ArticleNeuro-oncology advances
Is pulsed saturation transfer sufficient for differentiating radiation necrosis from tumor progression in brain metastases?
Article in Neuro-oncology advances. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Descriptive Analysis of Surgically Resected Pure Radiation Necrosis After Radiation Therapy for Brain Metastasis: Clinical Features, MRI Findings, and Outcomes.Brain tumor research and treatment · 2026Article
- Applications of Advanced Imaging for Radiotherapy Planning and Response Assessment in the Central Nervous System.Tomography (Ann Arbor, Mich.) · 2025Review
- Article
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22 authors.
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Abstract
Background: Stereotactic radiosurgery (SRS) for the treatment of brain metastases delivers a high dose of radiation with excellent local control but comes with the risk of radiation necrosis (RN), which can be difficult to distinguish from tumor progression (TP). Magnetization transfer (MT) and chemical exchange saturation transfer (CEST) are promising techniques for distinguishing RN from TP in brain metastases. Previous studies used a 2D continuous-wave (ie, block radiofrequency [RF] saturation) MT/CEST approach. The purpose of this study is to investigate a 3D pulsed saturation MT/CEST approach with perfusion MRI for distinguishing RN from TP in brain metastases. Methods: The study included 73 patients scanned with MT/CEST MRI previously treated with SRS or fractionated SRS who developed enhancing lesions with uncertain diagnoses of RN or TP. Perfusion MRI was acquired in 49 of 73 patients. Clinical outcomes were determined by at least 6 months of follow-up or via pathologic confirmation (in 20% of the lesions). Results: Univariable logistic regression resulted in significant variables of the quantitative MT parameter 1/(R Conclusions: Pulsed saturation transfer was sufficient for achieving a multivariable AUC of 75% for differentiating between RN and TP in brain metastases, but had lower AUCs compared to previous studies that used a block RF approach.
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