Semin Neurol 2012; 32(04): 476-486
DOI: 10.1055/s-0032-1331817
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Imaging Findings in Cancer Therapy-Associated Neurotoxicity

Isabel C. Arrillaga-Romany
1   Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts, Department of Neurology, Harvard Medical School
,
Jorg Dietrich
1   Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts, Department of Neurology, Harvard Medical School
› Author Affiliations
Further Information

Publication History

Publication Date:
29 January 2013 (online)

Abstract

Cancer therapy can cause several neurotoxic syndromes that are associated with distinct findings on cranial imaging. With the use of more aggressive and combined treatment modalities in oncology and prolonged overall patient survival, neurotoxicity has been reported with increasing frequency in patients with brain cancer and malignancies outside the nervous system. Both cranial irradiation and chemotherapy can be harmful to the nervous system, and be associated with acute and chronic nervous system toxicity. Here we discuss features and imaging characteristics of common neurotoxic syndromes, such as cerebrovascular complications, reversible leukoencephalopathy syndrome, progressive white matter injury, and diffuse brain atrophy. Neurologist and oncologists need to be familiar with the pattern, time course, and evolution of both acute and long-term neurologic complications of cancer therapy. Identification of causative agents and appropriate distinction between treatment-related toxicity and tumor-associated complications are critical steps to improve treatment monitoring and overall patient care.