Post-surgery detection of residual disease in Glioblastoma on multiparametric MRI: a challenge

Congress:

ECR 2019

Poster Number:

C-0871

Type:

Scientific Exhibit

Keywords:

Outcomes, Neoplasia, Cancer, Staging, MR-Diffusion/Perfusion, MR, Neuroradiology brain, CNS

Authors:

E. Soligo¹, S. Gangi¹, A. Trisoglio¹, S. Berardo², L. SUKHOVEI ¹, A. Stecco¹, A. Carriero³; ¹Novara/IT, ²Novara, Italy/IT, ³Novara (NO)/IT

DOI:

10.26044/ecr2019/C-0871

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-0871

Fig. 2: MRI T1 post-contrast obteined inside the first 24 hours after surgery:...

Fig. 1: Pre-operative imaging: glioblastoma multiforme in temporal right lobe.

Fig. 3: In the red circle, the focus was the presence of nodular impregnation that...

Aims and objectives

Actually maximal surgical resection of glial neoplasia, in our study in particular we studied a subgroup of neoplasias such as "Glioblastoma Multiforme", presents the most import prognostic value. MRI is important to distinguish, performed after surgery, "reactive impregnation", non-neoplastic and due to the surgical manipulation of the brain, and "nodular impregnation", neoplastic to plan appropriate therapies and to properly monitor the response to those. Differential diagnosis between both is a challenge: studieshave focused on the time to perform postoperative radiological investigation. In the study of...

Methods and materials

At the end of the work 152 patients were restropective evaluated but only 52 were enrolled. They presented diagnosis of glioblastoma multiforme, complete work-up of imaging, with pre-operative/post-operative and follow-up imaging, performed with 1.5 T scanner. MRI images were performed on a 1.5 T MR scanner (MRI-Philips, Achieva dStream 1.5T), with a standard protocol including the following sequences: Diffusion Weighted Imaging (DWI), with relative ADC map, Fluid-Attenuated Inversion-Recovery (FLAIR), T2-weighted Turbo-Spin-Echo (TSE), T1-weighted Spin-Echo (SE) and, after contrast agent, 3D T1-weighted Gradient-Echo. MRI scans were...

Results

Considering the first 24 hours after surgery sensibility was 100% (IC: 76.84 to 100%), while specificity 100% (IC: 47.82 to 100%), VPP 100% (IC: 76.84 to 100%); NPV 100% (IC: 47.72 to 100%). From25 to 48 hours after surgery variables respectively were: sensibility 91.70% (IC: 76 to 99.80%), while specificity 100% (IC: 19.41 to 100%), VPP 100% (IC: 58.72 to 100%); NPV 75% (IC: 19.41 to 99%). From 49 to 72 hours and >73, doubtful cases were presented, and the variables were calculated considering them...

Conclusion

Earlier post-operative MRI, before <48 hours, is the best way to evaluate residual neoplasia, considering our results.

Personal information

References

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