Treatment induced necrosis versus recurrent/progressing brain tumor: going beyond the boundaries of conventional morphologic imaging.
Brain tumor patients undergo various combinations therapies, leading to very complex and confusing imaging appearances on follow up MR imaging and hence, differentiating recurrent or progressing tumors from treatment induced necrosis or effects has always been a challenge in neuro-oncologic imaging. This particular topic has become more relevant these days because of the advent of newer anti-angiogenic and anti-neoplastic chemotherapeutic agents as well as use of salvage radiation therapy. Various clinically available functional imaging modalities can provide additional physiologic and metabolic information about the tumors which could be useful in identifying viable tumor from treatment induced necrosis and hence, can guide treatment planning. In this review we will discuss various functional neuro-imaging modalities, their advantages and limitations and also their utility in treatment planning.
Jain
Rajan
R
Division of Neuroradiology, Department of Radiology, Henry Ford Hospital, Detroit, MI, USA. rajanj@rad.hfh.edu
Narang
Jayant
J
Sundgren
Pia M
PM
Hearshen
David
D
Saksena
Sona
S
Rock
Jack P
JP
Gutierrez
Jorge
J
Mikkelsen
Tom
T
D000970:Antineoplastic Agents / Q000009:adverse effects*; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000628:therapy; D003952:Diagnostic Imaging / Q000379:methods; D018450:Disease Progression; D006801:Humans; D009336:Necrosis / Q000175:diagnosis / Q000209:etiology*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000209:etiology*; D011832:Radiation Injuries / Q000150:complications*
D000970:Antineoplastic Agents