| Autor: |
Mangesius J; Department of Radiation Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria., Mangesius S; Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria., Demetz M; Department of Neurosurgery, Medical University of Innsbruck, 6020 Innsbruck, Austria., Uprimny C; Department of Nuclear Medicine, Medical University of Innsbruck, 6020 Innsbruck, Austria., Di Santo G; Department of Nuclear Medicine, Medical University of Innsbruck, 6020 Innsbruck, Austria., Galijasevic M; Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria., Minasch D; Department of Radiation Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria., Gizewski ER; Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria., Ganswindt U; Department of Radiation Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria., Virgolini I; Department of Nuclear Medicine, Medical University of Innsbruck, 6020 Innsbruck, Austria., Thomé C; Department of Neurosurgery, Medical University of Innsbruck, 6020 Innsbruck, Austria., Freyschlag CF; Department of Neurosurgery, Medical University of Innsbruck, 6020 Innsbruck, Austria., Kerschbaumer J; Department of Neurosurgery, Medical University of Innsbruck, 6020 Innsbruck, Austria. |
| Abstrakt: |
Radiation necrosis represents a potentially devastating complication after radiation therapy in brain tumors. The establishment of the diagnosis and especially the differentiation from progression and pseudoprogression with its therapeutic implications requires interdisciplinary consent and monitoring. Herein, we want to provide an overview of the diagnostic modalities, therapeutic possibilities and an outlook on future developments to tackle this challenging topic. The aim of this report is to provide an overview of the current morphological, functional, metabolic and evolving imaging tools described in the literature in order to (I) identify the best criteria to distinguish radionecrosis from tumor recurrence after the radio-oncological treatment of malignant gliomas and cerebral metastases, (II) analyze the therapeutic possibilities and (III) give an outlook on future developments to tackle this challenging topic. Additionally, we provide the experience of a tertiary tumor center with this important issue in neuro-oncology and provide an institutional pathway dealing with this problem. |
