Magnetic resonance imaging appearance and changes on intracavitary Gliadel wafer placement:A pilot study

AIM:To investigate changes on magnetic resonance imaging(MRI) which occur with intracavitary Gliadel wafer placement in patients with glioblastoma multiforme(GBM).METHODS:This retrospective Health Insurance Portability and Accountability Act-compliant study was approved by the institutional review b...

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Published inWorld journal of radiology Vol. 3; no. 11; pp. 266 - 272
Main Authors Colen, Rivka R, Zinn, Pascal O, Hazany, Saman, Do-Dai, Daniel, Wu, Julian K, Yao, Kevin, Zhu, Jay J
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Co., Limited 28.11.2011
Subjects
Brief
chemotherapy
Gliadel
Glioblastoma
Glioma
Local
Pseudoprogression
wafers
Gliadel wafers
Local chemotherapy
Glioma
Pseudoprogression
Glioblastoma
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Summary:AIM:To investigate changes on magnetic resonance imaging(MRI) which occur with intracavitary Gliadel wafer placement in patients with glioblastoma multiforme(GBM).METHODS:This retrospective Health Insurance Portability and Accountability Act-compliant study was approved by the institutional review board,with a waiver of informed consent.A total of eight patients aged 29-67 years with GBM underwent Gliadel wafer placement.T2-weighted/FLAIR images and post-contrast T1-weighted images both before and after wafer placement were retrospectively reviewed in consensus to determine changes in the following parameters:appearance of the pericavitary tissue,pattern of tumor recurrence or progression and appearance of the Gliade lwafer itself.RESULTS:Five out of the eight patients had a progressive increase in enhancement and pericavitary T2/FLAIR hyperintensity within the first 2 mo and a subsequent decrease in these MRI findings.None ofthese patients had tumor recurrence within the first6 mo.Three out of the eight patients demonstrated aprogressive increase in enhancement and pericavitary T2 hyperintensity,which continued after the first 6 mo,and were subsequently diagnosed with true tumor progression.There was no increase in distant/nonlocal tumor recurrence.The Gliadel wafer appearance changed over time.CONCLUSION:Pseudoprogression is common after intracavitary Gliadel wafer placement and thus care should be taken before diagnosing tumor progression or recurrence within the first 2 mo.
Bibliography:Rivka R Colen,Department of Radiology,Brigham and Women’s Hospital,Boston,MA 02115,United States Pascal O Zinn,Department of Neurosurgery,Beth Israel Deaconess Medical Center,Boston,MA 02215,United States Saman Hazany,Department of Radiology,Beth Israel Deaconess Medical Center,Boston,MA 02215,United States Pascal O Zinn,Department of Radiation Oncology,Dana Farber Cancer Institute,Boston,MA 02115,United States Daniel Do-Dai,Department of Neuroradiology,Tufts Medical Center,Boston,MA 02115,United States Julian K Wu,Kevin Yao,Department of Neurosurgery,Tufts Medical Center,Boston,MA 02115,United States Jay J Zhu,Mischer Neuroscience Associates,UT Houston and Memorial Hermann Hospital,Houston,TX 77030,United States
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Correspondence to: Rivka R Colen, MD, Department of Radiology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, United States. rrcolen@partners.org
Telephone: +1-617-7325500 Fax: +1-617-5826033
Author contributions: Colen RR and Zinn PO contributed equally; Colen RR and Zinn PO analyzed the data and wrote the paper; Colen RR, Zinn PO, Wu JK and Zhu JJ designed the research; Colen RR, Zinn PO, Do-Dai D and Hazany S performed the research; Yao K and Wu JK performed the surgeries and performed data collection.
ISSN:1949-8470
1949-8470
DOI:10.4329/wjr.v3.i11.266