Radiation Necrosis, Pseudoprogression, Pseudoresponse, and Tumor Recurrence: Imaging Challenges for the Evaluation of Treated Gliomas

• Published in: Contrast media and molecular imaging Vol. 2018; no. 2018; pp. 1 - 6
• Main Authors: Voulgaris, Spyridon, Fotopoulos, Andreas, Alexiou, George A., Sioka, Chrissa, Zikou, Anastasia, Argyropoulou, Maria I.
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01.01.2018; Hindawi; Hindawi Limited
• Subjects: Adults; Antiangiogenics; Blood-brain barrier; Brain; Brain cancer; Brain research; Chemotherapy; Cytokines; Cytotoxicity; Diagnostic Imaging - adverse effects; Diagnostic Imaging - methods; Disease Progression; Edema; Enzymes; Glioblastoma; Glioblastoma - diagnostic imaging; Glioblastoma - therapy; Glioma; Glioma - diagnostic imaging; Glioma - therapy; Growth factors; Humans; Imaging techniques; Magnetic permeability; Magnetic resonance imaging; Magnetic resonance spectroscopy; Medical imaging; Medical prognosis; Necrosis; Neoplasia; Neoplasm Recurrence, Local - diagnostic imaging; Neuroimaging; NMR; Nuclear magnetic resonance; Nuclear medicine; Perfusion; Permeability; Positron emission; Positron emission tomography; Radiation; Radiation therapy; Reagents; Resonance; Review; Single photon emission computed tomography; Surgery; Temozolomide; Tensors; Tomography; Tumor necrosis factor-TNF; Tumors; Vascular endothelial growth factor
• ISSN: 1555-4309; 1555-4317; 1555-4317
• DOI: 10.1155/2018/6828396

Glioblastoma (GBM) is the most common primary malignant type of brain neoplasm in adults and carries a dismal prognosis. The current standard of care for GBM is surgical excision followed by radiation therapy (RT) with concurrent and adjuvant temozolomide-based chemotherapy (TMZ) by six additional cycles. In addition, antiangiogenic therapy with an antivascular endothelial growth factor (VEGF) agent has been used for recurrent glioblastoma. Over the last years, new posttreatment entities such as pseudoprogression and pseudoresponse have been recognized, apart from radiation necrosis. This review article focuses on the role of different imaging techniques such as conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), dynamic contrast enhancement (DCE-MRI) and dynamic susceptibility contrast (DSE-MRI) perfusion, magnetic resonance spectroscopy (MRS), and PET/SPECT in differentiation of such treatment-related changes from tumor recurrence.