ABSTRACT
Clinically, the need to distinguish radiation necrosis from tumour recurrence is common and critical, because the two are managed quite differently. On routine magnetic resonance (MR) imaging, a ‘soap bubble’ or ‘Swiss cheese-like’ interior favours radiation necrosis, although this sign is neither sufficiently sensitive nor specific.26 Other examples display features that are indistinguishable from high-grade glioma. Newer radiologic modalities, such as diffusion weighted imaging (DWI), perfusion studies, proton magnetic resonance spectroscopy (H-MRS), and positron emission tomography (PET) have further
Introduction .............................................................................1954 Radiation Necrosis and Other Forms of Radiation Injury ...........1954 Therapy-Induced Leukoencephalopathies and Vasculopathies .1956
