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Asymptomatic Radiation-induced Telangiectasia in Children after Cranial Irradiation: Frequency, Latency, and Dose Relation¹

¹ From the Department of Radiology, Kanagawa Childrens’ Medical Center, Yokohama, Japan (S.K., N.A., M.H., Y.O., K.F.); and Department of Radiology, Yokohama City University School of Medicine, 3–9 Fukuura Kanazawa-ku, Yokohama 236-0004, Japan (S.K., N.A., M.H., Y.O., T.I.). Received September 6, 2002; revision requested November 18; final revision received April 14, 2003; accepted June 10. Address correspondence to S.K. (e-mail: s-koike@ga2.so-net.ne.jp).

PURPOSE: To determine the frequency, dose relation, and latency of radiation-induced telangiectasias in children after cranial irradiation.

MATERIALS AND METHODS: The authors identified 90 children who had undergone cranial irradiation between 1981 and 2001 and undergone magnetic resonance (MR) imaging with follow-up for at least 6 months. Patients were assigned to low-dose (LD) and high-dose (HD) groups. All 24 children in the LD group received a radiation dose of 18.0 or 19.8 Gy. The 66 patients in the HD group received a dose of 32.0 Gy or greater. Telangiectasias were defined as small low-signal-intensity foci on intermediate- or T2-weighted MR images. For the patients who underwent serial MR imaging, the first depicted appearance of each telangiectatic lesion was recorded. Statistical analyses were performed.

RESULTS: Telangiectasias in at least one area were observed in 18 (20%) patients. The frequency of telangiectasia was 13% (three of 24 patients) in the LD group as compared with 23% (15 of 66 patients) in the HD group; this difference was not significant (P = .22, Fisher exact test). In 12 patients (one from LD and 11 from HD group) who underwent serial MR imaging follow-up for up to 10 years (mean, 8.1 years), a total of 31 lesions were detected. Twelve (39%) of these lesions were detected by the 3rd year, and 21 (68%) were evident by the 5th year. Six (50%) of the 12 patients who underwent serial MR imaging had telangiectatic foci after 5 years.

CONCLUSION: Radiation-induced telangiectasia appears to occur in at least 20% of children who undergo cranial irradiation. In this small series, higher radiation dose was not significantly associated with higher frequency of telangiectasia, although there was a trend in this direction.

© RSNA, 2003

Index terms: Brain, MR, 13.121411, 13.121416 • Radiations, injurious effects, complications of therapeutic radiology, 13.47 • Telangiectasia, 13.47, 13.759 • Therapeutic radiology, in infants and children

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