Is Current Imaging Good Enough to Differentiate Radiation-Induced Brain Injury from Tumor Recurrence?
Differentiating radiation-induced brain injury from tumor recurrence is a challenging problem. This is important in the current medical environment, where therapeutic strategies for CNS disorders are moving toward minimally invasive procedures. On many clinical occasions, imaging is the only reference for choosing an appropriate therapeutic strategy and for evaluating the therapeutic result. Gliomas, particularly those of high grade, contain heterogeneous tissue components with tumor necrosis. Their clinical and pathologic behaviors are different from that of radiation-induced necrosis. They may share similar imaging characters, although the management strategy and outcome of tumor necrosis and radiation necrosis are obviously different. In the current issue of AJNR, Asao et al present a series of 20 brain tumor lesions in 17 patients and in most (14/17) they were initially high grade (grade III and IV astrocytic tumors). At the time of study, 12 lesions in 10 patients developed radiat
