Department of Neurosurgery, Chinese Medicine Hospital of Guangdong Province, Guangzhou, China; The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.
International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, University Hospital, Uppsala University, S-75185 Uppsala, Sweden.
Int Rev Neurobiol. 2020;151:281-297. doi: 10.1016/bs.irn.2020.03.009. Epub 2020 May 13.
Gliomas are the most common malignant primary brain tumor, and their prognosis is extremely poor. Radiotherapy is an important treatment for glioma patients, but the changes caused by radiotherapy have brought difficulties in clinical image evaluation because differentiating glioma recurrence from post-radiotherapy changes including pseudo-progression (PD) and radiation necrosis (RN) remains a challenge. Therefore, accurate and reliable imaging evaluation is very important for making clinical decisions. In recent years, advanced multimodal imaging techniques have been applied to achieve the goal of better differentiating glioma recurrence from post-radiotherapy changes for minimizing errors associated with interpretation of treatment effects. In this review, we discuss the recent applications of advanced multimodal imaging such as diffusion MRI sequences, amide proton transfer MRI sequences, perfusion MRI sequences, MR spectroscopy and multinuclides PET/CT in the evaluation of post-radiotherapy treatment response in glioma patients and highlight their potential role in differentiating post-radiotherapy changes from glioma recurrence.
脑胶质瘤是最常见的原发性恶性脑肿瘤，其预后极差。放射治疗是脑胶质瘤患者的重要治疗方法，但放疗引起的变化给临床影像评估带来了困难，因为区分胶质瘤复发与放疗后变化（包括假性进展[PD]和放射性坏死[RN]）仍然具有挑战性。因此，准确可靠的影像学评估对于做出临床决策非常重要。近年来，先进的多模态成像技术已被应用于实现更好地区分胶质瘤复发与放疗后变化的目标，以最大程度地减少因解释治疗效果而产生的错误。在本综述中，我们讨论了扩散 MRI 序列、酰胺质子转移 MRI 序列、灌注 MRI 序列、磁共振波谱和多核素 PET/CT 等先进多模态成像在评估脑胶质瘤患者放疗后治疗反应中的最新应用，并强调了它们在区分放疗后变化与胶质瘤复发中的潜在作用。
