Differentiation of cerebral radiation necrosis from tumor recurrence by proton magnetic resonance spectroscopy.
Proton magnetic resonance spectroscopy (1H MRS) was evaluated for distinguishing between radiation necrosis and recurrent glioma in 11 patients after high-dose radiotherapy. Six patients had a histological diagnosis of recurrent glioma. Four patients had a histological diagnosis of radiation necrosis and one had a clinical course consistent with the diagnosis of radiation necrosis. 1H MRS showed cases of radiation necrosis had two characteristic 1H MRS patterns: markedly increased lactate/creatine and phosphocreatine (Cr) ratio and decreased choline-containing compounds/Cr ratio compared to that of recurrent glioma; or all the major metabolites were completely diminished. The N-acetyl aspartate signal was not helpful for differential diagnosis. 1H MRS is a potentially useful method for differentiating tumor recurrence from radiation necrosis in patients treated for malignant glioma.
Kamada
K
K
Department of Neurosurgery, Hokkaido University, School of Medicine Sapporo.
Houkin
K
K
Abe
H
H
Sawamura
Y
Y
Kashiwaba
T
T
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis*; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*