{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T05:39:35Z","timestamp":1757309975490,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>We aim to assess the imaging manifestations of brain involvement in paediatric immunocompromised patients with haematological malignancies on chemotherapy presenting with encephalitis and positive HSV CSF PCR. We also aim to determine whether our findings are similar or different to those described in literature for paediatric patients in general.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was performed in paediatric ALL\/lymphoma patients on chemotherapy, and cases with positive CSF HSV\u2010PCR with at least\u2009one head MRI scan were included. On imaging, location(typical\/atypical),\u2009post\u2010contrast enhancement and haemorrhage\/diffusivity\/gliosis were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>A total of 28 scans were included in study from 16 patients fulfilling inclusion criteria, 12 (75%) HSV\u20101 and 4 (25%) HSV\u20102. Of the 16 initial scans (CT <jats:italic>n<\/jats:italic>\u2009=\u200910, MRI <jats:italic>n<\/jats:italic>\u2009=\u20096), 11 were normal (CT\u2009=\u20097, MRI\u2009=\u20094). Fourteen patients had follow\u2010up MRI, of which two had normal scans. On the abnormal initial scan (5\/16), only 20% had typical medial temporal\/inferomedial frontal\/cingulate involvement. Most had frontal (80%), parietal (60%) and non\u2010medial temporal (40%) lesions. Abnormal diffusivity\/haemorrhage was absent in all, and postcontrast enhancement was seen in 20%. On follow\u2010up, more patients (33%) had typical medial temporal\/inferomedial frontal\/cingulate involvement. Widespread atypical site involvement of frontoparietal (75%), thalamus (58%), non\u2010medial temporal (50%), occipital\/basal ganglia (33%) and cerebellum (8%) was noted. Most lesions were cortical (91%)\/subcortical (75%) with few periventricular lesions (58%). Few showed abnormal diffusivity (16%), post\u2010contrast parenchymal enhancement\/haemorrhage (8%), post\u2010contrast meningeal enhancement (25%) and gliosis (16%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Immunocompromised paediatric patients with haematological malignancies have widespread atypical brain involvement in herpes simplex encephalitis with lack of diffusion restriction and post\u2010contrast enhancement, likely due to haematogenous spread of HSV across the blood\u2013brain barrier, lack of cellular immunity and limited inflammatory cytokine response.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.13326","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T10:03:53Z","timestamp":1631613833000},"page":"609-617","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Atypical imaging presentation of herpes simplex virus encephalitis in paediatric immunocompromised oncology patients"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5345-3597","authenticated-orcid":false,"given":"Tejas","family":"Kapadia","sequence":"first","affiliation":[{"name":"Tata Memorial Centre  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1549-3680","authenticated-orcid":false,"given":"Arpita","family":"Sahu","sequence":"additional","affiliation":[{"name":"Tata Memorial Centre and Homi Bhabha National Institute  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1897-7752","authenticated-orcid":false,"given":"Anurag","family":"Gupta","sequence":"additional","affiliation":[{"name":"Tata Memorial Centre and Homi Bhabha National Institute  Mumbai 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