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Fig. 8 | Cancer Imaging

Fig. 8

From: Improving the diagnosis of radiation necrosis after stereotactic radiosurgery to intracranial metastases with conventional MRI features: a case series

Fig. 8

Axial (a) and coronal (b) post-contrast T1WI in a patient who was treated with a right orbital exenteration and adjuvant intensity-modulated RT (60 Gy in 30 fractions) for metastatic cutaneous squamous cell carcinoma to the medial canthus. Three years later, new enhancement developed in the right temporal lobe. While FET-PET (not shown) suggested true tumor progression, the suspicion of RN remained based on MRI, prompting a short-interval follow-up MRI (c & d). While the lesion is similar in size overall, multiplanar assessment reveals a change in the shape. The temporo-occipital sulcus (arrowheads) and adjacent cortex, which are spared, divide the overall lesion into two contiguous components: medial and lateral. While the medial component has enlarged, the lateral component has receded. The lesion continued to regress thereafter, confirming RN

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