TY - JOUR
T1 - The surgical bed after BCNU polymer wafer placement for recurrent glioma
T2 - Serial assessment on CT and MR imaging
AU - Hammoud, Dima
AU - Belden, Clifford J.
AU - Ho, Amy C.
AU - Dal Pan, Gerald J.
AU - Herskovits, Edward H.
AU - Hilt, Dana C.
AU - Brem, Henry
AU - Pomper, Martin G.
PY - 2003/5/1
Y1 - 2003/5/1
N2 - OBJECTIVE. The objective of our study was to describe the CT and MR imaging appearances of the surgical bed in the brains of patients receiving biodegradable polymers impregnated with N, N1, 3-Bis-(2-chloroethyl)-N-nitrosourea (BCNU) for recurrent glioma and to determine whether patients receiving placebos could be differentiated from those receiving BCNU based on the pattern and growth kinetics of tumor recurrence. MATERIALS AND METHODS. The CT and MR images of 20 patients who underwent surgery for resection of recurrent high-grade gliomas and placement of intratumoral wafers (11 received BCNU polymer wafers, nine received control wafers) were analyzed for wafer appearance, volume of gas in the tumor bed, and volume of enhancement on serial scans. RESULTS. Wafers appeared as linear hyperdense structures on CT and as linear low-signal-intensity structures on MR imaging and caused no significant enhancement. In the BCNU polymer group, gas volume was 4.0 ± 3.4 cm3 (mean ± SD), whereas gas volume was 1.6 ± 3.0 cm3 for the placebo group (Mann-Whimey test, p = 0.03). A trend toward linear rather than exponential recurrent tumor growth was identified for the BCNU polymer group but not for the placebo group. CONCLUSION. BCNU polymer wafers have a specific appearance on CT and MR imaging with which radiologists should be familiar: gas in the surgical bed is an expected transient finding, and tumor regrowth in patients receiving BCNU polymer wafers appeared to occur at a slower rate than in those receiving the placebo.
AB - OBJECTIVE. The objective of our study was to describe the CT and MR imaging appearances of the surgical bed in the brains of patients receiving biodegradable polymers impregnated with N, N1, 3-Bis-(2-chloroethyl)-N-nitrosourea (BCNU) for recurrent glioma and to determine whether patients receiving placebos could be differentiated from those receiving BCNU based on the pattern and growth kinetics of tumor recurrence. MATERIALS AND METHODS. The CT and MR images of 20 patients who underwent surgery for resection of recurrent high-grade gliomas and placement of intratumoral wafers (11 received BCNU polymer wafers, nine received control wafers) were analyzed for wafer appearance, volume of gas in the tumor bed, and volume of enhancement on serial scans. RESULTS. Wafers appeared as linear hyperdense structures on CT and as linear low-signal-intensity structures on MR imaging and caused no significant enhancement. In the BCNU polymer group, gas volume was 4.0 ± 3.4 cm3 (mean ± SD), whereas gas volume was 1.6 ± 3.0 cm3 for the placebo group (Mann-Whimey test, p = 0.03). A trend toward linear rather than exponential recurrent tumor growth was identified for the BCNU polymer group but not for the placebo group. CONCLUSION. BCNU polymer wafers have a specific appearance on CT and MR imaging with which radiologists should be familiar: gas in the surgical bed is an expected transient finding, and tumor regrowth in patients receiving BCNU polymer wafers appeared to occur at a slower rate than in those receiving the placebo.
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U2 - 10.2214/ajr.180.5.1801469
DO - 10.2214/ajr.180.5.1801469
M3 - Article
C2 - 12704070
AN - SCOPUS:0242684513
SN - 0361-803X
VL - 180
SP - 1469
EP - 1475
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 5
ER -