Differentiation of tumor progression and radiation-induced effects after intracranial radiosurgery.

Mikhail F. Chernov, Yuko Ono, Kayoko Abe, Masao Usukura, Motohiro Hayashi, Masahiro Izawa, Sergey V. Diment, Pavel I. Ivanov, Yoshihiro Muragaki, Hiroshi Iseki, Tomokatsu Hori, Yoshikazu Okada, Kintomo Takakura

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

A number of intracranial tumors demonstrate some degree of enlargement after stereotactic radiosurgery (SRS). It necessitates differentiation of their regrowth and various treatment-induced effects. Introduction of low-dose standards for SRS of benign neoplasms significantly decreased the risk of the radiation-induced necrosis after -management of schwannomas and meningiomas. Although in such cases a transient increase of the mass volume within several months after irradiation is rather common, it usually followed by spontaneous shrinkage. Nevertheless, distinguishing tumor recurrence from radiation injury is often required in cases of malignant parenchymal brain neoplasms, such as metastases and gliomas. The diagnosis is frequently complicated by histopathological heterogeneity of the lesion with coexistent viable tumor and treatment-related changes. Several neuroimaging modalities, namely structural magnetic resonance imaging (MRI), diffusion-weighted imaging, diffusion tensor imaging, perfusion computed tomography (CT) and MRI, single-voxel and multivoxel proton magnetic resonance spectroscopy as well as single photon emission CT and positron emission tomography with various radioisotope tracers, may provide valuable diagnostic information. Each of these methods has advantages and limitations that may influence its usefulness and accuracy. Therefore, use of a multimodal radiological approach seems reasonable. Addition of functional and metabolic neuroimaging to regular structural MRI investigations during follow-up after SRS of parenchymal brain neoplasms may permit detailed evaluation of the treatment effects and early prediction of the response. If tissue sampling of irradiated intracranial lesions is required, it is preferably performed with the use of metabolic guidance. In conclusion, differentiation of tumor progression and radiation-induced effects after intracranial SRS is challenging. It should be based on a complex evaluation of the multiple clinical, radiosurgical, and radiological factors.

Original languageEnglish
Pages (from-to)193-210
Number of pages18
JournalActa neurochirurgica. Supplement
Volume116
Publication statusPublished - 2013
Externally publishedYes

Fingerprint

Radiosurgery
Radiation Effects
Neoplasms
Brain Neoplasms
Magnetic Resonance Imaging
Radiation Injuries
Functional Neuroimaging
Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging
Neurilemmoma
Meningioma
Single-Photon Emission-Computed Tomography
Neuroimaging
Glioma
Radioisotopes
Positron-Emission Tomography
Necrosis
Therapeutics
Perfusion
Tomography

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Chernov, M. F., Ono, Y., Abe, K., Usukura, M., Hayashi, M., Izawa, M., ... Takakura, K. (2013). Differentiation of tumor progression and radiation-induced effects after intracranial radiosurgery. Acta neurochirurgica. Supplement, 116, 193-210.

Differentiation of tumor progression and radiation-induced effects after intracranial radiosurgery. / Chernov, Mikhail F.; Ono, Yuko; Abe, Kayoko; Usukura, Masao; Hayashi, Motohiro; Izawa, Masahiro; Diment, Sergey V.; Ivanov, Pavel I.; Muragaki, Yoshihiro; Iseki, Hiroshi; Hori, Tomokatsu; Okada, Yoshikazu; Takakura, Kintomo.

In: Acta neurochirurgica. Supplement, Vol. 116, 2013, p. 193-210.

Research output: Contribution to journalArticle

Chernov, MF, Ono, Y, Abe, K, Usukura, M, Hayashi, M, Izawa, M, Diment, SV, Ivanov, PI, Muragaki, Y, Iseki, H, Hori, T, Okada, Y & Takakura, K 2013, 'Differentiation of tumor progression and radiation-induced effects after intracranial radiosurgery.', Acta neurochirurgica. Supplement, vol. 116, pp. 193-210.
Chernov, Mikhail F. ; Ono, Yuko ; Abe, Kayoko ; Usukura, Masao ; Hayashi, Motohiro ; Izawa, Masahiro ; Diment, Sergey V. ; Ivanov, Pavel I. ; Muragaki, Yoshihiro ; Iseki, Hiroshi ; Hori, Tomokatsu ; Okada, Yoshikazu ; Takakura, Kintomo. / Differentiation of tumor progression and radiation-induced effects after intracranial radiosurgery. In: Acta neurochirurgica. Supplement. 2013 ; Vol. 116. pp. 193-210.
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