Increase in FLAIR Signal of the Fluid Within the Resection Cavity as Early Recurrence Marker: Also Valid for Brain Metastases?

Bette, Stefanie; Gempt, Jens; Wiestler, Benedikt; Huber, Thomas S.; Specht, Hanno M.; Zimmer, Claus; Kirschke, Jan S.; Boeckh‐Behrens, Tobias

doi:10.1055/s-0042-119686

Cited by 4 publications

(4 citation statements)

References 34 publications

(39 reference statements)

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“…Similar findings have been reported by others (Zakaria et al, 2014). High FLAIR signal in the resection cavity in postoperative patients may indicate impending local recurrence after neurosurgical resection (Bette et al, 2016a). Conversely, neither pretreatment CBV (Essig et al, 2003) nor MRS is predictive of response to radiosurgery (Chernov et al, 2007).…”

Section: Predicting Response Prior To Treatment Initiation (Prognostimentioning

confidence: 99%

Brain metastases: neuroimaging

Pope

2018

Handbook of Clinical Neurology

149

130

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Magnetic resonance imaging (MRI) is the cornerstone for evaluating patients with brain masses such as primary and metastatic tumors. Important challenges in effectively detecting and diagnosing brain metastases and in accurately characterizing their subsequent response to treatment remain. These difficulties include discriminating metastases from potential mimics such as primary brain tumors and infection, detecting small metastases, and differentiating treatment response from tumor recurrence and progression. Optimal patient management could be benefited by improved and well-validated prognostic and predictive imaging markers, as well as early response markers to identify successful treatment prior to changes in tumor size. To address these fundamental needs, newer MRI techniques including diffusion and perfusion imaging, MR spectroscopy, and positron emission tomography (PET) tracers beyond traditionally used 18-fluorodeoxyglucose are the subject of extensive ongoing investigations, with several promising avenues of added value already identified. These newer techniques provide a wealth of physiologic and metabolic information that may supplement standard MR evaluation, by providing the ability to monitor and characterize cellularity, angiogenesis, perfusion, pH, hypoxia, metabolite concentrations, and other critical features of malignancy. This chapter reviews standard and advanced imaging of brain metastases provided by computed tomography, MRI, and amino acid PET, focusing on potential biomarkers that can serve as problem-solving tools in the clinical management of patients with brain metastases.

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Section: Predicting Response Prior To Treatment Initiation (Prognostimentioning

confidence: 99%

Brain metastases: neuroimaging

Pope

2018

Handbook of Clinical Neurology

149

130

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“…29,30,34,35,40,42 Other MRI techniques such as postcontrast T1-w and FLAIR can help to assess the response to treatment or the recurrence of BMs from BC. [33][34][35] Some MRI techniques such as DTI and rsfMRI can help to evaluate the cognitive impairment or the functional connectivity of BMs from BC. 29,32,36 MRI findings of BMs from BC can vary depending on the BC subtype, such as HER2-positive, luminal or triplenegative.…”

Section: Discussionmentioning

confidence: 99%

“…Some MRI techniques such as CE MRI, DWI, ADC, DSC and SWI can help to differentiate BMs from BC from other brain tumours such as GBM or ischemic lesions 29,30,34,35,40,42 . Other MRI techniques such as postcontrast T1‐w and FLAIR can help to assess the response to treatment or the recurrence of BMs from BC 33–35 . Some MRI techniques such as DTI and rsfMRI can help to evaluate the cognitive impairment or the functional connectivity of BMs from BC 29,32,36 …”

Section: Discussionmentioning

confidence: 99%

Brain metastases from breast cancer using magnetic resonance imaging: A systematic review

Mohammadi,

Hadizadeh

et al. 2023

J of Medical Radiation Sci

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Despite improvements in imaging and treatment approaches, brain metastases (BMs) continue to be the primary cause of mortality and morbidity in about 20% of adult cancer patients. This research aimed to review the magnetic resonance imaging (MRI) and clinical characteristics of BMs resulting from breast cancer (BC). A systematic review of original research articles published from January 2000 to June 2023. We selected studies that reported MRI findings of BMs in BC patients. We excluded reviews, case reports, books/book chapters, animal studies and irrelevant records. We identified 24 studies that included 1580 BC patients with BMs. T1‐weighted (T1‐w) (pre‐ and postcontrast), T2‐weighted (T2‐w), fluid‐attenuated inversion recovery (FLAIR) and T2*‐weighted (T2*‐w) was used to measure the lesion size, shape and area. In other studies, advanced structural techniques including diffusion‐weighted imaging (DWI), diffusion tensor imaging (DTI) and susceptibility‐weighted imaging (SWI) were used to more precisely and sensitively evaluate the pathological area. Furthermore, functional and metabolic techniques like functional MRI (fMRI), magnetic resonance spectroscopy (MRS) and perfusion‐weighted imaging (PWI) have also been utilised. The MRI findings of BMs varied depending on the MRI technique, the BC subtype, the lesion size and shape, the presence of haemorrhage or necrosis and the comparison with other brain tumours. Some MRI findings were associated with prognosis, recurrence or cognitive impairment in BC patients with BMs. MRI detects, characterises and monitors BMs from BC. Findings vary by MRI technique, BC subtype, lesion characteristics and comparison with other brain tumours. More research should validate emerging MRI techniques, determine the clinical implications of findings and explore the underlying mechanisms and biology of BMs from BC. MRI is a valuable tool for diagnosis, targeted therapy and studying BC metastasis.

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“…The result could be due to the hyperemic response of the margins that occurs 48 h after surgery. Both Bette et al and Forsyth et al identified an increase in reactive CE in the hours following surgery, indicative of a hypervascular response [ 25 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

T1-Weighted Contrast Enhancement, Apparent Diffusion Coefficient, and Cerebral-Blood-Volume Changes after Glioblastoma Resection: MRI within 48 Hours vs. beyond 48 Hours

et al. 2023

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Background: The aim of the study is to identify the advantages, if any, of post-operative MRIs performed at 48 h compared to MRIs performed after 48 h in glioblastoma surgery. Materials and Methods: To assess the presence of a residual tumor, the T1-weighted Contrast Enhancement (CE), Apparent Diffusion Coefficient (ADC), and Cerebral Blood Volume (rCBV) in the proximity of the surgical cavity were considered. The rCBV ratio was calculated by comparing the rCBV with the contralateral normal white matter. After the blind image examinations by the two radiologists, the patients were divided into two groups according to time window after surgery: ≤48 h (group 1) and >48 h (group 2). Results: A total of 145 patients were enrolled; at the 6-month follow-up MRI, disease recurrence was 89.9% (125/139), with a mean patient survival of 8.5 months (SD 7.8). The mean ADC and rCBV ratio values presented statistical differences between the two groups (p < 0.05). Of these 40 patients in whom an ADC value was not obtained, the rCBV values could not be calculated in 52.5% (21/40) due to artifacts (p < 0.05). Conclusion: The study showed differences in CE, rCBV, and ADC values between the groups of patients undergoing MRIs before and after 48 h. An MRI performed within 48 h may increase the ability of detecting GBM by the perfusion technique with the calculation of the rCBV ratio.

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Increase in FLAIR Signal of the Fluid Within the Resection Cavity as Early Recurrence Marker: Also Valid for Brain Metastases?

Cited by 4 publications

References 34 publications

Brain metastases: neuroimaging

Brain metastases: neuroimaging

Brain metastases from breast cancer using magnetic resonance imaging: A systematic review

T1-Weighted Contrast Enhancement, Apparent Diffusion Coefficient, and Cerebral-Blood-Volume Changes after Glioblastoma Resection: MRI within 48 Hours vs. beyond 48 Hours

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