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Early postoperative magnet resonance tomography after resection of cerebral metastases

Marcel A Kamp1, Marion Rapp, Julia Bühner

  • 1Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Moorenstraße 5, Düsseldorf, Germany, marcelalexander.kamp@med.uni-duesseldorf.de.

Acta Neurochirurgica
|July 10, 2015
PubMed
Abstract

Insights

Early postoperative MRI after brain metastasis surgery is crucial. Residual tumor, found in 20% of cases, significantly increases local recurrence risk, highlighting the need for this imaging in treatment planning.

Area of Science:

  • Neurosurgery
  • Oncology
  • Radiology

Background:

  • The prognostic impact of early postoperative MRI after cerebral metastasis surgery remains unclear, unlike for malignant gliomas.
  • This study investigates early MRI-based resection controls and in-brain progression rates in patients with cerebral metastases.

Purpose of the Study:

  • To analyze early MRI-based postoperative resection controls after cerebral metastasis surgery.
  • To determine the incidence of in-brain progression and its correlation with resection extent.

Main Methods:

  • Early postoperative contrast-enhanced 1.5-T MRI was used within 72 hours to verify surgical resection extent.
  • Correlations were analyzed between resection status and in-brain progression, leptomeningeal carcinomatosis, and progression-free survival.

Main Results:

  • Complete resection was confirmed in 61.5% of metastases; residual tumor was identified in 20%.
  • Local in-brain progression occurred in 30.8% of cases.
  • In-brain progression significantly correlated with dural contact (p<0.05) and residual tumor on early MRI (p<0.0001), with an 8.2-fold increased odds of recurrence if residual tumor was present.

Conclusions:

  • Nearly 20% of patients had residual tumor after metastasis surgery, as detected by early postoperative MRI, which significantly correlated with local in-brain progression.
  • Dural contact was identified as a risk factor for local recurrence.
  • Early postoperative MRI is recommended after cerebral metastasis resection to identify residual tumor and its impact on local recurrence.

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