Distinct Cerebrovascular Reactivity Patterns for Brain Radiation Necrosis

Background: Current imaging-based discrimination between radiation necrosis versus recurrent glioblastoma contrast-enhancing lesions remains imprecise but is paramount for prognostic and therapeutic evaluation. We examined whether patients with exhibit distinct patterns of blood oxygenation-level dependent fMRI cerebrovascular reactivity (BOLD-CVR) as the first step to better distinguishing from compared newly diagnosed before surgery radiotherapy. Methods: Eight consecutive primary secondary brain tumors a multidisciplinary clinical radiological diagnosis necrosis, fourteen underwent BOLD-CVR mapping. For all these patients, lesion was derived high-resolution T1-weighted MRI rendered volume-of-interest (VOI). From this VOI, additional 3 mm concentric expanding VOIs up 30 were created detailed perilesional tissue analysis two groups. Receiver operating characteristic curves assessed discriminative properties both Results: Mean intralesional values markedly lower in than (0.001 ± 0.06 vs. 0.057 0.05; p = 0.04). Perilesionally, pattern observed an improvement group persisting patients. The ROC discriminated against groups when parameters analyzed together (area under curve: 0.85, 95% CI: 0.65–1.00). Conclusions: In preliminary analysis, distinctive BOLD-cerebrovascular are found necrosis.