03 December 2025 : Clinical Research
Biologically Guided Gamma Knife Dose Painting for Recurrent High-Grade Gliomas: A Retrospective Study Using Functional MRI Techniques
Mehmet Hakan Seyithanoğlu
ABCDEFG 1*, İsmail Yurtsever ABCD 2, Meliha Gundag Papaker DEF 1, Ahmet Serdar Mutluer CDEF 3, Tolga Turan Dundar DEF 4,5, Serkan Kitis ABCEF 1, Kerime Akdur BEF 6, Alpaslan Mayadağlı AEF 6,7
DOI: 10.12659/MSM.949489
Med Sci Monit 2025; 31:e949489
Figure 5 Pre-stereotactic radiosurgery multivoxel MR spectroscopy supports biologic target definitionMultiplanar views show MR spectroscopy voxel placement and spectra in the recurrent glioblastoma. The medial tumor voxel demonstrates elevated choline (Cho) and reduced N-acetylaspartate (NAA) with Cho/NAA approximately equal to 2.69 (values displayed), corresponding spatially to the high-volume transfer constant (K-trans) region on dynamic contrast-enhanced MRI. These metabolite abnormalities contributed to labeling the sub-volume as aggressive for dose escalation in plan 2.