The distinction of radiation-induced brain necrosis (RBN) and recurrent glioblastoma multiform (rGBM) remains a diagnostic challenge due to their similarly on routine follow-up imaging studies and also their clinical manifestations. Our purpose of this review article is to evaluate the role of advanced MR imaging techniques such as Perfusion-weighted imaging (PWI), Diffusion-weighted imaging (DWI) and Magnetic resonance spectroscopy (MRS) in the differentiation of RBN and rGBM and their complications together with our experience and knowledge gained during our neuroimaging practice.
References
[1]
Mary Elizabeth, D. (2016) Glioblastoma: Overview of Disease and Treatment. Clinical Journal of Oncology Nursing, 20, S2-S8.
https://doi.org/10.1188/16.CJON.S1.2-8
[2]
Villà, S., Balañà, C. and Comas, S. (2014) Radiation and Concomitant Chemotherapy for Patients with Glioblastoma Multiforme. Chinese Journal of Cancer, 33, 25-31.
https://doi.org/10.5732/cjc.013.10216
[3]
Roy, S., Lahiri, D., Maji, T. and Biswas, J. (2015) Recurrent Glioblastoma: Where We Stand. South Asian Journal of Cancer, 4, 163-173.
https://doi.org/10.4103/2278-330X.175953
[4]
Young, R.M., Jamshidi, A., Davis, G. and Sherman, J.H. (2015) Current Trends in the Surgical Management and Treatment of Adult Glioblastoma. Annals of Translational Medicine, 3, Article No. 121.
[5]
Rees, J.H. (2011) Diagnosis and Treatment in Neuro-Oncology: An Oncological Perspective. British Journal of Radiology, 84, S82-S89.
https://doi.org/10.1259/bjr/18061999
[6]
Walker, A.J., Ruzevick, J., Malayeri, A.A., Rigamonti, D., Lim, M., Redmond, K.J., et al. (2014) Postradiation Imaging Changes in the CNS: How Can We Differentiate between Treatment Effect and Disease Progression? Future Oncology, 10, 1277-1297.
https://doi.org/10.2217/fon.13.271
[7]
Vellayappan, B., Tan, C.L., Yong, C., Khor, L.K., Koh, W.Y., Yeo, T.T., et al. (2018) Diagnosis and Management of Radiation Necrosis in Patients with Brain Metastases. Frontiers in Oncology, 8, Article No. 395.
https://doi.org/10.3389/fonc.2018.00395
[8]
Verma, N., Cowperthwaite, M.C., Burnett, M.G. and Markey, M.K. (2013) Differentiating Tumor Recurrence from Treatment Necrosis: A Review of Neuro-Oncologic Imaging Strategies. Neuro-Oncology, 15, 515-534.
https://doi.org/10.1093/neuonc/nos307
[9]
Nael, K., Bauer, A.H., Hormigo, A., Lemole, M., Germano, I.M., Puig, J. and Stea, B. (2018) Multiparametric MRI for Differentiation of Radiation Necrosis from Recurrent Tumor in Patients with Treated Glioblastoma. American Journal of Roentgenology, 210, 18-23. https://doi.org/10.2214/AJR.17.18003
[10]
Zikou, A., Sioka, C., Alexiou, G.A., Fotopoulos, A., Voulgaris, S. and Argyropoulou, M.I. (2018) Radiation Necrosis, Pseudoprogression, Pseudoresponse, and Tumor Recurrence: Imaging Challenges for the Evaluation of Treated Gliomas. Contrast Media & Molecular Imaging, 2018, Article ID: 6828396.
https://doi.org/10.1155/2018/6828396
[11]
Shah, R., Vattoth, S., Jacob, R., Manzil, F.F.P., O’Malley, J.P., Borghei, P., Patel, B.N. and Curé, J.K. (2012) Radiation Necrosis in the Brain: Imaging Features and Differentiation from Tumor Recurrence. Radiation Oncology, 31, 1343-1359.
https://doi.org/10.1148/rg.325125002
[12]
Chao, S.T., Ahluwalia, M.S., Barnett, G.H., Stevens, G.H.J., Murphy, E.S., Stockham, A.L., Shiue, K. and Suh, J.H. (2013) Challenges with the Diagnosis and Treatment of Cerebral Radiation Necrosis. International Journal of Radiation Oncology, Biology, Physics, 87, 449-457. https://doi.org/10.1016/j.ijrobp.2013.05.015
[13]
Miyatake, S., Nonoguchi, N., Furuse, M., Yoritsune, E., Miyata, T., Kawabata, S., et al. (2015) Pathophysiology, Diagnosis, and Treatment of Radiation Necrosis in the Brain. Neurologia Medico-Chirurgica, 55, 50-59.
https://doi.org/10.2176/nmc.ra.2014-0188
[14]
Kirkpatrick, J.P., Soltys, S.G., Lo, S.S., Beal, K., Shrieve, D.C. and Brown, P.D. (2017) The Radiosurgery Fractionation Quandary: Single Fraction or Hypofractionation? Neuro-Oncology, 19, ii38-ii49. https://doi.org/10.1093/neuonc/now301
[15]
Sawamura, Y., Shirato, H., Ikeda, J., Tada, M., Ishii, N., Kato, T., Abe, H. and Fujieda, K. (1998) Induction Chemotherapy Followed by Reduced-Volume Radiation Therapy for Newly Diagnosed Central Nervous System Germinoma. Journal of Neurosurgery, 88, 66-72. https://doi.org/10.3171/jns.1998.88.1.0066
[16]
Greene-Schloesser, D., Robbins, M.E., Peiffer, A.M., Shaw, E.G., Wheeler, K.T. and Chan, M.D. (2012) Radiation-Induced Brain Injury: A Review. Frontiers in Oncology, 2, Article No. 73. https://doi.org/10.3389/fonc.2012.00073
[17]
Akita, S. (2014) Treatment of Radiation Injury. Advances in Wound Care, 3, 1-11.
https://doi.org/10.1089/wound.2012.0403
[18]
Turnquist, C., Harris, B.T. and Harris, C.C. (2020) Radiation-Induced Brain Injury: Current Concepts and Therapeutic Strategies Targeting Neuroinflammation. Neuro-Oncology Advances, 2, vdaa057. https://doi.org/10.1093/noajnl/vdaa057
[19]
Sorby-Adams, A.J., Marcoionni, A.M., Dempsey, E.R., Woenig, J.A. and Turner, R.J. (2017) The Role of Neurogenic Inflammation in Blood-Brain Barrier Disruption and Development of Cerebral Oedema Following Acute Central Nervous System (CNS) Injury. International Journal of Molecular Sciences, 18, Article No. 1788.
https://doi.org/10.3390/ijms18081788
[20]
Lawrence, Y.R., Li, X.A., el Naqa, I., Hahn, C.A., Marks, L.B., Merchant, T.E., et al. (2010) Radiation Dose-Volume Effects in the Brain. International Journal of Radiation Oncology, Biology, Physics, 76, S20-S27.
https://doi.org/10.1016/j.ijrobp.2009.02.091
[21]
Yang, Z., Bai, S., Gu, B., Peng, S., Liao, W. and Liu, J. (2015) Radiation-Induced Brain Injury after Radiotherapy for Brain Tumor. In: Lichtor, T., Ed., Molecular Considerations and Evolving Surgical Management Issues in the Treatment of Patients with a Brain Tumor, IntechOpen, London. https://doi.org/10.5772/59045
[22]
Kessler, A.T. and Bhatt, A.A. (2018) Brain Tumour Post-Treatment Imaging and Treatment-Related Complications. Insights Imaging, 9, 1057-1075.
https://doi.org/10.1007/s13244-018-0661-y
[23]
Zhuang, H., Shi, S., Yuan, Z. and Chang, J.Y. (2019) Bevacizumab Treatment for Radiation Brain Necrosis: Mechanism, Efficacy and Issues. Molecular Cancer, 18, Article No. 21. https://doi.org/10.1186/s12943-019-0950-1
[24]
Spałek, M. (2016) Chronic Radiation-Induced Dermatitis: Challenges and Solutions. Clinical, Cosmetic and Investigational Dermatology, 9, 473-482.
https://doi.org/10.2147/CCID.S94320
[25]
Castellano, A. and Anzalone, N. (2019) Radiation and Chemotherapy Induced Injury. In: Barkhof, F., Jłger, H., Thurnher, M. and Rovira, à., Eds., Clinical Neuroradiology, Springer, Cham.
[26]
Takeshita, T., Yan, L., Asaoka, M., Rashid, O. and Takabe, K. (2019) Late Recurrence of Breast Cancer Is Associated with Pro-Cancerous Immune Microenvironment in the Primary Tumor. Scientific Reports, 9, Article No. 16942.
https://doi.org/10.1038/s41598-019-53482-x
[27]
Vilalta, M., Rafat, M. and Graves, E.E. (2016) Effects of Radiation on Metastasis and Tumor Cell Migration. Cellular and Molecular Life Sciences, 73, 2999-3007.
https://doi.org/10.1007/s00018-016-2210-5
[28]
Kraboth, Z. and Kalman, B. (2020) Longitudinal Characteristics of Glioblastoma in Genome-Wide Studies. Pathology & Oncology Research, 26, 2035-2047.
https://doi.org/10.1007/s12253-019-00705-1
[29]
Pauliah, M., Saxena, V., Haris, M., Husain, N., Rathore, R.K.S. and Gupta, R.K. (2007) Improved T1-Weighted Dynamic Contrast-Enhanced MRI to Probe Microvascularity and Heterogeneity of Human Glioma. Magnetic Resonance Imaging, 25, 1292-1299. https://doi.org/10.1016/j.mri.2007.03.027
[30]
Tekşam, M., Kayahan, E.M., Yerli, H. and Ağildere, A.M. (2004) Radyasyon nekrozu-tümör rekürensi ayriminda MR perfüzyon ve MR spektroskopi [Brain MR Perfusion and MR Spectroscopy in Differentiation of Radiation Necrosis from Tumor Recurrence (Case Report)]. Tani Girisim Radyol, 10, 263-267. (in Turkish)
[31]
Chuang, M.T., Liu, Y.S., Tsai, Y.S., Chen, Y.C. and Wang, C.K. (2016) Differentiating Radiation-Induced Necrosis from Recurrent Brain Tumor Using MR Perfusion and Spectroscopy: A Meta-Analysis. PLoS ONE, 11, e0141438.
https://doi.org/10.1371/journal.pone.0141438
[32]
Sugahara, T., Korogi, Y., Tomiguchi, S., Shigematsu, Y., Ikushima, I., Kira, T., Liang, L., Ushio, Y. and Takahashi, M. (2000) Posttherapeutic Intraaxial Brain Tumor: The Value of Perfusion-Sensitive Contrast-Enhanced MR Imaging for Differentiating Tumor Recurrence from Nonneoplastic Contrast-Enhancing Tissue. American Journal of Neuroradiology, 21, 901-909.
[33]
Padhani, A.R., Koh, D.M. and Collins, D.J. (2011) Whole-Body Diffusion-Weighted MR Imaging in Cancer: Current Status and Research Directions. Radiology, 261, 700-718. https://doi.org/10.1148/radiol.11110474
[34]
Drake-Pérez, M., Boto, J., Fitsiori, A., Lovblad, K. and Isabel Vargas, M. (2018) Clinical Applications of Diffusion Weighted Imaging in Neuroradiology. Insights into Imaging, 9, 535-547. https://doi.org/10.1007/s13244-018-0624-3
[35]
Doblas, S., He, T., Saunders, D., Hoyle, J., Smith, N., Pye, Q., et al. (2012) In Vivo Characterization of Several Rodent Glioma Models by 1H MRS. NMR in Biomedicine, 25, 685-694. https://doi.org/10.1002/nbm.1785
[36]
Nakamura, H., Doi, M., Suzuki, T., Yoshida, Y., Hoshikawa, M., Uchida, M., et al. (2018) The Significance of Lactate and Lipid Peaks for Predicting Primary Neuroepithelial Tumor Grade with Proton MR Spectroscopy. Magnetic Resonance in Medical Sciences, 17, 238-243. https://doi.org/10.2463/mrms.mp.2017-0042
[37]
Zeng, Q.S., Li, C.F., Zhang, K., Liu, H., Kang, X.S. and Zhen, J.H. (2007) Multivoxel 3D Proton MR Spectroscopy in the Distinction of Recurrent Glioma from Radiation Injury. Journal of Neuro-Oncology, 84, 63-69.
https://doi.org/10.1007/s11060-007-9341-3
[38]
Taylor, J.S., Langston, J.W., Reddick, W.E., Kingsley, P.B., Ogg, R.J, Pui, M.H., et al. (1996) Clinical Value of Proton Magnetic Resonance Spectroscopy for Differentiating Recurrent or Residual Brain Tumor from Delayed Cerebral Necrosis. International Journal of Radiation Oncology, Biology, Physics, 36, 1251-1261.
https://doi.org/10.1016/S0360-3016(96)00376-8
