Imaging Changes after Stereotactic Radiosurgery of Primary and Secondary Malignant Brain Tumors

摘要: After radiosurgery of malignant tumors, it can be difficult to discriminate between transient treatment effects, radiation necrosis, and tumor progression on post-treatment imaging. Misinterpretation an enlarging lesion may lead inappropriate contribute disagreements about efficacy. In effort clarify this problem, we reviewed our experience with interpreting post-radiosurgical imaging in patients primary secondary brain tumors. We results 30 gliomas 35 metastatic tumors minimum follow up 1 year or until death. Of gliomas, 73% were larger a mean 13 weeks after radiosurgery. metatstatic 22% 10 Eleven had 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) lesions. Eight showed increased activity respect brain; three decreased activity. the eight, six predicted incorrectly based upon patients' subsequent courses (all alive, 27 months), two correctly, dying from imaged lesions 8 months later. FDG uptake less than brain, one patient was alive 32 up, died 21 Radiographic enlargement is common, especially for gliomas. Physicians caring these should aware phenomenon cautious images. MRI appearance useful metastases. FDG-PET seems unreliable. Further evaluation Tl-201 HMPAO SPECT MRS warranted.