American Journal of Neuroradiology, Vol 14, Issue 1 77-87, Copyright © 1993 by American Society of Neuroradiology
ARTICLES |
Extirpation of glioblastomas: MR and CT follow-up of residual tumor and regrowth patterns
M Forsting, FK Albert, S Kunze, HP Adams, D Zenner and K Sartor
Department of Neuroradiology, University of Heidelberg Medical School, Germany.
PURPOSE: To optimize the timing of CT and MR after glioblastoma resection and to define the pattern of tumor regrowth. SUBJECTS AND METHODS: Sixty-eight patients with glioblastoma were studied prospectively with CT and MR. The first postoperative scan was obtained between day 1 and day 5; follow-up scans were obtained bimonthly. RESULTS: Residual tumor was shown most reliably on scans obtained shortly after surgery (MR, 77%; CT, 40.5%). After the fourth day up to 3 months postoperatively, surgically induced enhancement prevented recognition of residual tumor. Seventy-five percent of patients with residual tumor shown by early postoperative MR had progressive disease during follow-up, whereas only 36% of patients without evidence of residual tumor had MR signs of progressive disease. CONCLUSION: Early, enhanced, postoperative MR is the radiologic procedure of choice to determine the extent of glioblastoma resection. Gross total tumor resection as determined by early postoperative MR correlates with a prolongation of life.
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