The value of intraoperative and early postoperative MRI in low-grade glioma surgery A retrospective study.

The value of intraoperative and early postoperative MRI in low-grade glioma surgery A retrospective study.

World Neurosurg. 2016 Jun 8;

Authors: Pala A, Brand C, Kapapa T, Hlavac M, König R, Schmitz B, Wirtz CR, Coburger J

Abstract
Presence of residual tumor is crucial in decision making in low grade gliomas (LGGs), since patients with residual tumor and age over 40 are considered for adjuvant treatment. There are hints, that early postoperative FLAIR and T2 (within 48 hours) may overestimate residual tumor volume in LGG. Intraoperative MRI (iMRI) without subsequent resection or ultra-early postoperative MRI may assess the amount of residual tumor more adequately. To evaluate the utility of postoperative imaging in LGG we volumetrically analyzed intraoperative, early and late (3-4 months after surgery) postoperative MRI in LGG.
PATIENTS AND METHODS: A total of 33 patients with LGG were assessed retrospectively. Residual tumor was defined as signal enhanced tissue in T2 and FLAIR. Volumetric assessment was performed using intraoperative, early and late postoperative T2/Flair using Brainlab-iPlan 3.0. Wilcoxon and Chi-Square tests were used for statistical analysis.
RESULTS: A significant difference of FLAIR/T2 abnormalities was found in intraoperative and early postoperative MRI (FLAIR mean volume=5.433cm(3),T2 mean volume=3.374 cm(3) vs. FLAIR mean volume=14.090 cm(3), p=0.002,T2 mean volume=7.597 cm(3),p=0.006). There was no significant difference between intraoperative and late postoperative FLAIR/T2 abnormalities (late postoperative FLAIR/T2 mean volume=5.560 cm(3) and 2.370 cm(3), p=0.520, p=0,398) whereas a significant difference was detected between early and late postoperative images (FLAIR, p<0.0001,T2, p<0.00001).
CONCLUSION: Intraoperative MRI without further resection or ultra-early postoperative MRI seems to reflect the actual volume of residual tumor in LGG more precisely compared to early postoperative MRI and therefore seems to be more useful regarding decisions for adjuvant therapy.

PMID: 27288582 [PubMed - as supplied by publisher]

from Glioma via xlomafota13 on Inoreader http://ift.tt/1Uo64iN
http://ift.tt/1Uo64iN Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Yl6t7j
via IFTTT