title: Glioma recurrence versus radiation necrosis: accuracy of current imaging modalities.
abstract: Treatment for brain gliomas is a combined approach of surgery, radiation therapy and chemotherapy. Nevertheless, high-grade gliomas usually recur despite treatment. Ionizing radiation therapy to the central nervous system may cause post-radiation damage. Differentiation between post-irradiation necrosis and recurrent glioma on the basis of clinical signs and symptomatology has not been possible. Computed tomography (CT) and magnetic resonance imaging (MRI) suffer from significant limitations when applied to differentiate recurrent brain tumor from radiation necrosis. We reviewed the contribution of recent MRI techniques, single-photon emission CT and positron emission tomography to discriminate necrosis for glioma recurrence. We concluded that despite the progress being made, further research is needed to establish reliable imaging modalities that distinguish between true tumour progression and treatment-related necrosis.
authors.affiliation: Department of Neurosurgery, University Hospital of Ioannina, P.O. BOX 103, Neohoropoulo, Ioannina, 455 00, Greece. alexiougrg@yahoo.gr.
authors.forename: George A
authors.initials: GA
authors.lastname: Alexiou
authors.affiliation: Department of Nuclear Medicine, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Tsiouris
authors.affiliation: Department of Neurology, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Athanasios P
authors.initials: AP
authors.lastname: Kyritsis
authors.affiliation: Department of Neurosurgery, University Hospital of Ioannina, P.O. BOX 103, Neohoropoulo, Ioannina, 455 00, Greece.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Voulgaris
authors.affiliation: Department of Radiology, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Argyropoulou
authors.affiliation: Department of Nuclear Medicine, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Andreas D
authors.initials: AD
authors.lastname: Fotopoulos
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D003952:Diagnostic Imaging / Q000379:methods; D005910:Glioma / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D006801:Humans; D009336:Necrosis / Q000175:diagnosis / Q000209:etiology; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D016634:Radiosurgery / Q000009:adverse effects*
chemical_list: D019275:Radiopharmaceuticals