title: Increase in FLAIR Signal of the Fluid Within the Resection Cavity as Early Recurrence Marker: Also Valid for Brain Metastases?
abstract: PurposeIncrease in FLAIR signal of the fluid within the resection cavity is described as a highly specific and early sign for tumor recurrence in gliomas. The aim of this study was to assess the prognostic value of FLAIR signal increase in partially or completely resected brain metastases.Materials and Methods209 cases of surgery for brain metastases were assessed. 41 cases with at least two follow-up MRIs were retrospectively included in this study. Quantitative and qualitative assessment of the FLAIR signal intensity of the fluid within the resection cavity was performed in the MRI examination at recurrent disease/last contact and in the previous MRI examination.Results3 of 6 cases with local tumor recurrence showed a FLAIR signal increase (sensitivity 50.0 %, specificity 100.0 %). In one case, this sign was observed even about 3 months before tumor recurrence. The specificity of FLAIR signal increase for overall tumor recurrence (local and distant) was also 100.0 %, but with a lower sensitivity of 13.0 %. Quantitative analysis showed significant differences for signal intensity of the resection cavity as well as for the change of signal intensity of the resection cavity in cases with or without local tumor recurrence.ConclusionAn increase in FLAIR signal of the fluid within the resection cavity might be a highly specific and early sign of local tumor recurrence/tumor progression also for brain metastases.Key points:· An increase in FLAIR signal intensity of the fluid within the resection cavity is also observed in previously resected brain metastases.. · The pathophysiology of this sign might be due to a cell-proliferative process..Citation Format· Bette S, Gempt J, Wiestler B et al. Increase of the FLAIR Signal of the Fluid within the Resection Cavity as Early Recurrence Marker: Also Valid for Brain Metastases?. Fortschr Röntgenstr 2017; 189: 63 - 70.
authors.affiliation: Department of Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Bette
authors.affiliation: Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Gempt
authors.affiliation: Department of Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Wiestler
authors.affiliation: Department of Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Huber
authors.affiliation: Department of Radiation Oncology, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Hanno
authors.initials: H
authors.lastname: Specht
authors.affiliation: Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meyer
authors.affiliation: Department of Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Zimmer
authors.affiliation: Department of Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Jan S
authors.initials: JS
authors.lastname: Kirschke
authors.affiliation: Department of Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Boeckh-Behrens
mesh_terms: D014408:Biomarkers, Tumor; D001826:Body Fluids / Q000000981:diagnostic imaging*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000517:prevention & control; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor