Magnetic Resonance Imaging Mapping of Brain Tumor Burden: Clinical Implications for Neurosurgical Management: Case Report. Neurosurg Open 2021 Dec;2(4):okab029
Date
10/19/2021Pubmed ID
34661110Pubmed Central ID
PMC8508085DOI
10.1093/neuopn/okab029Abstract
BACKGROUND AND IMPORTANCE: Distinction of brain tumor progression from treatment effect on postcontrast magnetic resonance imaging (MRI) is an ongoing challenge in the management of brain tumor patients. A newly emerging MRI biomarker called fractional tumor burden (FTB) has demonstrated the ability to spatially distinguish high-grade brain tumor from treatment effect with important implications for surgical management and pathological diagnosis.
CLINICAL PRESENTATION: A 58-yr-old male with glioblastoma was treated with standard concurrent chemoradiotherapy (CRT) after initial resection. Throughout follow-up imaging, the distinction of tumor progression from treatment effect was of concern. The surgical report from a redo resection indicated recurrent glioblastoma, while the tissue sent for pathological diagnosis revealed no tumor. Presurgical FTB maps confirmed the spatial variation of tumor and treatment effect within the contrast-agent enhancing lesion. Unresected lesion, shown to be an active tumor on FTB, was the site of substantial tumor growth postresection.
CONCLUSION: This case report introduces the idea that a newly developed MRI biomarker, FTB, can provide information of tremendous benefit for surgical management, pathological diagnosis as well as subsequent treatment management decisions in high-grade glioma.
Author List
Connelly JM, Prah MA, Santos-Pinheiro F, Mueller W, Cochran E, Schmainda KMAuthors
Jennifer M. Connelly MD Professor in the Neurology department at Medical College of WisconsinKathleen M. Schmainda PhD Professor in the Biophysics department at Medical College of Wisconsin
