Recurrent brain tumor versus radiation necrosis; can dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging differentiate?

Publication date: Available online 21 June 2018Source: The Egyptian Journal of Radiology and Nuclear MedicineAuthor(s): Heba M. Soliman, Ahmed A. ElBeheiry, Amr A. Abdel-Kerim, Ahmed H. Farhoud, M. Ihab RedaAbstractBackgroundAssessment of treatment response in patients with a brain tumor is paramount, as true tumor recurrence and radiation necrosis are similar looking on conventional MRI.PurposeTo evaluate the role of dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging in the differentiation between recurrent brain tumors and radiation necrosis.Material and MethodsTwenty patients with a history of operated primary brain tumors and postoperative radiotherapy with or without chemotherapy were enrolled in this prospective study having conventional MRI findings of enhancing lesion suspicious of being recurrence or radiation necrosis. All patients were examined by DSC-perfusion MRI. Definitive diagnosis was reached through either subsequent surgical biopsy or follow up over 6-12 months.ResultsFifteen patients (75%) were diagnosed as tumor recurrence and 5 patients as radiation necrosis (25%). The relative cerebral blood volume (rCBV) and relative peak height (rPH) were significantly higher (P 
Source: The Egyptian Journal of Radiology and Nuclear Medicine - Category: Nuclear Medicine Source Type: research

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Conclusions: Percentage of signal recovery shows low recovery values in metastases, intermediate recovery values in glioma, and overshoot in lymphoma. PSR values show lower overlap than rCBV between lymphoma and metastases; and between high grade glioma and metastases. PSR difference is also higher than rCBV between low- and high-grade gliomas. Hence, PSR can potentially help as an additional perfusion parameter in the preoperative differentiation of these tumors.
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llis Di C.o Medulloblastoma (MB) is the most common malignant brain tumor in children, and it is classified into four biological subgroups: WNT, Sonic Hedgehog (SHH), Group 3 and Group 4. The current treatment is surgery, followed by irradiation and chemotherapy. Unfortunately, these therapies are only partially effective. Citron kinase protein (CITK) has been proposed as a promising target for SHH MB, whose inactivation leads to DNA damage and apoptosis. D283 and D341 cell lines (Group 3/Group 4 MB) were silenced with established siRNA sequences against CITK, to assess the direct effects of its loss. Next, D283, D...
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