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Research ArticleSpine

Radiosurgery for Metastatic Spinal Tumors: Follow-Up MR Findings

Y.J. Hwang, M.-J. Sohn, B.H. Lee, S.Y. Kim, J.W. Seo, Y.H. Han, J.Y. Lee, S.J. Cha and Y.H. Kim
American Journal of Neuroradiology February 2012, 33 (2) 382-387; DOI: https://doi.org/10.3174/ajnr.A2760
Y.J. Hwang
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M.-J. Sohn
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B.H. Lee
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S.Y. Kim
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J.W. Seo
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Y.H. Han
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J.Y. Lee
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S.J. Cha
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Y.H. Kim
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  • Fig 1.
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    Fig 1.

    Four types of T2 signal intensity changes after radiosurgery. A, Type 1: No changes in T2 signal intensity; 67-year-old man with prostate cancer, initial and 3-month follow-up images. B, Type 2: Increase homogeneously in T2 signal intensity; 79- year-old woman with thyroid carcinoma, initial and 7-month follow-up images. C, Type 3: Increase in T2 signal intensity with dark signal intensity; 78-year-old woman with colon cancer, initial and 12-month follow-up images. D, Type 4: Totally dark signal intensity; 54-year-old man with lung cancer, initial and 2-month follow-up images.

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    Fig 2.

    Initial and 27-month follow-up MR and CT images in 52-year-old man with lung cancer. A and B, T2 signal intensities of metastatic lesion in L3 body and right pedicle increased and intermixed with dark signal intensity on T2-weighted axial and sagittal images. C, Sclerotic changes are seen on follow-up CT image.

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    Fig 3.

    Expanded appearance with progressed sclerotic change. Initial and 11-month follow-up MR and CT images in 47-year-old woman with breast cancer. A, Signal intensity of metastatic lesion changed to dark signal intensity and area of signal intensity changes seemed to be increased on T2-weighted axial image. B, Contrast enhancement was not seen on contrast-enhanced T1 axial images. C, On CT image, sclerotic changes progressed at the periphery of the lesion.

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    Fig 4.

    Tumor growth without changes in T2 signal intensity and contrast enhancement pattern. Initial and 2-month follow-up MR images in 47-year-old man with hepatocellular carcinoma. A, T2 signal intensity shows no significant interval change on follow-up T2 sagittal image. B, There was also no significant interval change in contrast enhancement pattern on contrast-enhanced T1-weighted axial image, but tumor volume slightly increased with compression of dural sac.

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    Fig 5.

    Initial local control, with the subsequent growth of new lesions at the periphery of the tumors. Initial and 8-month follow-up T2 axial images in a 47-year-old man with hepatocellular carcinoma. Tumor volume in posterior compartment was decreased (arrow), but the tumor grew at the periphery of spinal body (arrowhead).

Tables

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    Table 1:

    Definitions of 3 groups for volume changes and 4 types of T2 signal changes

    Changes
    Group 1Decreased in volume
    Group 2Unchanged in volume
    Group 3Increased in volume
    Type 1No changes in T2 signal intensity
    Type 2Increase in T2 signal intensity
    Type 3Increase in T2 signal intensity intermixed with dark signal intensity
    Type 4Changed to totally dark signal intensity
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    Table 2:

    Volumetric changes of each group

    Pretreatment Volume (mm3)Posttreatment Volume (mm3)Ratio
    Group 1 (n = 32)64,742.39 (1274–423,401)42,750.41 (441–257,075)0.65 (0.08–0.88)
    Group 2 (n = 39)19,906.46 (510–112,890)19,337.26 (515–120,200)0.98 (0.9–1.08)
    Group 3 (n = 8)39,051.75 (1292–136,909)54,334.00 (1357–169,066)1.60 (1.17–2.82)
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    Table 3:

    Changes in T2 signal intensity and contrast enhancement patterns

    Group 1 (n = 32) Contrast EnhancementGroup 2 (n = 39) Contrast EnhancementGroup 3 (n = 8) Contrast Enhancement
    DecreasedPersistentDecreasedPersistentDecreasedPersistent
    Type 1 (n = 4)000202
    Type 2 (n = 3)200100
    Type 3 (n = 68)27136040
    Type 4 (n = 4)200020
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American Journal of Neuroradiology: 33 (2)
American Journal of Neuroradiology
Vol. 33, Issue 2
1 Feb 2012
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Cite this article
Y.J. Hwang, M.-J. Sohn, B.H. Lee, S.Y. Kim, J.W. Seo, Y.H. Han, J.Y. Lee, S.J. Cha, Y.H. Kim
Radiosurgery for Metastatic Spinal Tumors: Follow-Up MR Findings
American Journal of Neuroradiology Feb 2012, 33 (2) 382-387; DOI: 10.3174/ajnr.A2760

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Radiosurgery for Metastatic Spinal Tumors: Follow-Up MR Findings
Y.J. Hwang, M.-J. Sohn, B.H. Lee, S.Y. Kim, J.W. Seo, Y.H. Han, J.Y. Lee, S.J. Cha, Y.H. Kim
American Journal of Neuroradiology Feb 2012, 33 (2) 382-387; DOI: 10.3174/ajnr.A2760
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