title: Differentiation of cerebral radiation necrosis from tumor recurrence by proton magnetic resonance spectroscopy.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Hokkaido University, School of Medicine Sapporo.
authors.forename: K
authors.initials: K
authors.lastname: Kamada
authors.forename: K
authors.initials: K
authors.lastname: Houkin
authors.forename: H
authors.initials: H
authors.lastname: Abe
authors.forename: Y
authors.initials: Y
authors.lastname: Sawamura
authors.forename: T
authors.initials: T
authors.lastname: Kashiwaba
mesh_terms: 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*