Optic and peri-optic enhancement as an imaging finding after particle therapy.

Authors

Kentaro Yuba, Keita Watanabe, Ryo Kimura, Toshiyuki Ogata, Takuya Kimoto, Norihiro Aibe, Kentaro Akazawa, Gen Suzuki, Katsumi Hayakawa, Kei Yamada

Published in

The neuroradiology journal. Pages 19714009261487615. Sep 04, 2026. Epub Sep 04, 2026.

Abstract

BackgroundParticle therapy involving the optic nerve may cause optic neuropathy. Knowledge of post-treatment imaging findings is important for early detection.PurposeTo investigate optic nerve and peri-optic enhancement following particle therapy for periorbital malignancies.Materials and methodsThis retrospective study included 16 patients with contrast-enhanced MRI after particle therapy (15 proton beam therapy and one heavy-ion radiotherapy), comprising 24 evaluated optic nerve sides. Two experienced neuroradiologists independently reviewed the reference and most recent follow-up MR images, and disagreements were resolved by consensus. Exploratory dose associations were evaluated using side-level logistic generalized estimating equations accounting for within-patient correlation.ResultsGrade 2 enhancement was observed in 7 of 16 patients (43.8%) and 9 of 24 sides (37.5%), involving the optic nerve in 6 sides and the peri-optic region in 7. Among 21 sides in 14 proton-treated patients, optic nerve enhancement was not significantly associated with maximum dose (OR per 10 Gy [RBE], 1.481; 95% CI, 0.883-2.482; p = 0.137) but was nominally associated with BED₃ (OR, 1.705; 95% CI, 1.201-2.421; p = 0.003). Peri-optic enhancement was not significantly associated with maximum dose (OR, 1.479; 95% CI, 0.734-2.980; p = 0.274) or BED₃ (OR, 1.490; 95% CI, 0.999-2.222; p = 0.051). One patient was clinically diagnosed with RION; no visual symptoms were documented in the remaining 15 patients.ConclusionOptic nerve or peri-optic enhancement may occur after particle therapy, including in patients without documented visual symptoms, and may represent subclinical radiation-related injury or nonspecific post-radiation changes.

PMID:
42696717
Bibliographic data and abstract were imported from PubMed on 05 Sep 2026.

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