Differentiation of treatment-related radiation necrosis from recurrent neoplasm is often difficult and dynamic susceptibility contrast perfusion MR imaging (DSC-MRI) is reported to be a surrogate marker for distinguishing them. However, DSC technique is invasive and has its disadvantage. Three dimensional pseudo-continuous ASL (3D-pcASL) can provide noninvasive absolute cerebral blood flow (CBF) measurement with insensitivity to permeability, and it is especially necessary for the evaluation of the postoperative gliomas patients where the blood-brain barrier (BBB) is completely broken with much more leakage effects. This study aimed to differentiate true progression from radiation necrosis of gliomas by using 3D-pcASL and DSC-MRI.
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