チエルノフ　ミハイル
   Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Differentiation of the radiation-induced necrosis and tumor recurrence after gamma knife radiosurgery for brain metastases: importance of multi-voxel proton MRS
Journal Formal name：Minim Invasive Neurosurg
ISSN code：09467211
Domestic / ForeginForegin
Publisher © Georg Thieme Verlag Stuttgart · New York
Volume, Issue, Page 48(4),pp.228-234
Author and coauthor CHERNOV Mikhail, HAYASHI Motohiro, IZAWA Masahiro, OCHIAI Taku, YSUKURA Masao, ABE Kayoko, ONO Yuko, MURAGAKI Yoshihiro†, KUBO Osami, HORI Tomokatsu, TAKAKURA Kintomo
Authorship Lead author
Publication date 2005/08
Summary Comparative analysis of the diagnostic accuracy of FDG PET, single-voxel, and multi-voxel proton MRS for differentiation between radiation-induced necrosis and tumor recurrence was done in 9 patients with brain metastases treated by gamma knife radiosurgery. In all cases enlargement of the lesion and increase of the perilesional edema were demonstrated by MRI on average 10.6+/-2.6 months after initial treatment. Radiation-induced necrosis was identified in 5 patients (histologically in 2, clinically in 3). In one of these a false positive result of FDG PET was observed, whereas data of proton MRS were always correct. The diagnosis of tumor recurrence was established in 4 patients (histologically in 3, clinically in 1). Among these both FDG PET and single-voxel proton MRS showed false negative results (each method twice), whereas multi-voxel proton MRS always permitted us to establish the correct diagnosis. The present study demonstrates the higher diagnostic accuracy of multi-voxel proton MRS, in comparison with single-voxel proton MRS and FDG PET, for the differentiation of the radiation-induced necrosis and tumor recurrence. Its use is especially important in mixed lesions with co-existence of both post-irradiation changes and viable neoplasm. Monitoring of the treatment response by serial multi-voxel proton MRS seems to be reasonable during follow-up of patients with brain metastases after radiosurgery.
DOI 10.1055/s-2005-870952
Document No. 16172969
PMID 16172969