Differentiation of radiation necrosis from tumor progression using proton magnetic resonance spectroscopy.
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.
Schlemmer
H P
HP
Research Program Radiological Diagnostics and Therapy, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany. h.schlemmer@dkfz-heidelberg.de
Bachert
P
P
Henze
M
M
Buslei
R
R
Herfarth
K K
KK
Debus
J
J
van Kaick
G
G
D000328:Adult; D001254:Astrocytoma / Q000175:diagnosis* / Q000532:radiotherapy; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D011832:Radiation Injuries / Q000175:diagnosis*; D011878:Radiotherapy / Q000379:methods; D013997:Time Factors; D014055:Tomography, Emission-Computed
D003287:Contrast Media; D019786:Gadolinium DTPA