Glioma recurrence versus radiation necrosis: accuracy of current imaging modalities.
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.
Alexiou
George A
GA
Department of Neurosurgery, University Hospital of Ioannina, P.O. BOX 103, Neohoropoulo, Ioannina, 455 00, Greece. alexiougrg@yahoo.gr.
Tsiouris
Spyridon
S
Department of Nuclear Medicine, University Hospital of Ioannina, Ioannina, Greece.
Kyritsis
Athanasios P
AP
Department of Neurology, University Hospital of Ioannina, Ioannina, Greece.
Voulgaris
Spyridon
S
Department of Neurosurgery, University Hospital of Ioannina, P.O. BOX 103, Neohoropoulo, Ioannina, 455 00, Greece.
Argyropoulou
Maria I
MI
Department of Radiology, University Hospital of Ioannina, Ioannina, Greece.
Fotopoulos
Andreas D
AD
Department of Nuclear Medicine, University Hospital of Ioannina, Ioannina, Greece.
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*
D019275:Radiopharmaceuticals