Stefanie Bette1, Johannes Kaesmacher2, Thomas Huber2, Claire Delbridge3, Florian Ringel4, Tobias Boeckh-Behrens2, Bernhard Meyer4, Claus Zimmer2, Jan S Kirschke2, Jens Gempt4. 1. Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Electronic address: stefanie.bette@tum.de. 2. Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 3. Department of Neuropathology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 4. Department of Neurorsurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Abstract
OBJECTIVE: The evaluation of postoperative magnetic resonance imaging (MRI) in glioma with no or minimal enhancement is controversial because the evaluation of residual tumor volume can be biased. The purpose of this study was to clarify the value of early postoperative and 3-month MRI regarding its validity in predicting recurrent disease. METHODS: For this retrospective, single-center study, overall fluid attenuated inversion recovery (FLAIR) volumes (early postoperative [<48 hours] and 3-month MRI including FLAIR and T1-weighted sequences with and without contrast agent) of 99 patients were assessed using manual segmentation. FLAIR volume dynamic over the first 3 months after surgery and its effect on disease recurrence were evaluated while considering histopathologic features. RESULTS: Overall FLAIR-hyperintense volume significantly decreased between early postoperative and 3-month follow-up MRIs (P < 0.001). Early FLAIR volume increase had a high positive predictive value for overall disease recurrence after resection (85.71% [95%-CI: 62.64-96.24]). Early FLAIR volume dynamic (P < 0.001), isocitrate dehydrogenase 1/2 status (P = 0.002), and preoperative Karnofsky Performance Status (P = 0.012) were observed as independent factors for progression-free survival in multivariate analysis. CONCLUSION: Early postoperative FLAIR volume assessment in gliomas with no or minimal enhancement is susceptible to a systematic overestimation of residual tumors. Nevertheless, early FLAIR volume dynamic is an independent factor for tumor recurrence that should be evaluated in order timely adapt surveillance and therapy regimens accordingly.
OBJECTIVE: The evaluation of postoperative magnetic resonance imaging (MRI) in glioma with no or minimal enhancement is controversial because the evaluation of residual tumor volume can be biased. The purpose of this study was to clarify the value of early postoperative and 3-month MRI regarding its validity in predicting recurrent disease. METHODS: For this retrospective, single-center study, overall fluid attenuated inversion recovery (FLAIR) volumes (early postoperative [<48 hours] and 3-month MRI including FLAIR and T1-weighted sequences with and without contrast agent) of 99 patients were assessed using manual segmentation. FLAIR volume dynamic over the first 3 months after surgery and its effect on disease recurrence were evaluated while considering histopathologic features. RESULTS: Overall FLAIR-hyperintense volume significantly decreased between early postoperative and 3-month follow-up MRIs (P < 0.001). Early FLAIR volume increase had a high positive predictive value for overall disease recurrence after resection (85.71% [95%-CI: 62.64-96.24]). Early FLAIR volume dynamic (P < 0.001), isocitrate dehydrogenase 1/2 status (P = 0.002), and preoperative Karnofsky Performance Status (P = 0.012) were observed as independent factors for progression-free survival in multivariate analysis. CONCLUSION: Early postoperative FLAIR volume assessment in gliomas with no or minimal enhancement is susceptible to a systematic overestimation of residual tumors. Nevertheless, early FLAIR volume dynamic is an independent factor for tumor recurrence that should be evaluated in order timely adapt surveillance and therapy regimens accordingly.
Authors: Vasileios K Kavouridis; Alessandro Boaro; Jeffrey Dorr; Elise Y Cho; J Bryan Iorgulescu; David A Reardon; Omar Arnaout; Timothy R Smith Journal: J Neurosurg Date: 2019-10-25 Impact factor: 5.115
Authors: Thomas Huber; Georgina Alber; Stefanie Bette; Johannes Kaesmacher; Tobias Boeckh-Behrens; Jens Gempt; Florian Ringel; Hanno M Specht; Bernhard Meyer; Claus Zimmer; Benedikt Wiestler; Jan S Kirschke Journal: PLoS One Date: 2017-02-28 Impact factor: 3.240
Authors: Christian F Freyschlag; Sandro M Krieg; Johannes Kerschbaumer; Daniel Pinggera; Marie-Therese Forster; Dominik Cordier; Marco Rossi; Gabriele Miceli; Alexandre Roux; Andrés Reyes; Silvio Sarubbo; Anja Smits; Joanna Sierpowska; Pierre A Robe; Geert-Jan Rutten; Thomas Santarius; Tomasz Matys; Marc Zanello; Fabien Almairac; Lydiane Mondot; Asgeir S Jakola; Maria Zetterling; Adrià Rofes; Gord von Campe; Remy Guillevin; Daniele Bagatto; Vincent Lubrano; Marion Rapp; John Goodden; Philip C De Witt Hamer; Johan Pallud; Lorenzo Bello; Claudius Thomé; Hugues Duffau; Emmanuel Mandonnet Journal: J Neurooncol Date: 2018-07-10 Impact factor: 4.130