Artikel
Population-wide MRI-screening for early detection of glioblastoma? Considerations from a naturally occurring “Screening-Like” setting
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Veröffentlicht: | 8. Juni 2016 |
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Objective: Despite all medical efforts, the prognosis of patients with a new diagnosis of glioblastoma multiforme (GBM) remains very poor. Complete surgical removal of the lesion as visualized by MRI correlates with improved overall survival. Population-wide MRI-Screening could potentially lead to early diagnoses of GBM in statu nascendi and – combined with radical supratotal surgical therapy – improve patient survival.
Method: We reviewed the imaging records of all patients with a first histological diagnosis of GBM between 2004 and 2014 in our center for the presence of unremarkable cranial imaging prior to the diagnosis of GBM.
Results: 19 of 950 patients with a histological diagnosis of GBM had a previous imaging (13 MRI, 6 CT) without visible abnormities indicating a brain tumor at a median time of 1.7 years (range: 0.3 – 9.5 years) prior to the diagnosis of GBM. Imaging was performed due to cerebrovascular events in 4, headache in 3, neurological symptoms in 5 and unknown reasons in 7 patients. In 4 patients GBM emergence from an invisible lesion to a mean 4.5 cm tumor diameter was documented within less than 6 months.
Conclusions: Unremarkable MRI and CT may be obtained 4 - 6 months prior to the diagnosis of large GBM. The explosive growth kinetics of GBM seem to preclude the feasibility of a population-wide MRI-screening.