Differentiation of radiation necrosis from tumor progression using proton magnetic resonance spectroscopy

Neuroradiology. 2002 Mar;44(3):216-22. doi: 10.1007/s002340100703.


We report on a young woman who was treated by stereotactic radiotherapy for recurrence of an initially resected low-grade astrocytoma. MRI follow-up examination 7 months after radiotherapy showed a gadolinium-DTPA-enhancing mass lesion indicative of high-grade tumor progression. This assumption was also supported by positron emission tomography with [2-18F]fluoro-2-deoxy-D-glucose (FDG-PET). In contrast, proton MR spectroscopy (1H-MRS) indicated radiation necrosis, which was confirmed histopathologically in surgical specimens. Subsequent follow-up examinations up to 19 months after surgery showed no evidence of tumor recurrence.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Astrocytoma / diagnosis*
  • Astrocytoma / radiotherapy
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / radiotherapy
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Gadolinium DTPA
  • Humans
  • Magnetic Resonance Imaging
  • Magnetic Resonance Spectroscopy
  • Necrosis
  • Neoplasm Recurrence, Local / radiotherapy
  • Radiation Injuries / diagnosis*
  • Radiotherapy / methods
  • Time Factors
  • Tomography, Emission-Computed


  • Contrast Media
  • Gadolinium DTPA