title: Macroscopic tumor volume of malignant glioma determined by contrast-enhanced magnetic resonance imaging with and without magnetization transfer contrast.
abstract: The purposes of this study were to compare the conspicuity and lesion volume of contrast-enhancing macroscopic malignant glioma determined by postcontrast magnetic resonance (MR) imaging with and without magnetization transfer (MT) saturation, and to discuss possible implications for radiotherapy planning. Nineteen patients (age 24-60 years) with histologically proven malignant glioma were prospectively examined by MR imaging. After the administration of gadolinium dimeglumine (0.1 mmol/kg body weight), the lesions were imaged with an MT-weighted FLASH (fast, low-angle shot) pulse sequence and with a conventional T1-weighted spin-echo (SE) sequence without MT saturation. The mean tumor volumes of gliomas measured on MT-weighted FLASH images were significantly (p < .01) larger than those obtained from T1-weighted SE images (45 +/- 15 cm3 vs. 33 +/- 10 cm3). The mean contrast-to-noise ratio of enhancing lesions on MT-weighted FLASH was 48 +/- 14 compared with 30 +/- 14 on SE images, representing a significant (p < .01) improvement. We conclude that the volume of contrast enhancement of malignant glioma identified on MT-weighted FLASH images represents the area of disrupted blood-brain barrier. If this volume of subtle contrast enhancement is caused by tumor infiltration and represents the boost target volume for stereotactic radiosurgery or brachytherapy, MT-weighted FLASH images would be better than T1-weighted SE images to define these volumes. These improved delineation of areas at highest risk for recurrence following radiation therapy should enhance the efficacy of treatment planning for high-boost therapy.
authors.affiliation: Department of Radiology, German Cancer Research Center (dkfz), Heidelberg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Hawighorst
authors.forename: W
authors.initials: W
authors.lastname: Schreiber
authors.forename: M V
authors.initials: MV
authors.lastname: Knopp
authors.forename: M
authors.initials: M
authors.lastname: Essig
authors.forename: R
authors.initials: R
authors.lastname: Engenhart-Cabilic
authors.forename: G
authors.initials: G
authors.lastname: Brix
authors.forename: G
authors.initials: G
authors.lastname: van Kaick
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA