The Impact of an Ultra-Early Postoperative MRI on Treatment of Lower Grade Glioma
The timing of MRI imaging after surgical resection may have an important role in assessing the extent of resection (EoR) and in determining further treatment. The aim of our study was to evaluate the time dependency of T2 and FLAIR changes after surgery for LGG. The Log-Glio database of patients tre...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-06-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/12/2914 |
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| author | Andrej Pala Gregor Durner Michael Braun Bernd Schmitz Christian Rainer Wirtz Jan Coburger |
| author_facet | Andrej Pala Gregor Durner Michael Braun Bernd Schmitz Christian Rainer Wirtz Jan Coburger |
| author_sort | Andrej Pala |
| collection | DOAJ |
| description | The timing of MRI imaging after surgical resection may have an important role in assessing the extent of resection (EoR) and in determining further treatment. The aim of our study was to evaluate the time dependency of T2 and FLAIR changes after surgery for LGG. The Log-Glio database of patients treated at our hospital from 2016 to 2021 was searched for patients >18a and non-enhancing intra-axial lesion with complete MR-imaging protocol. A total of 16 patients matched the inclusion criteria and were thus selected for volumetric analysis. All patients received an intraoperative scan (iMRI) after complete tumor removal, an ultra-early postoperative scan after skin closure, an early MRI within 48 h and a late follow up MRI after 3–4 mo. Detailed volumetric analysis of FLAIR and T2 abnormalities was conducted. Demographic data and basic characteristics were also analyzed. An ultra-early postoperative MRI was performed within a median time of 30 min after skin closure and showed significantly lower FLAIR (<i>p</i> = 0.003) and T2 (<i>p</i> = 0.003) abnormalities when compared to early postoperative MRI (median 23.5 h), though no significant difference was found between ultra-early and late postoperative FLAIR (<i>p</i> = 0.422) and T2 (<i>p</i> = 0.575) images. A significant difference was calculated between early and late postoperative FLAIR (<i>p</i> = 0.005) and T2 (<i>p</i> = 0.019) MRI scans. Additionally, we found no significant difference between intraoperative and ultra-early FLAIR/T2 (<i>p</i> = 0.919 and 0.499), but we found a significant difference between iMRI and early MRI FLAIR/T2 (<i>p</i> = 0.027 and <i>p</i> = 0.035). Therefore, a postoperative MRI performed 24 h or 48 h might lead to false positive findings. An MRI scan in the first hour after surgery (ultra-early) correlated best with residual tumor at 3 months follow up. An iMRI with open skull, at the end of resection, was similar to an ultra-early MRI with regard to residual tumor. |
| first_indexed | 2024-03-10T10:31:29Z |
| format | Article |
| id | doaj.art-a543cf9c719b4ab990e6bbc064d9a253 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T10:31:29Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-a543cf9c719b4ab990e6bbc064d9a2532023-11-21T23:39:19ZengMDPI AGCancers2072-66942021-06-011312291410.3390/cancers13122914The Impact of an Ultra-Early Postoperative MRI on Treatment of Lower Grade GliomaAndrej Pala0Gregor Durner1Michael Braun2Bernd Schmitz3Christian Rainer Wirtz4Jan Coburger5Department of Neurosurgery, University of Ulm, 89312 Günzburg, GermanyDepartment of Neurosurgery, University of Ulm, 89312 Günzburg, GermanyDepartment of Neuroradiology, University of Ulm, 89312 Günzburg, GermanyDepartment of Neuroradiology, University of Ulm, 89312 Günzburg, GermanyDepartment of Neurosurgery, University of Ulm, 89312 Günzburg, GermanyDepartment of Neurosurgery, University of Ulm, 89312 Günzburg, GermanyThe timing of MRI imaging after surgical resection may have an important role in assessing the extent of resection (EoR) and in determining further treatment. The aim of our study was to evaluate the time dependency of T2 and FLAIR changes after surgery for LGG. The Log-Glio database of patients treated at our hospital from 2016 to 2021 was searched for patients >18a and non-enhancing intra-axial lesion with complete MR-imaging protocol. A total of 16 patients matched the inclusion criteria and were thus selected for volumetric analysis. All patients received an intraoperative scan (iMRI) after complete tumor removal, an ultra-early postoperative scan after skin closure, an early MRI within 48 h and a late follow up MRI after 3–4 mo. Detailed volumetric analysis of FLAIR and T2 abnormalities was conducted. Demographic data and basic characteristics were also analyzed. An ultra-early postoperative MRI was performed within a median time of 30 min after skin closure and showed significantly lower FLAIR (<i>p</i> = 0.003) and T2 (<i>p</i> = 0.003) abnormalities when compared to early postoperative MRI (median 23.5 h), though no significant difference was found between ultra-early and late postoperative FLAIR (<i>p</i> = 0.422) and T2 (<i>p</i> = 0.575) images. A significant difference was calculated between early and late postoperative FLAIR (<i>p</i> = 0.005) and T2 (<i>p</i> = 0.019) MRI scans. Additionally, we found no significant difference between intraoperative and ultra-early FLAIR/T2 (<i>p</i> = 0.919 and 0.499), but we found a significant difference between iMRI and early MRI FLAIR/T2 (<i>p</i> = 0.027 and <i>p</i> = 0.035). Therefore, a postoperative MRI performed 24 h or 48 h might lead to false positive findings. An MRI scan in the first hour after surgery (ultra-early) correlated best with residual tumor at 3 months follow up. An iMRI with open skull, at the end of resection, was similar to an ultra-early MRI with regard to residual tumor.https://www.mdpi.com/2072-6694/13/12/2914lower grade gliomaintraoperative MRIultra-early postoperative MRI |
| spellingShingle | Andrej Pala Gregor Durner Michael Braun Bernd Schmitz Christian Rainer Wirtz Jan Coburger The Impact of an Ultra-Early Postoperative MRI on Treatment of Lower Grade Glioma Cancers lower grade glioma intraoperative MRI ultra-early postoperative MRI |
| title | The Impact of an Ultra-Early Postoperative MRI on Treatment of Lower Grade Glioma |
| title_full | The Impact of an Ultra-Early Postoperative MRI on Treatment of Lower Grade Glioma |
| title_fullStr | The Impact of an Ultra-Early Postoperative MRI on Treatment of Lower Grade Glioma |
| title_full_unstemmed | The Impact of an Ultra-Early Postoperative MRI on Treatment of Lower Grade Glioma |
| title_short | The Impact of an Ultra-Early Postoperative MRI on Treatment of Lower Grade Glioma |
| title_sort | impact of an ultra early postoperative mri on treatment of lower grade glioma |
| topic | lower grade glioma intraoperative MRI ultra-early postoperative MRI |
| url | https://www.mdpi.com/2072-6694/13/12/2914 |
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