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Intraoperative dynamic MRI: Localization of sites of brain tumor recurrence after high‐dose radiotherapy
Author(s) -
Schwartz Richard B.,
Hsu Liangge,
Kacher Daniel F.,
Wong Terence Z.,
Alexander Eben,
Okon Stephen,
Guttmann Charles R. G.,
Black Peter McL.,
Kelley Raymond A.,
Moriarty Thomas,
Martin Claudia,
Isbister Holly G.,
Cahill Cheryl D.,
Spaulding Sharon A.,
Jolesz Ferenc A.
Publication year - 1998
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.1880080513
Subject(s) - medicine , radiation therapy , magnetic resonance imaging , nuclear medicine , radiology , brain tumor , pathology
In patients with malignant astrocytomas or metastatic brain disease treated with high‐dose radiotherapy, conventional imaging methods may not adequately distinguish recurrent tumor from radiation change. We used a fast spoiled gradient refocusing technique in the open‐configuration intraoperative MR system to assess the rate of regional enhancement of the treated tumor bed and to localize specific sites for pathologic sampling to determine whether gadolinium uptake correlated with histologic data. Twenty‐four patients were studied. Fourteen of 15 patients with areas of early enhancement had recurrent tumor present in histologic samples, and 8 of the remaining 9 patients had only reactive changes. Dynamic MRI was predictive of recurrent tumor ( P < .0005, Fisher exact test and P < .002, Student t test). We conclude that dynamic MRI in the open‐bore magnet is a promising method for localizing potential sites of active tumor growth in patients treated for malignant astrocytomas and metastatic brain lesions.