Early MRI changes in glioblastoma in the period between surgery and adjuvant therapy

Paolo Farace, Dante Amelio, Giuseppe K. Ricciardi, Giada Zoccatelli, Stefano Magon, Francesca Pizzini, Franco Alessandrini, Andrea Sbarbati, Maurizio Amichetti, Alberto Beltramello

Research output: Contribution to journalArticlepeer-review

Abstract

To investigate the increase in MRI contrast enhancement (CE) occurring in glioblastoma during the period between surgery and initiation of chemo-radiotherapy, thirty-seven patients with newly diagnosed glioblastoma were analyzed by early post-operative magnetic resonance (EPMR) imaging within three days of surgery and by pre-adjuvant magnetic resonance (PAMR) examination before adjuvant therapy. Areas of new CE were investigated by use of EPMR diffusion-weighted imaging and PAMR perfusion imaging (by arterial spin-labeling). PAMR was acquired, on average, 29.9 days later than EPMR (range 20-37 days). During this period an increased area of CE was observed for 17/37 patients. For 3/17 patients these regions were confined to areas of reduced EPMR diffusion, suggesting postsurgical infarct. For the other 14/17 patients, these areas suggested progression. For 11/17 patients the co-occurrence of hyperperfusion in PAMR perfusion suggested progression. PAMR perfusion and EPMR diffusion did not give consistent results for 3/17 patients for whom small new areas of CE were observed, presumably because of the poor spatial resolution of perfusion imaging. Before initiation of adjuvant therapy, areas of new CE of resected glioblastomas are frequently observed. Most of these suggest tumor progression, according to EPMR diffusion and PAMR perfusion criteria.

Original languageEnglish
Pages (from-to)177-185
Number of pages9
JournalJournal of Neuro-Oncology
Volume111
Issue number2
DOIs
Publication statusPublished - Jan 2013

Keywords

  • Diffusion MRI
  • Gadolinium DTPA
  • Glioblastoma
  • Neurosurgery
  • Perfusion-weighted MRI

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neurology

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