Malignant gliomas: MR imaging spectrum of radiation therapy- and chemotherapy-induced necrosis of the brain after treatment.

By Ashok J. Kumar, N. Leeds, Gregory N. Fuller, P. Tassel', M. Maor, Raymond E. Sawaya, Victor A. Levin. Radiology, 2000

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Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. (2010, background): “Increased enhancement can also be induced by a variety of nontumoral processes such as treatment-related inflammation, seizure activity, postsurgical changes, ischemia, subacute radiation effects, and radiation necrosis.(20-23) As a result, there are significant limitations in equating changes in en”
Response Assessment in Neuro-Oncology working group and European Association for Neuro-Oncology recommendations for the clinical use of PET imaging in gliomas. (2016, background): “The extent of contrast enhancement on MRI is usually considered an indicator of treatment response (eg, Macdonald criteria, RANO criteria),(5,57) although its reliability in distinguishing tumor tissue from treatment effects, which can include blood–brain barrier breakdown, is limited.(58) For examp”