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Review
. 2014 Jul 3;15(7):11832-46.
doi: 10.3390/ijms150711832.

The diagnosis and treatment of pseudoprogression, radiation necrosis and brain tumor recurrence

Kashif Parvez  1 , Aatif Parvez  2 , Gelareh Zadeh  3
Affiliations
Review

The diagnosis and treatment of pseudoprogression, radiation necrosis and brain tumor recurrence

Kashif Parvez et al. Int J Mol Sci. .

Abstract

Radiation therapy is an important modality used in the treatment of patients with brain metastatic disease and malignant gliomas. Post-treatment surveillance often involves serial magnetic resonance imaging. A challenge faced by clinicians is in the diagnosis and management of a suspicious gadolinium-enhancing lesion found on imaging. The suspicious lesion may represent post-treatment radiation effects (PTRE) such as pseudoprogression, radiation necrosis or tumor recurrence. Significant progress has been made in diagnostic imaging modalities to assist in differentiating these entities. Surgical and medical interventions have also been developed to treat PTRE. In this review, we discuss the pathophysiology, clinical presentation, diagnostic imaging modalities and provide an algorithm for the management of pseudoprogression, radiation necrosis and tumor recurrence.

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Figures

Figure 1
Figure 1
An algorithm to aid in the diagnosis and management of patients with pseudoprogression, radiation necrosis and tumor recurrence/progression.
See this image and copyright information in PMC

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