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Cerebral necrosis after radiotherapy and/or intraarterial chemotherapy for brain tumors: PET and neuropathologic studies
Abstract
Cerebral necrosis after radiotherapy for brain tumors is being recognized as a problem more common than previously estimated. Distinction between this iatrogenic complication and tumor recurrence cannot be made by either CT or MR imaging. By using positron emission tomography (PET) with 18F-deoxyglucose (FDG) we were able to reach a diagnosis of radiation necrosis, later verified, in 10 of 95 patients referred for the purpose of differentiating tumor recurrence from necrosis. The critical PET-FDG feature was focal hypometabolism in the area of necrosis, which contrasted with the hypermetabolism associated with the residual/recurrent tumor. In addition, four cases of cerebral necrosis after supraophthalmic, intraarterial chemotherapy (BCNU) were studied with the PET-FDG method. The area of chemotherapy damage was also characterized by marked hypometabolism. Histology revealed both similarities and differences between radio- and chemonecrosis.
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Citations
Cited by
From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors
Wahl, R. L., Jacene, H., Kasamon, Y., & Lodge, M. A. (2009) · Journal of Nuclear Medicine · doi:10.2967/jnumed.108.057307 · Cited by 3,777
“demonstrated that a negative 18F-FDG PET scan could help distinguish brain tumor necrosis from viable tumor at the end of therapy, despite the overlapping anatomic appearance of brain tumor and necrosis on CT (16,17).”
BackgroundRadiation response of the central nervous system
Schultheiss, T. E., Kun, L. E., Ang, K. K., & Stephens, L. C. (1995) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/0360-3016(94)00655-5 · Cited by 653
Hu, L. S., Baxter, L. C., Smith, K. A., Feuerstein, B. G., Karis, J. P., Eschbacher, J. M., Coons, S. W., Nakaji, P., Yeh, R. F., Debbins, J., et al. (2009) · American Journal of Neuroradiology · doi:10.3174/ajnr.a1377 · Cited by 396
Evaluation of Benign vs Malignant Hepatic Lesions With Positron Emission Tomography
Delbeke, D. (1998) · Archives of Surgery · doi:10.1001/archsurg.133.5.510 · Cited by 312
Metadata
- Authors
- Di Chiro, G., Oldfield, E., Wright, D., De Michele, D., Katz, D., Patronas, N., Doppman, J., Larson, S., Ito, M., & Kufta, C.
- Venue
- American Journal of Roentgenology
- Publisher
- American Roentgen Ray Society
- Published
- 1988-01-01
- Volume
- 150
- Issue
- 1
- Pages
- 189-197
- ISSN
- 0002-9580 (ISSN-L)
- 0361-803X
- 1546-3141
- OpenAlex
- W2013611417
- Cited by
- 422
- References
- 0
- FWCI
- 9.36
- Type
- journal article
- Language
- en
- Open access
- closed
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- Di Chiro, G., Oldfield, E., Wright, D., De Michele, D., Katz, D., Patronas, N., Doppman, J., Larson, S., Ito, M., & Kufta, C. (1988). Cerebral necrosis after radiotherapy and/or intraarterial chemotherapy for brain tumors: PET and neuropathologic studies. American Journal of Roentgenology. https://doi.org/10.2214/ajr.150.1.189
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