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Differentiating brain radionecrosis from tumour recurrence: a role for contrast-enhanced ultrasound?

  • Case Report - Brain Tumors
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Abstract

Differentiating radionecrosis from tumour recurrence is a major issue in neuro-oncology. Conventional imaging is far from being validated as an alternative to histological assessment. We report the case of a patient operated on for suspected recurrence of brain metastasis 9 months after cyberknife radiosurgery. While magnetic resonance imaging showed strong enhancement of the lesion, intraoperative contrast-enhanced ultrasonography (CEUS) surprisingly did not—different from what is expected for brain metastases. Histopathological examination documented radionecrosis. For the first time, we describe radionecrosis with CEUS; further investigation is needed; however, the lack of enhancement could represent an important hallmark in differential diagnosis with neoplastic tissue.

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Acknowledgements

The research leading to these results has received funding from the European Union Seventh Framework Programme FP7/2007–2013 under grant agreement no. 602923.

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Authors and Affiliations

  1. Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Via Celoria 11, 20133, Milan, Italy

    Luca Mattei, Francesco Prada & Francesco DiMeco

  2. Department of Neurological Surgery, University of Virginia Health Science Center, Charlottesville, VA, USA

    Francesco Prada

  3. Unit of Radiotherapy, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

    Marcello Marchetti

  4. Division of Neurology II - Neuro-Oncology, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

    Paola Gaviani

  5. Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, MD, USA

    Francesco DiMeco

Authors
  1. Luca Mattei
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  2. Francesco Prada
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  3. Marcello Marchetti
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  4. Paola Gaviani
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  5. Francesco DiMeco
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Corresponding author

Correspondence to Francesco Prada.

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The authors declare that there is no conflict of interest.

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Mattei, L., Prada, F., Marchetti, M. et al. Differentiating brain radionecrosis from tumour recurrence: a role for contrast-enhanced ultrasound?. Acta Neurochir 159, 2405–2408 (2017). https://doi.org/10.1007/s00701-017-3306-x

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  • DOI: https://doi.org/10.1007/s00701-017-3306-x

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