Radiation-induced leukoencephalopathy

Case contributed by Ammar Haouimi
Diagnosis probable


Known for ovarian carcinoma with cerebral metastases. Two MRI exams are shown below before and after cranial radiation therapy.

Patient Data

Age: 55 years
Gender: Female

There are two intra-axial lesions at the grey-white matter junction in the right parietal region (16 mm) and left temporo-occipital region (25 mm). They elicit an iso-to low signal to the cortical grey matter on T1, iso-to high signal on T2 and FLAIR with restricted diffusion mainly peripherally. The postcontrast sequences show a vivid heterogeneous enhancement. Surrounding vasogenic edema is noted with a mass effect on the trigone of the left lateral ventricle. Findings in keeping with cerebral metastases.

MRI exam performed after cranial radiation therapy (6 months later) shows:

  • complete regression of the cerebral metastases with however persistence of a small area of gliosis in the right parietal region
  • confluent hyperintensities on T2/FLAIR of the periventricular white matter, corona radiata and centra semiovale sparing the U-fibers, in keeping with a radiation-induced leukoencephalopathy
  • punctate areas of high signal on FLAIR and T2 with restricted diffusion are noted in the cerebellum and centra semiovale of ischemic nature, suggestive of radiation-induced vasculopathy

Case Discussion

MRI features suggestive of radiation-induced leukoencephalopathy with vasculopathy in a patient treated with cranial radiation therapy for cerebral metastases from ovarian carcinoma.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.