Evaluation of brain edema formation defined by MRI after LINAC-based stereotactic radiosurgery

  • Maciej Harat Department of Radiotherapy, Franciszek Łukaszczyk Oncology Centre,
  • Andrzej Lebioda Department of Oncology and Brachytherapy, The Franciszek Lukaszczyk Oncology Center, Bydgoszcz, Poland.
  • Judyta Lasota Department of Medical Physics, The Franciszek Lukaszczyk Oncology Center, Bydgoszcz, Poland.
  • Roman Makarewicz Department of Oncology and Brachytherapy, Nicolaus Copernicus University, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland;

Abstract

Background and Purpose: Peri-lesional edema is a serious and well-known complication of stereotactic radiosurgery (SRS). Here we evaluated edema risk after SRS and assessed its formation and resolution dynamics.

Materials and methods: 107 patients underwent SRS for heterogeneous diagnoses: 34 (29%) with arteriovenous malformations, 38 (35%) with meningiomas, 16 (15%) with metastatic tumors, 16 (15%) with acoustic neuromas, 3 with (3%) cavernomas, and 2 (2%) each with anaplastic astrocytomas and anaplastic oligoastrocytomas. Edema area was delineated in MRI T2-FLAIR sequences 0, 6, 12, 18, 24, 30, and 38 months after treatment. Lesion location was defined as either above (n=80) or below (n=32) the “Frankfurt modified line” (FML).

Results: 17% of patients developed or had worsening post-treatment edema. Edema volume was maximal at 6 months (mean 7.2, SD 1.2) post radiosurgery. Post-SRS edema was 5.1 (1.06-24.53) times more likely in patients with lesions above the FML. There was no association between edema development and age, PTV size, number of beams, and diagnosis (p=0.07).

Conclusions: Radiosurgery-associated edema develops within 6 months of treatment and decreases over time. Edema occurrence is strongly related to lesion location, and its presence is much more likely when the treated lesions are situated above the Frankfurt line.

Published
2017-06-07
How to Cite
Harat, M., Lebioda, A., Lasota, J., & Makarewicz, R. (2017). Evaluation of brain edema formation defined by MRI after LINAC-based stereotactic radiosurgery. Radiology and Oncology, 51(2). Retrieved from https://radioloncol.com/index.php/ro/article/view/2683
Section
Clinical oncology