23Na-MRI of recurrent glioblastoma multiforme after intraoperative radiotherapy

• Verfasst von: Haneder, Stefan [VerfasserIn]
• Verfasst von: Giordano, Frank Anton [VerfasserIn]
• Verfasst von: Brehmer, Stefanie [VerfasserIn]
• Verfasst von: Büsing, Karen-Anett [VerfasserIn]
• Verfasst von: Schmiedek, Peter [VerfasserIn]
• Verfasst von: Schad, Lothar R. [VerfasserIn]
• Verfasst von: Wenz, Frederik [VerfasserIn]
• Verfasst von: Schönberg, Stefan [VerfasserIn]
• Verfasst von: Meyer, Melissa [VerfasserIn]
• Titel: 23Na-MRI of recurrent glioblastoma multiforme after intraoperative radiotherapy
• Titelzusatz: technical note
• Verf.angabe: Stefan Haneder, Frank A. Giordano, Simon Konstandin, Stefanie Brehmer, Karen A. Buesing, Peter Schmiedek, Lothar R. Schad, Frederik Wenz, Stefan O. Schoenberg, Melissa M. Ong
• Jahr des Originals: 2014
• Umfang: 6 S.
• Fussnoten: Gesehen am 02.11.2017 ; Im Titel ist „23” hochgestellt.
• Titel Quelle: Enthalten in: Neuroradiology
• Jahr Quelle: 2015
• Band/Heft Quelle: 57(2015), 3, S. 321-326
• ISSN Quelle: 1432-1920
• DOI: doi:10.1007/s00234-014-1468-2
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1564925021

Abstract

Introduction: We report the first case of an intraoperative radiotherapy (IORT) in a patient with recurrent glioblastoma multiforme (GBM) who was followed up with a novel magnetic resonance imaging (MRI) method - 23Na-MRI - in comparison to a standard contrast-enhanced 1H-MRI and 18F-FET-PET. Methods: A 56-year-old female patient with diagnosed GBM in July 2012 underwent tumor resection, radiochemotherapy, and three cycles of chemotherapy. After a relapse, 6 months after the initial diagnosis, an IORT was recommended which was performed in March 2013 using the INTRABEAM system (Carl Zeiss Meditec AG, Germany) with a 3-cm applicator and a surface dose of 20 Gy. Early post-operative contrast-enhanced and 1-month follow-up 1H-MRI and a 18F-FET-PET were performed. In addition, an IRB-approved 23Na-MRI was performed on a 3.0-T MR scanner (MAGNETOM TimTrio, Siemens Healthcare, Germany). Results: After re-surgery and IORT in March 2013, only a faint contrast enhancement but considerable surrounding edema was visible at the medio-posterior resection margins. In April 2013, new and progressive contrast enhancement, edema, 23Na content, and increased uptake in the 18F-FET-PET were visible, indicating tumor recurrence. Increased sodium content within the area of contrast enhancement was found in the 23Na-MRI, but also exceeding this area, very similar to the increased uptake depicted in the 18F-FET-PET. The clearly delineable zone of edema in both examinations exhibits a lower 23Na content compared to areas with suspected proliferating tumor tissue. Conclusion: 23Na-MRI provided similar information in the suspicious area compared to 18F-FET-PET, exceeding conventional 1H-MRI. Still, 23Na-MRI remains an investigational technique, which is worth to be further evaluated.