Differentiation of cerebral radiation necrosis from tumor recurrence by proton magnetic resonance spectroscopy

Neurol Med Chir (Tokyo). 1997 Mar;37(3):250-6. doi: 10.2176/nmc.37.250.


Proton magnetic resonance spectroscopy (1H MRS) was evaluated for distinguishing between radiation necrosis and recurrent glioma in 11 patients after high-dose radiotherapy. Six patients had a histological diagnosis of recurrent glioma. Four patients had a histological diagnosis of radiation necrosis and one had a clinical course consistent with the diagnosis of radiation necrosis. 1H MRS showed cases of radiation necrosis had two characteristic 1H MRS patterns: markedly increased lactate/creatine and phosphocreatine (Cr) ratio and decreased choline-containing compounds/Cr ratio compared to that of recurrent glioma; or all the major metabolites were completely diminished. The N-acetyl aspartate signal was not helpful for differential diagnosis. 1H MRS is a potentially useful method for differentiating tumor recurrence from radiation necrosis in patients treated for malignant glioma.

MeSH terms

  • Adult
  • Aged
  • Brain Neoplasms / diagnosis*
  • Female
  • Glioblastoma / diagnosis*
  • Humans
  • Magnetic Resonance Spectroscopy
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis*