BACKGROUND AND PURPOSE: Methotrexate is a major cause of treatment-related acute neurotoxicity in children with hematologic malignancies. The purpose of this study was to investigate whether diffusion-weighted MR imaging (DWI) detects acute methotrexate white matter neurotoxicity in this patient population. METHODS: Six children-three female and three male-with hematologic malignancies were studied at time of onset of neurologic dysfunction during the delayed intensification or consolidation phase of therapy, when intensive intrathecal methotrexate is given. MR imaging including DWI was performed on 1.5 T MR scanners. RESULTS: DWI demonstrated abnormal restriction of motion of water in the centrum semiovale in all six patients. This finding correlated to the acute onset of hemiparesis or aphasia. Fluid-attenuated inversion recovery imaging was not positive at this time, but it was positive in all five patients in whom follow-up imaging was performed. CONCLUSION: Early detection of methotrexate white matter injury by DWI has the potential to alert the oncologist to this event and provide a technique by which treatment of neurotoxicity can be monitored.
BACKGROUND AND PURPOSE:Methotrexate is a major cause of treatment-related acute neurotoxicity in children with hematologic malignancies. The purpose of this study was to investigate whether diffusion-weighted MR imaging (DWI) detects acute methotrexatewhite matter neurotoxicity in this patient population. METHODS: Six children-three female and three male-with hematologic malignancies were studied at time of onset of neurologic dysfunction during the delayed intensification or consolidation phase of therapy, when intensive intrathecal methotrexate is given. MR imaging including DWI was performed on 1.5 T MR scanners. RESULTS: DWI demonstrated abnormal restriction of motion of water in the centrum semiovale in all six patients. This finding correlated to the acute onset of hemiparesis or aphasia. Fluid-attenuated inversion recovery imaging was not positive at this time, but it was positive in all five patients in whom follow-up imaging was performed. CONCLUSION: Early detection of methotrexatewhite matter injury by DWI has the potential to alert the oncologist to this event and provide a technique by which treatment of neurotoxicity can be monitored.
Authors: Javier M Romero; Pamela W Schaefer; P Ellen Grant; Lino Becerra; R Gilberto González Journal: Neuroimaging Clin N Am Date: 2002-02 Impact factor: 2.264
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Authors: K Matsumoto; S Takahashi; A Sato; M Imaizumi; S Higano; K Sakamoto; H Asakawa; K Tada Journal: Int J Radiat Oncol Biol Phys Date: 1995-07-15 Impact factor: 7.038
Authors: N D Sabin; Y T Cheung; W E Reddick; D Bhojwani; W Liu; J O Glass; T M Brinkman; S N Hwang; D Srivastava; C-H Pui; L L Robison; M M Hudson; K R Krull Journal: AJNR Am J Neuroradiol Date: 2018-09-13 Impact factor: 3.825
Authors: Maria Camilla Rossi Espagnet; Luca Pasquini; Antonio Napolitano; Antonella Cacchione; Angela Mastronuzzi; Roberta Caruso; Paolo Tomà; Daniela Longo Journal: Pediatr Radiol Date: 2016-12-09