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[Effect of brain edema on the recurrence pattern of malignant gliomas]
M Hartmann1, O Jansen, T Egelhof
1Abteilung Neuroradiologie, Universitätsklinik Heidelberg.
Purpose:
To assess the influence of initial preoperative brain edema in malignant gliomas on regrowth patterns.
Subjects And Methods:
79 patients with histologically verified supratentorial malignant glioma were prospectively studied by magnetic resonance imaging (MRI) before and every 2-3 months after surgery. The median follow-up time was 11 months. We correlated the configuration of the initial vasogenic edema on T2-weighted images with tumor regrowth patterns on contrast-enhanced T1-weighted images.
Results:
35/47 tumor regrowths (75%) imitated the initial edema configuration, while 11/47 occurred within the initial tumor bed; in one case tumor recurrence was multilocal.
Conclusion:
In glioblastoma, tumor regrowth patterns correlate positively with the configuration of the initial vasogenic brain edema. The initial, "presurgical" peritumoral edema should thus be considered when planning further treatment.