The Central Vein Sign as a Radiologic Tool to Predict the Diagnosis of Radiation Necrosis in Intracranial Metastatic Cancer Patients

Radiosurgery (SRS) is a primary treatment for intracranial metastatic disease, but it can lead to cerebral radiation necrosis (RN) in approximately 25% of cases. Unlike tumor progression (TP), which indicates a lack of response to treatment, RN suggests an effective SRS response. Differentiating RN...

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Main Authors: Joseph P. Antonios, Nana Adenu-Mensah, Brianna C. Theriault, Miguel Millares-Chavez, Anita Huttner, Mariam Aboian, Veronica L. Chiang
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Clinical and Translational Neuroscience
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Online Access:https://www.mdpi.com/2514-183X/9/1/10
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author Joseph P. Antonios
Nana Adenu-Mensah
Brianna C. Theriault
Miguel Millares-Chavez
Anita Huttner
Mariam Aboian
Veronica L. Chiang
author_facet Joseph P. Antonios
Nana Adenu-Mensah
Brianna C. Theriault
Miguel Millares-Chavez
Anita Huttner
Mariam Aboian
Veronica L. Chiang
author_sort Joseph P. Antonios
collection DOAJ
description Radiosurgery (SRS) is a primary treatment for intracranial metastatic disease, but it can lead to cerebral radiation necrosis (RN) in approximately 25% of cases. Unlike tumor progression (TP), which indicates a lack of response to treatment, RN suggests an effective SRS response. Differentiating RN from TP is challenging using standard radiological imaging, often necessitating surgical biopsy. This study investigates the utility of the central vein sign (CVS), a novel MRI biomarker associated with immune infiltrate-rich perivascular spaces, to differentiate RN from TP. Overall, our findings suggest that pre-SRS CVS could serve as a non-invasive marker to distinguish RN from TP, aiding in treatment decisions. Further research is needed to validate CVS as a predictive marker in larger patient cohorts and explore its potential in guiding cancer therapy response.
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series Clinical and Translational Neuroscience
spelling doaj-art-423c0960cf694e9fbd765dcee860a6f22025-08-20T02:42:42ZengMDPI AGClinical and Translational Neuroscience2514-183X2025-02-01911010.3390/ctn9010010The Central Vein Sign as a Radiologic Tool to Predict the Diagnosis of Radiation Necrosis in Intracranial Metastatic Cancer PatientsJoseph P. Antonios0Nana Adenu-Mensah1Brianna C. Theriault2Miguel Millares-Chavez3Anita Huttner4Mariam Aboian5Veronica L. Chiang6Department of Neurosurgery, Yale School of Medicine, Yale University, New Haven, CT 06519, USADepartment of Neurosurgery, Yale School of Medicine, Yale University, New Haven, CT 06519, USADepartment of Neurosurgery, Yale School of Medicine, Yale University, New Haven, CT 06519, USADepartment of Neurosurgery, Yale School of Medicine, Yale University, New Haven, CT 06519, USADepartment of Pathology, Yale School of Medicine, Yale University, New Haven, CT 06519, USADepartment of Radiology, Yale School of Medicine, Yale University, New Haven, CT 06519, USADepartment of Neurosurgery, Yale School of Medicine, Yale University, New Haven, CT 06519, USARadiosurgery (SRS) is a primary treatment for intracranial metastatic disease, but it can lead to cerebral radiation necrosis (RN) in approximately 25% of cases. Unlike tumor progression (TP), which indicates a lack of response to treatment, RN suggests an effective SRS response. Differentiating RN from TP is challenging using standard radiological imaging, often necessitating surgical biopsy. This study investigates the utility of the central vein sign (CVS), a novel MRI biomarker associated with immune infiltrate-rich perivascular spaces, to differentiate RN from TP. Overall, our findings suggest that pre-SRS CVS could serve as a non-invasive marker to distinguish RN from TP, aiding in treatment decisions. Further research is needed to validate CVS as a predictive marker in larger patient cohorts and explore its potential in guiding cancer therapy response.https://www.mdpi.com/2514-183X/9/1/10RN (radiation necrosis)TP (tumor progression)SRS (stereotactic radiosurgery)
spellingShingle Joseph P. Antonios
Nana Adenu-Mensah
Brianna C. Theriault
Miguel Millares-Chavez
Anita Huttner
Mariam Aboian
Veronica L. Chiang
The Central Vein Sign as a Radiologic Tool to Predict the Diagnosis of Radiation Necrosis in Intracranial Metastatic Cancer Patients
Clinical and Translational Neuroscience
RN (radiation necrosis)
TP (tumor progression)
SRS (stereotactic radiosurgery)
title The Central Vein Sign as a Radiologic Tool to Predict the Diagnosis of Radiation Necrosis in Intracranial Metastatic Cancer Patients
title_full The Central Vein Sign as a Radiologic Tool to Predict the Diagnosis of Radiation Necrosis in Intracranial Metastatic Cancer Patients
title_fullStr The Central Vein Sign as a Radiologic Tool to Predict the Diagnosis of Radiation Necrosis in Intracranial Metastatic Cancer Patients
title_full_unstemmed The Central Vein Sign as a Radiologic Tool to Predict the Diagnosis of Radiation Necrosis in Intracranial Metastatic Cancer Patients
title_short The Central Vein Sign as a Radiologic Tool to Predict the Diagnosis of Radiation Necrosis in Intracranial Metastatic Cancer Patients
title_sort central vein sign as a radiologic tool to predict the diagnosis of radiation necrosis in intracranial metastatic cancer patients
topic RN (radiation necrosis)
TP (tumor progression)
SRS (stereotactic radiosurgery)
url https://www.mdpi.com/2514-183X/9/1/10
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