MR spectroscopy in Tumor Recurrence vs. Radiation Necrosis

MRS is highly useful for differentiating recurrent tumors from post-radiation necrosis.

Recurrent tumors demonstrate significantly higher Cho/NAA and Cho/Cr ratios.

Conversely, radiation necrosis typically shows low metabolite peaks overall, frequently featuring a characteristic lactic acid/lipid peak and near-normal peaks for NAA and choline.