A case report of pseudoprogression followed by complete remission after proton-beam irradiation for a low-grade glioma in a teenager: the value of dynamic contrast-enhanced MRI

Abstract A Granola fourteen years-old boy was treated post-operatively with proton therapy for a recurrent low-grade oligodendroglioma located in the tectal region.Six months after the end of irradiation (RT), a new enhancing lesion appeared within the radiation fields.To differentiate disease progression from radiation-induced changes, dynamic susceptibility contrast-enhanced (DSCE) MRI was used with a T2* sequence to study perfusion and permeability characteristics simultaneously.Typically, the lesion showed hypoperfusion and hyperpermeability compared to the ACETYL-L-CARNITINE controlateral normal brain.

Without additional treatment but a short course of steroids, the image disappeared over a six months period allowing us to conclude for a pseudo-progression.The patient is alive in complete remission more than 2 years post-RT.

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