title: Treatment induced necrosis versus recurrent/progressing brain tumor: going beyond the boundaries of conventional morphologic imaging.
abstract: 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.
authors.affiliation: Division of Neuroradiology, Department of Radiology, Henry Ford Hospital, Detroit, MI, USA. rajanj@rad.hfh.edu
authors.forename: Rajan
authors.initials: R
authors.lastname: Jain
authors.forename: Jayant
authors.initials: J
authors.lastname: Narang
authors.forename: Pia M
authors.initials: PM
authors.lastname: Sundgren
authors.forename: David
authors.initials: D
authors.lastname: Hearshen
authors.forename: Sona
authors.initials: S
authors.lastname: Saksena
authors.forename: Jack P
authors.initials: JP
authors.lastname: Rock
authors.forename: Jorge
authors.initials: J
authors.lastname: Gutierrez
authors.forename: Tom
authors.initials: T
authors.lastname: Mikkelsen
mesh_terms: 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*
chemical_list: D000970:Antineoplastic Agents