Differentiation of radiation necrosis from tumor progression using proton magnetic resonance spectroscopy

• Published in: Neuroradiology Vol. 44; no. 3; pp. 216 - 222
• Main Authors: SCHLEMMER, H.-P, BACHERT, P, HENZE, M, BUSLEI, R, HERFARTH, K. K, DEBUS, J, VAN KAICK, G
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.03.2002; Springer Nature B.V
• Subjects: Adult; Astrocytoma - diagnosis; Astrocytoma - radiotherapy; Biological and medical sciences; Brain Neoplasms - diagnosis; Brain Neoplasms - radiotherapy; Contrast Media; Diagnosis, Differential; Female; Follow-Up Studies; Gadolinium DTPA; Humans; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Medical sciences; Necrosis; Neoplasm Recurrence, Local - radiotherapy; Neurology; Radiation Injuries - diagnosis; Radiotherapy - methods; Time Factors; Tomography, Emission-Computed; Tumors of the nervous system. Phacomatoses; Human; Intracranial; Nervous system diseases; Emission; Exploration; Surgical resection; NMR spectrometry; Radiotherapy; Nuclear magnetic resonance imaging; Cerebral disorder; Necrosis; Case study; Glioma; Surgery; Central nervous system disease; Stereotaxic surgery; Medical imagery; Tumor; Astrocytoma; Positron; Emission tomography
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s002340100703

We report on a young woman who was treated by stereotactic radiotherapy for recurrence of an initially resected low-grade astrocytoma. MRI follow-up examination 7 months after radiotherapy showed a gadolinium-DTPA-enhancing mass lesion indicative of high-grade tumor progression. This assumption was also supported by positron emission tomography with [2-18F]fluoro-2-deoxy-D-glucose (FDG-PET). In contrast, proton MR spectroscopy (1H-MRS) indicated radiation necrosis, which was confirmed histopathologically in surgical specimens. Subsequent follow-up examinations up to 19 months after surgery showed no evidence of tumor recurrence.