Fig. 6
From: MRI characteristics of chemotherapy-related central neurotoxicity: a pictorial review
Examples of posterior reversible encephalopathic syndrome (PRES) related to chemotherapeutic agents. a A 52-year-old female with stage IV gallbladder carcinoma underwent a cisplatin-based chemotherapy regimen. Following the third cycle, she experienced worsening headache and giddiness, leading to hospital admission after two episodes of generalized tonic–clonic seizures. Axial FLAIR images (a1, a2) display hyperintensities in bilateral parietal, occipital, and posterior temporal lobes. The corresponding axial DWI image (a3) reveals increased signal and low apparent diffusion coefficient (ADC) (not shown), suggestive of PRES. A follow-up axial FLAIR image (a4) six weeks post-chemotherapy cessation shows near-complete resolution, with only residual signal in the right lingual gyrus (curved arrow). b A 45-year-old female with triple-negative breast cancer (TNBC) underwent mastectomy and received a Bevacizumab-based chemotherapy regimen. Axial T2 (b1) and FLAIR (b2) MRI brain images exhibit symmetrical hyperintensities in bilateral centrum semiovale and corona radiata (arrows), indicating Bevacizumab-related PRES. Subsequent MRI post-bevacizumab cessation demonstrates significant improvement in signal abnormalities on axial T2 (arrows, b3) and FLAIR (arrows, b4) images