Magnetic resonance imaging evaluation of brain glioma before postoperative radiotherapy

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RESEARCH ARTICLE

Magnetic resonance imaging evaluation of brain glioma before postoperative radiotherapy Z. Sui1,2 · X. Zhang1 · H. Li1 · D. Xu1 · G. Li1  Received: 1 June 2020 / Accepted: 3 August 2020 © Federación de Sociedades Españolas de Oncología (FESEO) 2020

Abstract Purpose  To investigate the magnetic resonance imaging (MRI) images of brain glioma before postoperative radiotherapy, and to provide reference for the delineation of postoperative radiotherapy target area. Methods  Retrospective analysis was performed on 106 cases of brain glioma confirmed by surgery and pathology in our hospital, including 70 cases of high-grade glioma (HGG) and 36 cases of low-grade glioma (LGG). The MRI images of the lesions within 1 month before and after surgery were analyzed, the apparent diffusion coefficient (ADC) values in the near and far tumor areas were measured, respectively, and the corresponding rADC values were calculated. Results  The incidence of residual tumors of postoperative HGG and LGG was 0, 15.7% (0/36, 11/70), respectively. The incidence of postoperative reactive enhancement was 11.0% and 52.9% (4/36 and 37/70), respectively. About 30.6% and 81.4% (11/36 and 57/70) of patients with adjacent meningeal enhancement were found in the operative area. Conclusions  The MRI images of HGG and LGG before postoperative radiotherapy had certain characteristics, providing a favorable guidance for the delineation of the target area of radiotherapy and the formulation of treatment plan. Keywords  High-grade glioma · Low-grade glioma · Magnetic resonance imaging · Postoperative radiotherapy · Apparent diffusion coefficient

Introduction Brain glioma is the most common primary intracranial tumor, accounting for about 35%–61% of intracranial tumors, among which high-grade glioma (HGG) accounts for about 76% of brain gliomas, and the incidence is increasing year by year [1, 2]. Surgical resection is the main treatment, but because of its biological characteristics of invasive growth, complete resection is difficult and easy to recur, so postoperative radiotherapy is often used. Low-grade glioma (LGG) usually can be eradicated by surgical resection, and the prognosis is good. The magnetic resonance imaging (MRI) manifestations of HGG and LGG before postoperative radiotherapy have certain characteristics, which help us to define the position, size and morphology of residual * G. Li [email protected] 1



Radiotherapy Inpatient Ward II, the First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou 450000, Henan, China



Yellow River Central Hospital, Zhengzhou, Henan, China

2

tumors, accurately delineate the target area of radiotherapy, so as to achieve accurate treatment, reduce normal tissue damage, reduce recurrence rate and improve survival rate of patients.

Materials and methods Clinical data A retrospective analysis was performed on 106 cases of brain gliomas confirmed by surgery and pathology from June 2013 to June 2014 in our hospital, including 36 LGG (WHOI, WHOII), all of w