Differentiating tumor recurrence from treatment necrosis: a review of neuro-oncologic imaging strategies.
TLDR
The possibility of computational approaches to investigate the usefulness of fine-grained imaging characteristics that are difficult to observe through visual inspection of images and a flexible treatment-planning algorithm that incorporates advanced functional imaging techniques when indicated by the patient's routine follow-up images and clinical condition are discussed.Abstract:
Differentiating treatment-induced necrosis from tumor recurrence is a central challenge in neuro-oncology. These 2 very different outcomes after brain tumor treatment often appear similarly on routine follow-up imaging studies. They may even manifest with similar clinical symptoms, further confounding an already difficult process for physicians attempting to characterize a new contrast-enhancing lesion appearing on a patient's follow-up imaging. Distinguishing treatment necrosis from tumor recurrence is crucial for diagnosis and treatment planning, and therefore, much effort has been put forth to develop noninvasive methods to differentiate between these disparate outcomes. In this article, we review the latest developments and key findings from research studies exploring the efficacy of structural and functional imaging modalities for differentiating treatment necrosis from tumor recurrence. We discuss the possibility of computational approaches to investigate the usefulness of fine-grained imaging characteristics that are difficult to observe through visual inspection of images. We also propose a flexible treatment-planning algorithm that incorporates advanced functional imaging techniques when indicated by the patient's routine follow-up images and clinical condition.read more
Citations
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Current Clinical Brain Tumor Imaging.
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Safety of combining radiotherapy with immune-checkpoint inhibition.
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MR perfusion-weighted imaging in the evaluation of high-grade gliomas after treatment: a systematic review and meta-analysis.
Praneil Patel,Hediyeh Baradaran,Diana Delgado,Gulce Askin,Paul J. Christos,Apostolos John Tsiouris,Ajay Gupta +6 more
TL;DR: Evaluating whether dynamic susceptibility contrast-enhanced and dynamic contrast enhanced perfusion-weighted imaging metrics can effectively differentiate between recurrent tumor and posttreatment changes within the enhancing signal abnormality on conventional MRI found them to demonstrate relatively good accuracy.
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The Diagnosis and Treatment of Pseudoprogression, Radiation Necrosis and Brain Tumor Recurrence
TL;DR: The pathophysiology, clinical presentation, diagnostic imaging modalities and algorithm for the management of pseudoprogression, radiation necrosis and tumor recurrence are discussed and provided.
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Diagnostic accuracy of magnetic resonance imaging techniques for treatment response evaluation in patients with high-grade glioma, a systematic review and meta-analysis
TL;DR: Meta-analysis demonstrates that advanced MRI showed higher diagnostic accuracy than anatomical MRI, the highest for spectroscopy, supporting the use in treatment response assessment in high-grade gliomas.
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