No abstract

While the prognosis of acute childhood leukemia has improved, long-term survivors are increasingly experiencing late effects of the treatment. Cranially irradiated survivors are predisposed to the development of CNS tumors. Our aim was to describe the incidence of secondary brain tumors and to define the significance of treatment-related risk factors and host characteristics in a cohort of childhood leukemia survivors. Our cohort consisted of 60 consecutive cranially irradiated adult survivors of childhood leukemia treated in Oulu University Hospital (Oulu, Finland); MRI of the brain was performed on 49. The sites of the tumors, their histology, and details of the leukemia treatment were determined. Of the 49 patients, 11 (22%) 1-8 years of age at the time of diagnosis developed meningioma later in life, while no other brain tumors were seen. In this cohort, the development of meningioma seemed to show undisputable linkage with long latency periods (mean, 25 years; range, 14-34 years) and an increasing incidence 20 years after the treatment (47%). Three patients had multiple meningiomas, two had recurrent disease, and one had an atypical meningioma. Age at the time of irradiation, gender, or cumulative doses of chemotherapeutic agents showed no significant association with the development of meningiomas. The high incidence of meningiomas in this study was associated with long follow-up periods. Although the cohort is small, it seems probable that the increasing incidence of meningioma will shadow the future of cranially irradiated leukemia survivors. Systematic brain imaging after the treatment is therefore justifiable.

We suggest that decreased ADC values reflect the lost integrity of the intervertebral disc. ADC measurements at MR may prove sensitive depicting of early degenerative changes in vertebral discs.

Apparent diffusion coefficient values (ADC) of healthy intervertebral discs of young volunteers in the thoracolumbar spine were determined using a single‐shot EPI sequence. ADCz was in the lumbar spine slightly higher than ADCx or ADCy. In vivo diffusion measurements of intervertebral discs may offer a novel diagnostic tool to evaluate disc diseases in early phases. J. Magn. Reson. Imaging 2000;12:255–260. © 2000 Wiley‐Liss, Inc.