Diffusion restriction in a non-enhancing metastatic brain tumor treated with bevacizumab - recurrent tumor or atypical necrosis?

Lakshmanan Sivasundaram, Saman Hazany, Naveed Wagle, Gabriel Zada, Thomas C. Chen, Alexander Lerner, John L. Go, Francesco D'Amore, Meng Law, Mark S. Shiroishi

Research output: Contribution to journalArticleOtherpeer-review

4 Citations (Scopus)


A 38-year-old female with metastatic brain cancer developed non-enhancing, diffusion restricted lesions following bevacizumab treatment. From our review of the literature, this is the first reported case of this type of lesion. Clinicians should be wary of these lesions, as they can represent either tumor progression or necrosis/effects of chronic hypoxia from anti-angiogenic therapy. Further investigation is necessary to determine the biological mechanism and clinical significance of this type of imaging appearance.

Original languageEnglish
Pages (from-to)724-726
Number of pages3
JournalClinical Imaging
Issue number5
Publication statusPublished - 1 Jan 2014
Externally publishedYes


  • Atypical necrosis
  • Bevacizumab
  • Brain metastases
  • DWI
  • Recurrent tumor

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