Postoperative Neuroimaging of High-grade Gliomas: Comparison of Transcranial Sonography, Magnetic Resonance Imaging, and Computed Tomography

Postoperative Neuroimaging of High-grade Gliomas: Comparison of Transcranial Sonography, Magnetic... AbstractBACKGROUND:A precise and comprehensive knowledge of tumor burden and its extent and growth pattern in the pre- and postsurgical states is required to optimize tumor therapy and to determine treatment success and failure. This prospective study compares the diagnostic potential of computed tomography (CT), magnetic resonance imaging (MRI), and transcranial sonography (TCS) in the postoperative follow-up of brain tumors.METHOD:Twenty-six patients with high-grade gliomas were included in the study. After tumor debulking, a total of 31 biopsy specimens were obtained from the resection margin in 21 patients and histological findings were compared with the findings of early postoperative TCS, CT, and MRI. Findings indicating residual tumor tissue were nonlinear contrast enhancement at the resection site revealed by CT or MRI or hyperechogenic lesions revealed by TCS. Follow-up examinations using all three imaging techniques were performed every 3 months. The end points of the follow-up were tumor recurrence as defined by CT and MRI, death, or severe clinical deterioration.RESULTS:On the basis of the above criteria, TCS identified residual tumor more often than did CT or MRI. In the group of 19 patients with histologically proven tumor remnants, residual tumor tissue was identified by TCS in all patients, whereas MRI and CT failed to show contrast enhancement in three and eight patients, respectively. However, the results of the TCS were false positive for one patient because of hemorrhage into the resection site. The average time to identification of tumor regrowth was 27 weeks using TCS, 29 weeks using CT, and 33 weeks using MRI. Only the differences between TCS and MRI reached statistical significance. For one patient, multi- centric tumor recurrence was not detected using TCS.CONCLUSION:TCS may complement CT and MRI in the postoperative follow-up of patients with high-grade gliomas. Because none of these modalities alone is both sensitive and specific, an integrated analysis of imaging findings is recommended. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Postoperative Neuroimaging of High-grade Gliomas: Comparison of Transcranial Sonography, Magnetic Resonance Imaging, and Computed Tomography

Postoperative Neuroimaging of High-grade Gliomas: Comparison of Transcranial Sonography, Magnetic Resonance Imaging, and Computed Tomography

Postoperative Neuroimaging of High-grade Gliomas: Comparison of Transcranial Sonography, Magnetic Resonance Imaging, and Computed Tomography Georg Becker, M .D ., Erich Hofmann, M .D ., Michael Woydt, M .D ., Ulrich Hulsmann, Mathias Maurer, M .D ., Alfred Lindner, M .D ., Thomas Becker, M .D ., Andreas Krone, M .D. Departments of Neurology (G B, MM), Neurosurgery (MW, U H , AK), and Neuroradiology (EH, TB), University of Wurzburg, Wurzburg, Germany; Department of Neurology (AL), University of Halle, Wittenberg, Germany; and Institute of Psychiatry (TB), London, England B A C K G R O U N D : A precise and comprehensive knowledge of tumor burden and its extent and growth pattern in the pre- and postsurgical states is required to optimize tumor therapy and to determine treatment success and failure. This prospective study compares the diagnostic potential of computed tomography (CT), magnetic resonance imaging (MRI), and transcranial sonography (TCS) in the postoperative follow-up of brain tumors. METHOD: Twenty-six patients with high-grade gliomas were included in the study. After tumor debulking, a total of 31 biopsy specimens w ere obtained from the resection margin in 21 patients and histological findings were compared with the findings of early postoperative TCS, C T , and MRI. Findings indicating residual tumor tissue were nonlinear contrast enhancem ent at the resection site revealed by C T or MRI or hyperechogenic lesions revealed by TCS. Follow-up examinations using all three imaging techniques were performed every 3 months. The end points of the follow-up w ere tumor recurrence as defined by C T and MRI, death, or severe clinical deterioration. RESULTS: O n the basis of the above criteria, TCS identified residual tumor more often than did C T or MRI. In the group of 19 patients with histologically proven tumor remnants, residual tumor tissue was identified by TCS in all patients, whereas MRI and C T failed to show contrast enhancement in three and eight...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199903000-00016
Publisher site
See Article on Publisher Site

Abstract

AbstractBACKGROUND:A precise and comprehensive knowledge of tumor burden and its extent and growth pattern in the pre- and postsurgical states is required to optimize tumor therapy and to determine treatment success and failure. This prospective study compares the diagnostic potential of computed tomography (CT), magnetic resonance imaging (MRI), and transcranial sonography (TCS) in the postoperative follow-up of brain tumors.METHOD:Twenty-six patients with high-grade gliomas were included in the study. After tumor debulking, a total of 31 biopsy specimens were obtained from the resection margin in 21 patients and histological findings were compared with the findings of early postoperative TCS, CT, and MRI. Findings indicating residual tumor tissue were nonlinear contrast enhancement at the resection site revealed by CT or MRI or hyperechogenic lesions revealed by TCS. Follow-up examinations using all three imaging techniques were performed every 3 months. The end points of the follow-up were tumor recurrence as defined by CT and MRI, death, or severe clinical deterioration.RESULTS:On the basis of the above criteria, TCS identified residual tumor more often than did CT or MRI. In the group of 19 patients with histologically proven tumor remnants, residual tumor tissue was identified by TCS in all patients, whereas MRI and CT failed to show contrast enhancement in three and eight patients, respectively. However, the results of the TCS were false positive for one patient because of hemorrhage into the resection site. The average time to identification of tumor regrowth was 27 weeks using TCS, 29 weeks using CT, and 33 weeks using MRI. Only the differences between TCS and MRI reached statistical significance. For one patient, multi- centric tumor recurrence was not detected using TCS.CONCLUSION:TCS may complement CT and MRI in the postoperative follow-up of patients with high-grade gliomas. Because none of these modalities alone is both sensitive and specific, an integrated analysis of imaging findings is recommended.

Journal

NeurosurgeryOxford University Press

Published: Mar 1, 1999

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