"Although post-radiation treatment effects include pseudoprogression 3, which by definition is considered to be radiation treatment-related necrosis, particularly in the setting of concurrent chemotherapy for glioblastoma (Stupp protocol), this article focuses on the delayed onset effects of radiation necrosis, which appears months to several years after radiation therapy and involves a space-occupying necrotic lesion with mass effect and neurological dysfunction 10."
"T2/FLAIR: white matter high signal"
"18F-FET-PET"
"pure radiation necrosis will show low choline, creatine, and NAA with elevated lipid and lactate"
"radiation necrosis has both lower mean and max SUV uptake compared to normal brain parenchyma 7"
"Boswellia serrata supplements: may have a role in improving perilesional oedema as a steroid-sparing therapy 9"
"Boswellia serrata supplements: may have a role in improving perilesional oedema as a steroid-sparing therapy 9"
Expected headings
"FDG-PET"
"18F-FET-PET"
"Cerebral radiation necrosis or radionecrosis refers to necrotic degradation of brain tissue following intracranial or regional radiation, either delivered for the treatment of intracranial pathology (e.g. astrocytoma, cerebral arteriovenous malformation) or as a result of irradiation of head and neck tumours (e.g. nasopharyngeal carcinoma)."
"There are numerous potential pathways to radiation necrosis, which include:"
"chronically fibrosis, hyalinisation and stenosis can occur with eventual thrombosis and infarction"
"MRI is the modality of choice to assess potential radiation necrosis. Combining morphology and perfusion, diffusion and spectroscopy, it is often possible to distinguish necrosis from other pathologies, particularly tumour recurrence 1,2."
"these may also be present in tumours, however and are thus of limited help in distinguishing between the two entities 12"
"In cases that are refractory to corticosteroids, alternative or advanced therapies include:"