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MR findings in methotrexate-induced CNS abnormalities.
1Department of Radiology, Karl-Franzens-University Graz, Medical School, Austria.
AJR. American Journal of Roentgenology
|December 1, 1989
Summary
Magnetic resonance imaging (MRI) can detect brain abnormalities in osteosarcoma patients treated with high-dose methotrexate. These findings, including edema and necrosis, correlate with neurological issues.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Osteosarcoma treatment often involves high-dose methotrexate, a chemotherapy agent with potential neurotoxicity.
- Monitoring central nervous system (CNS) effects is crucial for patients undergoing such treatment.
Observation:
- This study evaluated eight pediatric patients (mean age 14.9 years) with osteosarcoma who received intravenous high-dose methotrexate.
- Brain magnetic resonance imaging (MRI) was performed during or after treatment to assess for treatment-induced abnormalities.
Findings:
- MRI revealed brain abnormalities in four patients, with three exhibiting concurrent neurological dysfunction.
- Pathologic findings on MRI included chronic brain edema (persisting 3-14 months), multifocal white matter necrosis, and deep brain atrophy.
- One case of chronic brain edema was confirmed by autopsy.
Implications:
- MRI is a valuable tool for detecting methotrexate-induced brain abnormalities in osteosarcoma patients.
- Early detection of these CNS changes may aid in managing treatment-related side effects and improving patient outcomes.
- Further research can explore the long-term neurological consequences and optimal management strategies for these MRI findings.