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Abstract #1854

Differential diagnosis of brain tumor recurrence and radiation necrosis using MR spectroscopy

Dita Wagnerova 1 , Alberto Malucelli 2 , Monika Dezortova 1 , Filip Jiru 1 , Antonin Skoch 1 , Robert Bartos 2 , Martin Sames 2 , and Milan Hajek 1

1 Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic, 2 Department of Neurosurgery, JE Purkyne University and Masaryk Hospital, Usti nad Labem, Czech Republic

MR imaging and MR spectroscopy are used for a differential diagnosis (DD) between tumor recurrence and radionecrosis. In case of MR spectroscopy, most of the authors recommend using increased Choline to Creatine ratio (Cho/Cr) as a marker of tumor recurrence. To further explore this issue, we compared several MRS evaluation methods with histopathology. We found statistically different Cho/Cr values between group of tumor recurrence and group of radionecrosis. However, case-by-case specificity was low. As tumor recurrence showed interhemispheral Choline increase > 15% and radionecrosis < 15%, interhemispheral comparison of Choline values in individual subjects was the best method for DD.

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