Intraoperative dynamic MRI: localization of sites of brain tumor recurrence after high-dose radiotherapy

J Magn Reson Imaging. 1998 Sep-Oct;8(5):1085-9. doi: 10.1002/jmri.1880080513.


In patients with malignant astrocytomas or metastatic brain disease treated with high-dose radiotherapy, conventional imaging methods may not adequately distinguish recurrent tumor from radiation change. We used a fast spoiled gradient refocusing technique in the open-configuration intraoperative MR system to assess the rate of regional enhancement of the treated tumor bed and to localize specific sites for pathologic sampling to determine whether gadolinium uptake correlated with histologic data. Twenty-four patients were studied. Fourteen of 15 patients with areas of early enhancement had recurrent tumor present in histologic samples, and 8 of the remaining 9 patients had only reactive changes. Dynamic MRI was predictive of recurrent tumor (P < .0005, Fisher exact test and P < .002, Student t test). We conclude that dynamic MRI in the open-bore magnet is a promising method for localizing potential sites of active tumor growth in patients treated for malignant astrocytomas and metastatic brain lesions.

MeSH terms

  • Brain / pathology*
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / surgery
  • Contrast Media
  • Female
  • Gadolinium DTPA
  • Glioblastoma / pathology*
  • Glioblastoma / radiotherapy
  • Glioblastoma / surgery
  • Humans
  • Intraoperative Care / methods
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / surgery
  • Radiosurgery
  • Radiotherapy, High-Energy
  • Sensitivity and Specificity


  • Contrast Media
  • Gadolinium DTPA