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The authors evaluated the feasibility of MR permeability imaging by comparison with ¹¹C-methionine-PET, FDG-PET, and DWI for differentiating radiation necrosis from recurrent tumors in 15 patients with 18 lesions following gamma knife radiosurgery. The area under the ROC curve for differentiating radiation necrosis from recurrent tumors was the best for the ¹¹C-methionine ratio (0.90) followed by the contrast-enhancement ratio (0.81), maximum slope of increase (millimole/second) (0.80), and the initial area under the signal intensity–time curve (0.78). They conclude that PET using ¹¹C-methionine may be superior to MR permeability imaging, ADC, and FDG-PET for differentiating radiation necrosis from recurrent tumors after gamma knife radiosurgery for metastatic brain tumors.

Sixty-two patients with acute basilar artery occlusion underwent multimodal endovascular therapy with stent-retriever thrombectomy as a first-line endovascular therapy. Patients with underlying intracranial atherosclerotic stenosis underwent additional intracranial angioplasty and stent placement. Underlying intracranial atherosclerotic stenosis was identified at the occlusion site in 15 patients (24.1%). Occlusion in the proximal segment of the basilar artery was more common in patients with intracranial atherosclerotic stenosis (60% versus 6.4%), whereas occlusion in the distal segment was more common in those without it. Patients with and without underlying intracranial atherosclerotic stenosis who underwent endovascular therapy had similar outcomes.