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radiation necrosis

Radiation necrosis in the brain can produce a clinical picture & result in CT or MRI imaging studies indistinguishable from recurrent high-grade tumor. PET & SPECT scan may be useful for distinguishing the two. Theoretically, necrosis should show hypometabolism & tumor recurrence should show hypermetabolism. However, both radiation necrosis & tumor recurrence may both be present making interpretation of PET & SPECT scans difficult. Management: 1) no adequate treatment 2) anticoagulation has been reported to be of benefit 3) experimental - in mice, fluoroquinolone & an endotoxin-clearing protein (rBPI21) mitigate radiation-induced bone marrow aplasia & necrosis

Related

radiation therapy (XRT)

General

necrosis radiation injury; radiation toxicity

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  2. Guinan EC et al. Bactericidal/permeability-increasing protein (rBPI21) and fluoroquinolone mitigate radiation-induced bone marrow aplasia and death. Sci Transl Med 2011 Nov 23; 3:110ra118 Not yet indeexed in PubMed http://stm.sciencemag.org/content/3/110/110ra118