Radionecrosis in Brain Tumors: Challenges in Diagnosis and Treatment

Rationale and Significance:With the increasing use of radiation therapy and radiosurgery in managing brain tumors, radionecrosis has become a growing clinical challenge. Distinguishing radionecrosis from tumor recurrence remains a critical issue in neuro-oncology, as both can present similarly in imaging and clinical evaluation. The lack of definitive diagnostic criteria often leads to unnecessary interventions or delays in appropriate treatment. Moreover, therapeutic strategies for radionecrosis remain limited, with corticosteroids, bevacizumab, and emerging techniques such as laser interstitial thermal therapy (LITT) offering varying degrees of success. This topic aims to explore the pathophysiology, diagnostic advancements, and evolving treatment approaches for radionecrosis.Scope and Focus Areas:• Pathophysiology and Risk Factors: Mechanisms underlying radiation-induced necrosis and patient-specific risk factors.• Diagnostic Challenges and Advances: Differentiating radionecrosis from tumor progression and pseudo-progression using advanced imaging modalities (e.g., perfusion MRI, PET, radiomics), AI-driven analysis, and liquid biopsy approaches.• Current and Emerging Therapeutic Strategies: Corticosteroids, bevacizumab, hyperbaric oxygen therapy, LITT, and novel neuroprotective strategies.• Impact on Patient Outcomes: Functional and cognitive consequences of radionecrosis, quality-of-life considerations, and long-term management strategies.• Future Directions in Research: Potential biomarkers, immunomodulatory approaches, and personalized treatment paradigms.This topic will provide a comprehensive overview of the current landscape of radionecrosis in neuro-oncology, fostering discussion on innovative diagnostic and therapeutic solutions. Contributions from clinicians, radiologists, neurosurgeons, and researchers will be encouraged to enhance the translational impact of this collection. Topic editors: Güliz Acker, Peter Vajkoczy, Alfredo Conti, Selcuk Peker Source: https://www.frontiersin.org/research-topics/79881/radionecrosis-in-brain-tumors-challenges-in-diagnosis-and-treatment