Incidental detection of late subsequent intracranial neoplasms with magnetic resonance imaging among adult survivors of childhood cancer

Noah D. Sabin, Aimee K. Santucci, Paul Klimo, Melissa M. Hudson, Deokumar Srivastava, Nan Zhang, Larry E. Kun, Matthew J. Krasin, Ching Hon Pui, Zoltan Patay, Wilburn E. Reddick, Robert J. Ogg, Claudia M. Hillenbrand, Leslie L. Robison, Kevin R. Krull, Gregory Armstrong

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Abstract

Purpose: Survivors of childhood cancer are at an increased risk of developing subsequent neoplasms. In long-term survivors of childhood malignancies treated with and without cranial radiation therapy (CRT), undergoing unenhanced magnetic resonance imaging (MRI) of the brain, we estimated detection of intracranial neoplasms. Methods: To investigate neurocognitive outcomes, 219 survivors of childhood cancer underwent unenhanced screening MRI of the brain. Of the survivors, 164 had been treated for acute lymphoblastic leukemia (ALL) (125 received CRT) and 55 for Hodgkin lymphoma (HL) (none received CRT). MRI examinations were reviewed and systematically coded by a single neuroradiologist. Demographic and treatment characteristics were compared for survivors with and without subsequent neoplasms. Results: Nineteen of the 219 survivors (8.7 %) had a total of 31 subsequent intracranial neoplasms identified by neuroimaging at a median time of 25 years (range 12-46 years) from diagnosis. All neoplasms occurred after CRT, except for a single vestibular schwannoma within the cervical radiation field in a HL survivor. The prevalence of subsequent neoplasms after CRT exposure was 14.4 % (18 of 125). By noncontrast MRI, intracranial neoplasms were most suggestive of meningiomas. Most patients presented with no specific, localizing neurological complaints. In addition to the schwannoma, six tumors were resected based on results of MRI screening, all of which were meningiomas on histologic review. Conclusion: Unenhanced brain MRI of long-term survivors of childhood cancer detected a substantial number of intracranial neoplasms. Screening for early detection of intracranial neoplasms among aging survivors of childhood cancer who received CRT should be evaluated. Implications for Cancer Survivors: The high prevalence of incidentally detected subsequent intracranial neoplasms after CRT in long-term survivors of childhood cancer and the minimal symptoms reported by those with intracranial tumors in our study indicate that brain MRI screening of long-term survivors who received CRT may be warranted. Prospective studies of such screening are needed.

Original languageEnglish (US)
Pages (from-to)329-335
Number of pages7
JournalJournal of Cancer Survivorship
Volume8
Issue number3
DOIs
StatePublished - Jan 1 2014

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Brain Neoplasms
Survivors
Magnetic Resonance Imaging
Radiotherapy
Neoplasms
Brain
Meningioma
Hodgkin Disease
Acoustic Neuroma
Neurilemmoma
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Neuroimaging
Demography
Prospective Studies
Radiation

All Science Journal Classification (ASJC) codes

  • Oncology
  • Oncology(nursing)

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Incidental detection of late subsequent intracranial neoplasms with magnetic resonance imaging among adult survivors of childhood cancer. / Sabin, Noah D.; Santucci, Aimee K.; Klimo, Paul; Hudson, Melissa M.; Srivastava, Deokumar; Zhang, Nan; Kun, Larry E.; Krasin, Matthew J.; Pui, Ching Hon; Patay, Zoltan; Reddick, Wilburn E.; Ogg, Robert J.; Hillenbrand, Claudia M.; Robison, Leslie L.; Krull, Kevin R.; Armstrong, Gregory.

In: Journal of Cancer Survivorship, Vol. 8, No. 3, 01.01.2014, p. 329-335.

Research output: Contribution to journalArticle

Sabin, ND, Santucci, AK, Klimo, P, Hudson, MM, Srivastava, D, Zhang, N, Kun, LE, Krasin, MJ, Pui, CH, Patay, Z, Reddick, WE, Ogg, RJ, Hillenbrand, CM, Robison, LL, Krull, KR & Armstrong, G 2014, 'Incidental detection of late subsequent intracranial neoplasms with magnetic resonance imaging among adult survivors of childhood cancer', Journal of Cancer Survivorship, vol. 8, no. 3, pp. 329-335. https://doi.org/10.1007/s11764-014-0344-8
Sabin, Noah D. ; Santucci, Aimee K. ; Klimo, Paul ; Hudson, Melissa M. ; Srivastava, Deokumar ; Zhang, Nan ; Kun, Larry E. ; Krasin, Matthew J. ; Pui, Ching Hon ; Patay, Zoltan ; Reddick, Wilburn E. ; Ogg, Robert J. ; Hillenbrand, Claudia M. ; Robison, Leslie L. ; Krull, Kevin R. ; Armstrong, Gregory. / Incidental detection of late subsequent intracranial neoplasms with magnetic resonance imaging among adult survivors of childhood cancer. In: Journal of Cancer Survivorship. 2014 ; Vol. 8, No. 3. pp. 329-335.
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abstract = "Purpose: Survivors of childhood cancer are at an increased risk of developing subsequent neoplasms. In long-term survivors of childhood malignancies treated with and without cranial radiation therapy (CRT), undergoing unenhanced magnetic resonance imaging (MRI) of the brain, we estimated detection of intracranial neoplasms. Methods: To investigate neurocognitive outcomes, 219 survivors of childhood cancer underwent unenhanced screening MRI of the brain. Of the survivors, 164 had been treated for acute lymphoblastic leukemia (ALL) (125 received CRT) and 55 for Hodgkin lymphoma (HL) (none received CRT). MRI examinations were reviewed and systematically coded by a single neuroradiologist. Demographic and treatment characteristics were compared for survivors with and without subsequent neoplasms. Results: Nineteen of the 219 survivors (8.7 {\%}) had a total of 31 subsequent intracranial neoplasms identified by neuroimaging at a median time of 25 years (range 12-46 years) from diagnosis. All neoplasms occurred after CRT, except for a single vestibular schwannoma within the cervical radiation field in a HL survivor. The prevalence of subsequent neoplasms after CRT exposure was 14.4 {\%} (18 of 125). By noncontrast MRI, intracranial neoplasms were most suggestive of meningiomas. Most patients presented with no specific, localizing neurological complaints. In addition to the schwannoma, six tumors were resected based on results of MRI screening, all of which were meningiomas on histologic review. Conclusion: Unenhanced brain MRI of long-term survivors of childhood cancer detected a substantial number of intracranial neoplasms. Screening for early detection of intracranial neoplasms among aging survivors of childhood cancer who received CRT should be evaluated. Implications for Cancer Survivors: The high prevalence of incidentally detected subsequent intracranial neoplasms after CRT in long-term survivors of childhood cancer and the minimal symptoms reported by those with intracranial tumors in our study indicate that brain MRI screening of long-term survivors who received CRT may be warranted. Prospective studies of such screening are needed.",
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T1 - Incidental detection of late subsequent intracranial neoplasms with magnetic resonance imaging among adult survivors of childhood cancer

AU - Sabin, Noah D.

AU - Santucci, Aimee K.

AU - Klimo, Paul

AU - Hudson, Melissa M.

AU - Srivastava, Deokumar

AU - Zhang, Nan

AU - Kun, Larry E.

AU - Krasin, Matthew J.

AU - Pui, Ching Hon

AU - Patay, Zoltan

AU - Reddick, Wilburn E.

AU - Ogg, Robert J.

AU - Hillenbrand, Claudia M.

AU - Robison, Leslie L.

AU - Krull, Kevin R.

AU - Armstrong, Gregory

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Purpose: Survivors of childhood cancer are at an increased risk of developing subsequent neoplasms. In long-term survivors of childhood malignancies treated with and without cranial radiation therapy (CRT), undergoing unenhanced magnetic resonance imaging (MRI) of the brain, we estimated detection of intracranial neoplasms. Methods: To investigate neurocognitive outcomes, 219 survivors of childhood cancer underwent unenhanced screening MRI of the brain. Of the survivors, 164 had been treated for acute lymphoblastic leukemia (ALL) (125 received CRT) and 55 for Hodgkin lymphoma (HL) (none received CRT). MRI examinations were reviewed and systematically coded by a single neuroradiologist. Demographic and treatment characteristics were compared for survivors with and without subsequent neoplasms. Results: Nineteen of the 219 survivors (8.7 %) had a total of 31 subsequent intracranial neoplasms identified by neuroimaging at a median time of 25 years (range 12-46 years) from diagnosis. All neoplasms occurred after CRT, except for a single vestibular schwannoma within the cervical radiation field in a HL survivor. The prevalence of subsequent neoplasms after CRT exposure was 14.4 % (18 of 125). By noncontrast MRI, intracranial neoplasms were most suggestive of meningiomas. Most patients presented with no specific, localizing neurological complaints. In addition to the schwannoma, six tumors were resected based on results of MRI screening, all of which were meningiomas on histologic review. Conclusion: Unenhanced brain MRI of long-term survivors of childhood cancer detected a substantial number of intracranial neoplasms. Screening for early detection of intracranial neoplasms among aging survivors of childhood cancer who received CRT should be evaluated. Implications for Cancer Survivors: The high prevalence of incidentally detected subsequent intracranial neoplasms after CRT in long-term survivors of childhood cancer and the minimal symptoms reported by those with intracranial tumors in our study indicate that brain MRI screening of long-term survivors who received CRT may be warranted. Prospective studies of such screening are needed.

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