{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T22:30:37Z","timestamp":1789252237668,"version":"build-2803163510"},"reference-count":39,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Institute research fund","award":["ZL202114"],"award-info":[{"award-number":["ZL202114"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Acta Radiol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Distinguishing radiation necrosis (RN) from recurrent tumor (RT) in patients with gliomas treated with radiation therapy presents an important clinical dilemma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the diagnostic performance of multiparametric magnetic resonance imaging (MRI) techniques in distinguishing RN from RT in patients with histologically confirmed glioma treated previously with radiotherapy and chemotherapy or without chemotherapy using a combination of dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>\n                      Patients with glioma who developed a new enhancing mass after standard treatment were retrospectively evaluated. Conventional MRI, DTI, DSC, and MRS were performed. The region of interest (ROI) was manually drawn in the enhancing lesions, peri-lesional white matter edema, and the contralateral normal-appearing white matter. Apparent diffusion coefficient (ADC), fractional anisotropy (FA), relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), N-acetylaspartate (NAA), choline (Cho), creatine (Cr), NAA\/Cr, Cho\/NAA, and Cho\/Cr were calculated. Two-tailed\n                      <jats:italic>t<\/jats:italic>\n                      -test and receiver operating characteristic (ROC) curve analysis were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 34 patients with RT and 25 with RN met our inclusion criteria. FA, rCBF, rCBV, Cho\/NAA, Cho\/Cr were statistically significant between the two groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). The sensitivity and specificity of FA, rCBF, rCBV, Cho\/NAA, and Cho\/Cr in the diagnosis of RT were 70.6%, 97.1%, 91.2%, 91.2%, and 82.4% and 64%, 100%, 100%, 96%, and 72% respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DTI, DSC, and MRS are of great value in the differential diagnosis of RN and RT of glioma. The diagnostic performance of DSC is better than DTI and MRS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02841851241310392","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T02:46:21Z","timestamp":1738723581000},"page":"386-392","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Diagnostic value and efficacy of multimodal magnetic resonance imaging in differentiating radiation necrosis from tumor recurrence in glioblastomas"],"prefix":"10.1177","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5831-1722","authenticated-orcid":false,"given":"Xiao-Qiong","family":"Lv","sequence":"first","affiliation":[{"name":"Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Rong","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Dong","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2217\/cns.14.35"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1580"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-015-4046-z"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-011-0694-2"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcl.2019.07.003"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12460"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.13050"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2016.02.016"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-009-1449-8"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-017-2407-y"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2014.09.018"},{"key":"e_1_3_2_13_2","first-page":"515","article-title":"Differentiating tumor recurrence from treatment necrosis: a review of neuro-oncologic imaging strategies","volume":"15","author":"Verma N","year":"2013","unstructured":"Verma N, Cowperthwaite MC, Burnett MG, et al. Differentiating tumor recurrence from treatment necrosis: a review of neuro-oncologic imaging strategies. Neurooncol 2013;15:515\u2013534.","journal-title":"Neurooncol"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.17.18003"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2532090007"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-019-1228-x"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2015.11.015"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-009-0106-z"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-010-0731-4"},{"key":"e_1_3_2_20_2","first-page":"201","article-title":"Diffusion-weighted imaging in the follow-up of treated high-grade gliomas: tumor recurrence versus radiation injury","volume":"25","author":"Hein PA","year":"2004","unstructured":"Hein PA, Eskey CJ, Dunn JF, et al. Diffusion-weighted imaging in the follow-up of treated high-grade gliomas: tumor recurrence versus radiation injury. AJNR Am J Neuroradiol 2004;25:201\u2013209.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2006.07.008"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.12.001"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-009-9897-1"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-017-1955-3"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/now148"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.26621"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/6828396"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2008.08.009"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2018.01.009"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.14791\/btrt.2015.3.1.8"},{"key":"e_1_3_2_31_2","first-page":"941","article-title":"Contrast-enhanced perfusion MR imaging to differentiate between recurrent\/residual brain neoplasms and radiation necrosis","volume":"19","author":"Metaweh NAK","year":"2018","unstructured":"Metaweh NAK, Azab AO, El Basmy AAH, et al. Contrast-enhanced perfusion MR imaging to differentiate between recurrent\/residual brain neoplasms and radiation necrosis. Asian Pac J Cancer Prev 2018;19:941\u2013948.","journal-title":"Asian Pac J Cancer Prev"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-009-0613-9"},{"key":"e_1_3_2_33_2","first-page":"81","article-title":"Differentiation between brain tumor recurrence and radiation injury using perfusion, diffusion-weighted imaging and MR spectroscopy","volume":"48","author":"Bobek-Billewicz B","year":"2010","unstructured":"Bobek-Billewicz B, Stasik-Pres G, Majchrzak H, et al. Differentiation between brain tumor recurrence and radiation injury using perfusion, diffusion-weighted imaging and MR spectroscopy. Folia Neuropathol 2010;48:81\u201392.","journal-title":"Folia Neuropathol"},{"key":"e_1_3_2_34_2","first-page":"901","article-title":"Posttherapeutic intraaxial brain tumor: the value of perfusion-sensitive contrast-enhanced MR imaging for differentiating tumor recurrence from nonneoplastic contrast-enhancing tissue","volume":"21","author":"Sugahara T","year":"2000","unstructured":"Sugahara T, Korogi Y, Tomiguchi S, et al. Posttherapeutic intraaxial brain tumor: the value of perfusion-sensitive contrast-enhanced MR imaging for differentiating tumor recurrence from nonneoplastic contrast-enhancing tissue. AJNR Am J Neuroradiol 2000;21:901\u2013909.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002340100703"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-017-4789-9"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-019-1271-7"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.09.233"},{"key":"e_1_3_2_39_2","first-page":"912","article-title":"Correlations between magnetic resonance spectroscopy and image-guided histopathology, with special attention to radiation necrosis","volume":"51","author":"Rock JP","year":"2002","unstructured":"Rock JP, Hearshen D, Scarpace L, et al. Correlations between magnetic resonance spectroscopy and image-guided histopathology, with special attention to radiation necrosis. Neurosurgery 2002;51:912\u2013919.","journal-title":"Neurosurgery"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-007-9341-3"}],"container-title":["Acta Radiologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02841851241310392","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02841851241310392","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02841851241310392","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:34:26Z","timestamp":1777390466000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02841851241310392"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":39,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/02841851241310392"],"URL":"https:\/\/doi.org\/10.1177\/02841851241310392","relation":{},"ISSN":["0284-1851","1600-0455"],"issn-type":[{"value":"0284-1851","type":"print"},{"value":"1600-0455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,4]]}}}