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PubMed1991

Clinical value of PET with 18F-fluorodeoxyglucose and L-methyl-11C-methionine for diagnosis of recurrent brain tumor and radiation injury.

We studied 15 patients clinically suspected to have recurrent brain tumor or radiation injury, using positron emission tomography (PET) with 18F-fluorodeoxyglucose (18FDG) and L-methyl-11C-methionine (11C-Met). PET with 11C-Met (Met-PET) clearly delineated the extent of recurrent brain tumor as focal areas of increased accumulation of 11C-Met, and was useful for early detection of recurrent brain tumor. PET with 18FDG (FDG-PET) showed focal 18FDG-hypermetabolism in one patient with malignant transformation of low grade glioma, and demonstrated its usefulness for evaluation of malignant transformation. 18FDG-hypometabolism was observed in all patients with radiation injury, but was also found in one patient with recurrent malignant brain tumor. 11C-Met uptake in 3 patients with radiation injury was similar to that of the normal cortical tissue. FDG-PET can be used to initially exclude recurrent brain tumor which is seen as 18FDG-hypermetabolism. The combined use of Met-PET in addition to FDG-PET can improve the accuracy of differentiation of recurrent brain tumor with 18FDG-hypometabolism from radiation injury.

Adolescent↗
PubMed1982

The pathogenesis of radiation injury in complex tissues: an overview of problems and probes.

The evaluation of radiation injury in complex organs has tended to lag behind comparable areas of investigative interest. This observation is somewhat surprising in view of the increased use of radiotherapy as a primary or adjuvant mode of therapy for malignant disease. In part, this problem appears to relate to the difficulty of identifying and quantifying the morphologic consequences of radiation injury in complex organs, in which the various component tissues exhibit a broad spectrum of radiosensitivities. Two approaches have been employed to address this problem: (1) utilization of sophisticated probes to evaluate the functional and morphologic sequelae of radiation injury and (2) segmentation of complex tissues into their component parts, which are then evaluated individually. Both approaches are illustrated in the papers presented in this issue. The purpose of this overview is to call attention to some of the attendant difficulties of the former approach, as seen in an ongoing investigative program concerned with radiation injury of the kidney.

Animals↗
PubMedDate not supplied

[Effect of microbial derived agents on the level of blood cytokines, hematological status and survival of mice following combined radiation injury].

Mice models of acute radiation and combined radiation injuries (whole body irradiation + thermal burn) were used for the experiments. Blood serum response of IL-1 beta, TNF-alpha, IL-6, IL-3, and GM-CSF was evaluated after single injection of bacterially derived products (BDPs). As it was established, BDPs revealed different ability for cytokine increasing activity: Imuvert (extract from Serratia marcescens) > synthetic trehalose dicorynomycolate > heat-killed Lactobacillus acidophilus. The capacity of BDPs to enhance survival of animals did not depend on its cytokine-inducing and hematopoietic activities.

Animals↗
PubMedDate not supplied

[Possibility of biological indication of radiation injury from the blood levels of deoxynucleosides and deoxynucleotides in combined radiation-mechanical injuries].

A study was made of the dependence of a total content of deoxynucleosides and deoxynucleotides in blood serum and blood clot leukocytes upon radiation dose and time lapsed after radiation- and radiation-mechanical affection. It was established that after radiation-mechanical affection this dependence was different from that observed after the effect of radiation alone. From the analysis of the data obtained it was inferred that deoxynucleosides and deoxynucleotides could be used for biological indication of radiation damage in conditions of radiation-mechanical affection.

Animals↗
PubMed1992

Protocol for the treatment of radiation injuries.

Despite adequate precautionary measures and high-quality safeguard devices, many accidental radiation exposures continue to occur and may pose greater risks in the future, including radiation exposure in the space environment. The medical management of radiation casualties is of major concern to health care providers. Such medical management was addressed at The First Consensus Development Conference on the Treatment of Radiation Injuries, Washington, DC, 1989. The conference addressed the most appropriate treatment for the hematopoietic and infectious complications that accompany radiation injuries and for combined radiation and traumatic/burn injuries. Based on the evidence presented at the conference, a consensus statement was formulated by expert physicians and scientists. The recommended therapies, including a suggested algorithm incorporating these recommendations for the treatment of radiation injuries, will be discussed.

Anti-Bacterial Agents↗
PubMed1991

[Preventive treatment of local radiation injuries in combined radiotherapy of rectal cancer].

Preventive therapy of local radiation injuries was conducted in 46 patients with inoperable rectal cancer during a course of combined radiotherapy after a radical program. Preventive therapy of local radiation injuries included a general action drug and a local use of ethonium. This course of radiotherapy after a radical program with the delivery of doses up to 90-95 Gy resulted in the reduction of the number of late local radiation injuries.

Adult↗
PubMed2000

Hyperbaric oxygen in the treatment of delayed radiation injuries of the extremities.

Hyperbaric oxygen (HBO2) is used as an adjunct in the treatment of radiation injury at many sites, including the mandible, larynx, chest wall, bladder, and rectum. In these disorders, HBO2 is effective in stimulating neovascularization and reducing fibrosis. No previous publications report the application of HBO2 to radiation injuries of the extremities. From 1979 until 1997, 17 patients were treated at the Southwest Texas Methodist and Nix Hospitals for nonhealing necrotic wounds of the extremities within previously irradiated fields. All but one wound involved a lower extremity. Most of the patients had been irradiated for soft tissue sarcomas or skin cancers. The rest were irradiated for a variety of malignancies. HBO2 was delivered in a multiplace chamber at 2.4 atm abs daily for 90 min of 100% oxygen at pressure. This report is a retrospective, uncontrolled review of these patients. Eleven patients (65%) healed completely whereas five (29%) failed to heal and one (6%) was lost to follow-up. Three (60%) of those who failed were found to have local or distant recurrence of their tumor early in their course of hyperbaric treatment and were discontinued from therapy at that time. When last seen in the clinic, the wound of the patient who was lost to follow-up was improved but not completely healed. Four of those who failed (including the two with local tumor recurrence) required amputation. If we exclude those with active cancer and the patient lost to follow-up, the success rate was 11 of 13 or 85%. HBO2 was applied successfully with complete wound healing and the avoidance of amputation in a majority of these patients. The consequences of failure in patients suffering from radiation necrosis of the extremities (some complicated by the presence of tumor) are significant, with 80% of the five failures requiring amputation. In radiation injuries of the extremities as in delayed radiation injury at other sites, HBO2 is a useful adjunct and should be part of the overall management.

Adult↗
PubMed2005

[Magnetic resonance imaging manifestations of radiation injury in brain stem and cervical spinal cord of nasopharyngeal carcinoma patients after radiotherapy].

BACKGROUND & OBJECTIVE: It is very important to diagnose the radiation injury in brain stem and cervical spinal cord of patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Magnetic resonance imaging (MRI) manifestations of radiation encephalopathy have been widely reported, while those of radiation injury in brain stem and cervical spinal cord have been seldom reported. This study was to analyze the MRI characteristics of radiation injury in brain stem and cervical spinal cord of patients with NPC after radiotherapy. METHODS: MRI was performed in 60 NPC patients 6 months to 5 years after radiotherapy. The imaging sequences included T(1)-weighted image (T(1)WI), T2-weighted image (T(2)WI), fluid attenuated inversion recovery (FLAIR). All patients received T(1)WI contrast-enhanced scanning. RESULTS: Of the 60 patients, 6 had lesions in cervical spinal cord, 54 had lesions in brain stem. Of the 54 cases of radiation injury in brain stem, most lesions located in pons (20 cases), basis pons and medulla oblongata (26 cases), others located in mesencephalon (3 cases), medulla oblongata (5 cases). All lesions showed hypo- or iso-intense signal on T(1)WI, and hyper-intense signal on T(2)WI. After contrast-enhanced scanning, 11 cases (18.3%) had no enhancement; 49 (81.7%) markedly enhanced with 21 cases (42.9%) of homogenous patchy enhancement, and 28 cases (57.1%) of hetergenerous ringed and patchy enhancement. CONCLUSION: MRI shows clearly the radiation injury in brain stem and cervical spinal cord of NPC patients after radiotherapy.

Adult↗
PubMed1999

Late radiation injury to the temporal lobes: morphologic evaluation at MR imaging.

PURPOSE: To study the morphologic characteristics of late radiation injury to the temporal lobes of the brain on magnetic resonance (MR) images. MATERIALS AND METHODS: This was a prospective study involving 34 patients (age range, 37-72 years) with known radiation injury to the temporal lobes from radiation therapy administered 2-10 years previously for nasopharyngeal carcinoma MR imaging was performed with T2-weighted gradient- and spin-echo, gradient-recalled echo, T1-weighted spin-echo, fluid-attenuated inversion-recovery, and T1-weighted postcontrast spin-echo sequences. RESULTS: Radiation injury was present in 57 of the 68 temporal lobes. The white matter lesions in radiation-induced injury were predominantly hyperintense on T2-weighted images, but in 37 (65%) of the 57 lobes, foci with heterogeneous signal intensity consistent with necrosis were detected. In the 57 involved lobes, gray matter lesions were detected in 50 (88%); blood-brain barrier disruption based on parenchymal contrast enhancement, in 51 (89%); and hemosiderin deposits, in 30 (53%). There was a significant correlation between white matter necrosis, gray matter lesions, and blood-brain barrier disruption, all of which were located mainly in the inferior temporal lobes that received the highest radiation dose. CONCLUSION: The lesion components of radiation-induced injury to the temporal lobes at MR imaging were more varied than have been previously described. In addition to the classic white matter lesions, gray matter lesions, blood-brain barrier disruption, and hemosiderin deposition also were frequently seen.

Adult↗
PubMed2005

Diagnostic value of thallium-201 chloride single-photon emission computerized tomography in differentiating tumor recurrence from radiation injury after gamma knife surgery for metastatic brain tumors.

OBJECT: The authors assessed the diagnostic value of 201Tl Cl single-photon emission computerized tomography (SPECT), performed after gamma knife surgery (GKS) for metastatic brain tumors in differentiating tumor recurrence from radiation injury. METHODS: Of 6503 metastatic brain tumors treated with GKS, 201Tl SPECT was required in 72 to differentiate between tumor recurrence and radiation injury. When the Tl index was greater than 5, the lesion was diagnosed as a tumor recurrence. When the index was < 3.0 it was called radiation injury. In cases with a Tl index between 3 and 5, 201Tl SPECT was repeated once per month until the Tl index was greater than 5 or less than 3. If the Tl index fluctuated between 3 and 5 for 2 months, the lesion was diagnosed as radiation injury. The final diagnosis was based on histological examination or clinical course. The sensitivity of the method was 91%; thus 201Tl SPECT is effective for differentiating between tumor recurrence and radiation injury in metastatic brain tumors treated with GKS. Caution is necessary, however, for the following reasons: 1) simple interinstitutional comparisons of Tl indices are not possible because measurement methods are institute specific; 2) steroid administration decreases the Tl index to a variable degree; and 3) a severe radiation injury lesion, as is often seen after repeated GKS or very high dose GKS, may have a Tl index greater than 5. CONCLUSIONS: Used with critical insight 201Tl Cl SPECT can be useful in distinguishing between tumor regrowth and radiation necrosis in patients with cerebral metastases.

Aged↗
PubMed2002

Cu, Fe, Mn, and Zn chelates offer a medicinal chemistry approach to overcoming radiation injury.

This review points out that treatment with essential metalloelement (Cu, Fe, Mn, and Zn) chelates facilitate tissue repair processes required for recovery from radiation injury including survival of lethally irradiated mice and rats. Results of studies pertaining to successful uses of bioavailable essential metalloelement chelates and combinations of them as well as aminothiols, Ca-channel blockers, acyl Melatonin homologs, substituted anilines, and curcumin radioprotectants are included in this review to suggest their use as chelates in overcoming radiation injury. Additional reports document that non-toxic doses of essential metalloelement chelates are effective in increasing survival and repairing radiation injury when administered before irradiation, in the radiation protection paradigm, and effective in increasing survival when used to treat after irradiation, in the radiorecovery paradigm. There are no other agents known to be effective in increasing survival when they are used to treat after irradiation. These approaches to radioprotection and radiorecovery offer promising approaches to facilitating recovery from radiation-induced injury experienced by patients undergoing radiation therapy for their neoplastic disease and by individuals who experience environmental, occupational, or accidental exposure to ionizing radiation. These individuals include those exposed to radiation resulting from nuclear accidents, the use of depleted uranium missiles, and astronauts undertaking space travel. Since there are no existing safe and effective treatments of radiation injury, studies of essential metalloelement chelates and combinations of them, as well as combinations of them with existing radioprotectant aminothiols, Ca-channel blockers, acyl Melatonin homologs, substituted anilines, and curcumin as radioprotectants seem worthwhile.

Animals↗
PubMed1974

Analytic methods for biochemical indicators of radiation injury.

Since the development of biochemical indicators of radiation injury has been hampered often by the lack of simple and rapid methods of determination, techniques for the measurement of 30 urinary compounds are presented. These methods have been in part taken from the literature, in part they have been modified or developed by us. They represent a compromise between speed and simplicity of execution and specificity of assay.

Animals↗