ArticleJournal of neuro-oncology2025
Percentage of signal recovery (PSR): a more accurate marker than rCBV for differentiating radiation necrosis from tumor progression in brain metastases treated with stereotactic radiosurgery.
Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Advances in the prevention and treatment of radiation-induced brain necrosis: a narrative review.Frontiers in oncology · 2026Review
- A clinical decision-support framework to differentiate radiation necrosis from tumor progression in brain metastases.Neuro-oncology advancesArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo compare the diagnostic performance of relative cerebral blood volume (rCBV) and percentage of signal recovery (PSR), both derived from dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI), in distinguishing tumor progression from radiation necrosis in brain metastases that have been treated with stereotactic radiosurgery (SRS).
methodsThis retrospective, single-centre study analysed 96 brain metastases with post-radiotherapy increase in contrast enhancement. The lesions were classified as tumor progression (n = 46) or radiation necrosis (n = 50) based on histopathology and clinical evolution determined by consensus in the multidisciplinary committee. All patients underwent dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) with leakage correction and contrast preload, and rCBV was normalised to contralateral white matter. PSR was calculated from the T2* signal-time curve as (S
resultsThe median rCBV was significantly higher in tumor progression than in radiation necrosis (4.21 vs. 1.6; p < 0.001), whereas the PSR was significantly lower (59.58% vs. 88.61%, p < 0.001). AUC was 0.86 for rCBV and 0.99 for PSR. PSR outperformed rCBV (p = 0.0028, DeLong test). An optimal cut-off value for rCBV of 2.42 yielded 91.7% sensitivity and 72.2% specificity and for PSR of 68.8% yielded 95.8% sensitivity and 98.1% specificity.
conclusionPSR is more accurate than rCBV in distinguishing tumor progression versus radiation necrosis after SRS in brain metastases. PSR is a reliable, non-invasive biomarker that can improve clinical decision-making.
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