PT  - JOURNAL ARTICLE
AU  - Jäger, H R
AU  - Williams, E J
AU  - Savage, D G
AU  - Rule, S A
AU  - Hajnal, J V
AU  - Sikora, K
AU  - Goldman, J M
AU  - Bydder, G M
TI  - Assessment of brain changes with registered MR before and after bone marrow transplantation for chronic myeloid leukemia.
DP  - 1996 Aug 01
TA  - American Journal of Neuroradiology
PG  - 1275--1282
VI  - 17
IP  - 7
4099  - http://www.ajnr.org/content/17/7/1275.short
4100  - http://www.ajnr.org/content/17/7/1275.full
SO  - Am. J. Neuroradiol.1996 Aug 01; 17
AB  - PURPOSE To determine the frequency and nature of changes to the brain resulting from chemotherapy, radiation therapy, and bone marrow transplantation for chronic myeloid leukemia and to compare the sensitivity of conventional and registered MR scans for detecting these changes.METHODS In 15 patients, conventional T1-weighted, T2-weighted, and fluid-attenuated inversion recovery MR sequences, as well as T1-weighted radio frequency spoiled 3-D volume MR scans were performed before, 4 to 6 days after, and up to 339 days after transplantation (13 allografts, two autografts). A subvoxel registration program was used to match the volume images precisely so that small changes could be detected after subtraction of scans. Five healthy adult control subjects were also studied on two occasions 1 month apart.RESULTS Studies performed 4 to 339 days after transplantation showed ventricular enlargement and cortical atrophy in all 13 patients who had allografts. The changes were evident at 4 to 6 days after transplantation and became more obvious during later follow-up examinations. Similar changes were seen in one patient with an autograft but no significant change was seen in the other patient with an autograft or in the five control subjects. Accurately registered volume scans were more sensitive than unregistered conventional scans in detecting early (9/10 versus 0/10), intermediate (12/13 versus 3/12), and late (10/10 versus 4/9) ventricular enlargement on follow-up examinations. The same applied to cortical atrophy (9/10 versus 0/10, 12/13 versus 0/12, and 10/10 versus 0/9).CONCLUSION The specific cause and clinical significance of these changes are uncertain. Subvoxel registration of serial MR images may reveal changes that are poorly seen or not apparent on conventional scans.