SynthesisPloS one2016
Differentiating Radiation-Induced Necrosis from Recurrent Brain Tumor Using MR Perfusion and Spectroscopy: A Meta-Analysis.
Synthesis in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 3 of them syntheses that pooled it.
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Who cites it
74 citing papers in PubMed, 3 syntheses or guidelines pooled it, 155 citations in OpenAlex.
- Timing matters: radiation necrosis risk of antibody-drug conjugates (ADCs) combined with radiation therapy in breast cancer brain metastases: a systematic review and comparative meta-analysis.Neurosurgical review · 2026Pooled it
- Ultra-High-Field MRI in the Diagnosis and Management of Gliomas: A Systematic Review.Frontiers in neurology · 2022Pooled it
- The diagnostic performance of perfusion MRI for differentiating glioma recurrence from pseudoprogression: A meta-analysis.Medicine · 2017Pooled it
- Article
- Mechanisms, Imaging Phenotypes, and Therapeutic Advances of Neovascularization in Brain Metastases.Biomedicines · 2026Review
- Diagnostic imaging and emerging image-guided neurointervention in brain tumors: a narrative review.Frontiers in radiology · 2026Review
- A Radiogenomic Deep Ensemble Learning Model for Identifying Radionecrosis Following Brain Metastases (BM) Stereotactic Radiosurgery in Patients With Non-small Cell Lung Cancer BM.Advances in radiation oncology · 2025Article
- Article
- Improving Diagnostic Robustness of Perfusion MRI in Brain Metastases: A Focus on 3D ROI Techniques and Automatic Thresholding.Cancers · 2025Article
- Longitudinal Overlap and Metabolite Analysis in Spectroscopic MRI-Guided Proton Beam Therapy in Pediatric High-Grade Glioma.Tomography (Ann Arbor, Mich.) · 2025Article
- Stereotactic radiosurgery for patients with brain metastases: current principles, expanding indications and opportunities for multidisciplinary care.Nature reviews. Clinical oncology · 2025Review
- Radiogenomic explainable AI with neural ordinary differential equation for identifying post-SRS brain metastasis radionecrosis.Medical physics · 2025Article
- Differentiation Between Radiation Necrosis and True Tumour Progression After Radiotherapy to Intracranial Metastases.Journal of medical imaging and radiation oncology · 2025Review
- Multiple pseudoprogressions during ongoing immunotherapy-based treatment of advanced gastric neuroendocrine carcinoma: A case report and review of literature.World journal of gastrointestinal oncology · 2025Article
- Modernizing Neuro-Oncology: The Impact of Imaging, Liquid Biopsies, and AI on Diagnosis and Treatment.International journal of molecular sciences · 2025Review
- Development and validation of a deep learning algorithm for discriminating glioma recurrence from radiation necrosis on MRI.Frontiers in oncology · 2025Article
- Long-Term Imaging Follow-up of Radiation Necrosis After Stereotactic Radiosurgery: A Case Report and Lessons Learned.Advances in radiation oncology · 2024Article
- Evaluating the Efficacy of Perfusion MRI and Conventional MRI in Distinguishing Recurrent Cerebral Metastasis from Brain Radiation Necrosis.Brain sciences · 2024Article
- Novel radiotherapeutic strategies in the management of brain metastases: Challenging the dogma.Neuro-oncology · 2024Review
- Clinical Practice Guidelines for Brain Metastasis From Solid Tumors.Brain tumor research and treatment · 2024Review
14 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis meta-analysis examined roles of several metabolites in differentiating recurrent tumor from necrosis in patients with brain tumors using MR perfusion and spectroscopy.
methodsMedline, Cochrane, EMBASE, and Google Scholar were searched for studies using perfusion MRI and/or MR spectroscopy published up to March 4, 2015 which differentiated between recurrent tumor vs. necrosis in patients with primary brain tumors or brain metastasis. Only two-armed, prospective or retrospective studies were included. A meta-analysis was performed on the difference in relative cerebral blood volume (rCBV), ratios of choline/creatine (Cho/Cr) and/or choline/N-acetyl aspartate (Cho/NAA) between participants undergoing MRI evaluation. A χ2-based test of homogeneity was performed using Cochran's Q statistic and I2.
resultsOf 397 patients in 13 studies who were analyzed, the majority had tumor recurrence. As there was evidence of heterogeneity among 10 of the studies which used rCBV for evaluation (Q statistic = 31.634, I2 = 97.11%, P < 0.0001) a random-effects analysis was applied. The pooled difference in means (2.18, 95%CI = 0.85 to 3.50) indicated that the average rCBV in a contrast-enhancing lesion was significantly higher in tumor recurrence compared with radiation injury (P = 0.001). Based on a fixed-effect model of analysis encompassing the six studies which used Cho/Cr ratios for evaluation (Q statistic = 8.388, I2 = 40.39%, P = 0.137), the pooled difference in means (0.77, 95%CI = 0.57 to 0.98) of the average Cho/Cr ratio was significantly higher in tumor recurrence than in tumor necrosis (P = 0.001). There was significant difference in ratios of Cho to NAA between recurrent tumor and necrosis (1.02, 95%CI = 0.03 to 2.00, P = 0.044).
conclusionsMR spectroscopy and MR perfusion using Cho/NAA and Cho/Cr ratios and rCBV may increase the accuracy of differentiating necrosis from recurrent tumor in patients with primary brain tumors or metastases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.