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

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• 作者：Paolo Farace (1) (2)
  Dante Amelio (3)
  Giuseppe K. Ricciardi (4)
  Giada Zoccatelli (4)
  Stefano Magon (1)
  Francesca Pizzini (4)
  Franco Alessandrini (4)
  Andrea Sbarbati (1)
  Maurizio Amichetti (3)
  Alberto Beltramello (4)
  
• 关键词：Glioblastoma ; Gadolinium DTPA ; Diffusion MRI ; Perfusion ; weighted MRI ; Neurosurgery
• 刊名：Journal of Neuro-Oncology
• 出版年：2013
• 出版时间：January 2013
• 年：2013
• 卷：111
• 期：2
• 页码：177-185
• 全文大小：484KB
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• 作者单位：Paolo Farace (1) (2)
  Dante Amelio (3)
  Giuseppe K. Ricciardi (4)
  Giada Zoccatelli (4)
  Stefano Magon (1)
  Francesca Pizzini (4)
  Franco Alessandrini (4)
  Andrea Sbarbati (1)
  Maurizio Amichetti (3)
  Alberto Beltramello (4)
  
  1. Anatomy and Histology Section, Department of Morphological and Biomedical Sciences, University of Verona, Via Le Grazie 8, 37134, Verona, VR, Italy
  2. Department of Radio-oncology, Oncologic Hospital of Cagliari, Cagliari, Italy
  3. Proton Therapy Unit, APSS, Via Fratelli Perini 181, Trento, Italy
  4. Neuroradiology Unit, University of Verona, Piazzale Stefani 1, Verona, Italy
  
• ISSN：1573-7373

文摘

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 20-7?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.