Early Postoperative Expansion of Parenchymal High-intensity Areas on T₂-weighted Imaging Predicts Delayed Cerebral Edema Caused by Carmustine Wafer Implantation in Patients with High-grade Glioma

• MASUDA Yosuke

  Department of Neurosurgery, Faculty of Medicine, University of Tsukuba

• ISHIKAWA Eiichi

  Department of Neurosurgery, Faculty of Medicine, University of Tsukuba

• YAMAMOTO Tetsuya

  Department of Neurosurgery, Faculty of Medicine, University of Tsukuba

• MATSUDA Masahide

  Department of Neurosurgery, Faculty of Medicine, University of Tsukuba

• AKUTSU Hiroyoshi

  Department of Neurosurgery, Faculty of Medicine, University of Tsukuba

• KOHZUKI Hidehiro

  Department of Neurosurgery, Faculty of Medicine, University of Tsukuba

• NAKAI Kei

  Department of Neurosurgery, Faculty of Medicine, University of Tsukuba

• OKAMOTO Emiko

  Department of Neurosurgery, Faculty of Medicine, University of Tsukuba

• TAKANO Shingo

  Department of Neurosurgery, Faculty of Medicine, University of Tsukuba

• MASUMOTO Tomohiko

  Department of Radiology, University of Tsukuba

• MATSUMURA Akira

  Department of Neurosurgery, Faculty of Medicine, University of Tsukuba

抄録

Background: Carmustine (BCNU) wafer (Gliadel^® Wafer) implantation after tumor resection is an approved treatment for high-grade glioma (HGG). These wafers change various characteristics on early postoperative magnetic resonance imaging (ep-MRI) including slight expansion of high-intensity areas on T₂-weighted imaging (ep-T₂-HIAs) into adjacent parenchyma without restricted diffusivity. We assessed the frequency of the ep-T₂-HIAs after BCNU wafer implantation in HGG patients. Moreover, we focused on ep-T₂-HIA expansion and its relation to delayed cerebral edema.<br>Methods: Twenty-five consecutive HGG patients who underwent BCNU wafer implantation were assessed. First, patients were divided into ep-T₂-HIA and non-ep-T₂-HIA groups, and the incidence of delayed adverse effects was compared between the two groups. Subsequently, the patients were divided into delayed edema and non-delayed edema groups, and pre-, intra-, and postoperative data were compared between the two groups.<br>Results: The ep-T₂-HIA expansion and the delayed edema were evident in 9 cases (36%) and 12 cases (48%), respectively. In comparison of the ep-T₂-HIA and non-ep-T₂-HIA groups, delayed edema was the only delayed adverse effect associated with ep-T₂-HIA expansion (P = 0.004). Univariate analysis showed a significantly higher ratio of delayed edema in the subgroups with maximal diameter of removed cavity ≤40 mm (P = 0.047) and the ep-T₂-HIA expansion in comparison of the delayed edema and non-delayed edema groups. Multivariate analysis showed that the ep-T₂-HIA expansion was the only independent factor associated with delayed edema (P = 0.021).<br>Conclusion: In BCNU wafer implantation cases, ep-T₂-HIA expansion was a predictive factor for delayed cerebral edema.

収録刊行物

• Magnetic Resonance in Medical Sciences

  Magnetic Resonance in Medical Sciences 15 (3), 299-307, 2016

  日本磁気共鳴医学会

キーワード

• intraoperative magnetic resonance imaging
• chemotherapy
• high-grade glioma
• glioblastoma
• BCNU wafer

詳細情報

• CRID: 1390001205194949888
• NII論文ID: 130005163437
• NII書誌ID: AA11648770
• DOI: 10.2463/mrms.mp.2015-0054
• ISSN: 18802206
• ISSN: 13473182
• HANDLE: 2241/00143764
• PubMed: 26726015
• Web Site: https://tsukuba.repo.nii.ac.jp/records/39094
• Web Site: https://www.jstage.jst.go.jp/article/mrms/15/3/15_mp.2015-0054/_pdf
• 本文言語コード: en
• データソース種別:
  • JaLC
  • IRDB
  • Crossref
  • PubMed
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可