attributable to treatment, or be considered as recurrence. To meet these needs, imaging techniques are the subject of constant research. However, an exponential growth after radiotherapy must be interpreted with caution, even in the presence of results suspicious of tumor progression by advanced techniques, because it may be due to inflammatory changes. The aim of this paper is to familiarize the reader with inflammatory phenomena of brain metastases treated with radiotherapy and to describe two related radiological signs "the inflammatory cloud" and "incomplete ring enhancement", in order to adopt a conservative management with close follow-up.

Asunto(s)

Neoplasias Encefálicas; Traumatismos por Radiación; Radiología; Humanos; Radiografía; Neoplasias Encefálicas/diagnóstico por imagen; Tratamiento Conservador

Palabras clave

Anomalía inducida por radiación; Diffusion MRI; Incomplete ring enhancement sign; Inflammatory Cloud sign; Linfocitos infiltrantes de tumor; Local neoplasm recurrence; Magnetic resonance imaging; Malignant brain neoplasm; Multiparametric MRI; Neoplasia cerebral maligna; Perfusion magnetic resonance imaging; Radiation-Induced abnormality; Radiocirugía estereotáxica; Recurrencia tumoral local; Resonancia magnética; Resonancia magnética de difusión; Resonancia magnética de perfusión; Resonancia magnética multiparamétrica; Signo de la nube inflamatoria; Signo del realce en anillo incompleto; Stereotactic radiosurgery; Tumor-Infiltrating lymphocytes

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos por Radiación / Radiología / Neoplasias Encefálicas Límite: Humans Idioma: En Revista: Radiologia (Engl Ed) Año: 2024 Tipo del documento: Article Pais de publicación: España

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