Differentiating radionecrosis from tumour recurrence is a major issue in neuro-oncology. Conventional imaging is far from being validated as an alternative to histological assessment. We report the case of a patient operated on for suspected recurrence of brain metastasis 9 months after cyberknife radiosurgery. While magnetic resonance imaging showed strong enhancement of the lesion, intraoperative contrast-enhanced ultrasonography (CEUS) surprisingly did not-different from what is expected for brain metastases. Histopathological examination documented radionecrosis. For the first time, we describe radionecrosis with CEUS; further investigation is needed; however, the lack of enhancement could represent an important hallmark in differential diagnosis with neoplastic tissue.
Differentiating brain radionecrosis from tumour recurrence: a role for contrast-enhanced ultrasound? / L. Mattei, F. Prada, M. Marchetti, P. Gaviani, F. Dimeco. - In: ACTA NEUROCHIRURGICA. - ISSN 0942-0940. - 159:12(2017 Dec), pp. 2405-2408. [10.1007/s00701-017-3306-x]
Differentiating brain radionecrosis from tumour recurrence: a role for contrast-enhanced ultrasound?
L. Mattei;F. Prada;M. Marchetti;F. Dimeco
2017
Abstract
Differentiating radionecrosis from tumour recurrence is a major issue in neuro-oncology. Conventional imaging is far from being validated as an alternative to histological assessment. We report the case of a patient operated on for suspected recurrence of brain metastasis 9 months after cyberknife radiosurgery. While magnetic resonance imaging showed strong enhancement of the lesion, intraoperative contrast-enhanced ultrasonography (CEUS) surprisingly did not-different from what is expected for brain metastases. Histopathological examination documented radionecrosis. For the first time, we describe radionecrosis with CEUS; further investigation is needed; however, the lack of enhancement could represent an important hallmark in differential diagnosis with neoplastic tissue.File | Dimensione | Formato | |
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