gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Evaluation of brain tumor regrowth in relation to motor areas – a multimodal approach

Meeting Abstract

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  • Tobias Laub - Klinikum rechts der Isar TU München , Klinik für Neurochirurgie, München, Deutschland
  • Nico Sollmann - Klinikum rechts der Isar TU München , Klinik für Neurochirurgie, München, Deutschland
  • Anna Kelm - Klinikum rechts der Isar TU München , Klinik für Neurochirurgie, München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Stephanie Combs - Technische Universität München, Klinikum Rechts der Isar, Klinik und Poliklinik für RadioOnkologie und Strahlentherapie, München, Deutschland
  • Sandro Krieg - Klinikum rechts der Isar TU München , Klinik für Neurochirurgie, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.17.06

doi: 10.3205/17dgnc277, urn:nbn:de:0183-17dgnc2770

Published: June 9, 2017

© 2017 Laub et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Glioma cells spread towards blood-supply-sufficient microenvironments. Since neuronal activity in response to movement, for instance, induces a higher regional blood flow and oxygenation level in the respective area of activation, we examined whether glioma recurrences show a grow pattern towards motor-eloquent areas.

Methods: 60 patients with motor-eloquent high-grade gliomas (HGGs) were enrolled. All patients underwent magnetic resonance imaging (MRI) and navigated transcranial magnetic stimulation (nTMS) for motor mapping prior to surgery and suffered a relapse during long-term follow-up. Motor-eloquent areas were defined via nTMS and nTMS-based tractography. According to postoperative MRI, patients were separated into three groups: patients without a residual tumor (group 1), patients with a residual tumor moving away from motor areas (group 2), and patients with a residual tumor moving towards motor areas (group 3).

Results: Average growth towards motor areas mapped by nTMS was 2.1 ± 4.5 mm/month in the FLAIR sequences and 2.2 ± 6.1 mm/month in the contrast-enhanced T1-weighted sequences. The major growth direction was towards motor eloquent areas as defined by nTMS in all groups. Moreover, there was no significant difference in growth speed between the three groups for contrast-enhanced T1-weighted (group 1: 1.1 ± 2.0 mm/month, group 2: 1.4 ± 3.5 mm/month, group 3: 4.5 ± 7.7 mm/month) as well as FLAIR sequences (group 1: 1.5 ± 1.3 mm/month, group 2: 0.8 ± 3.4 mm/month, group 3: 3.8 ± 5.7 mm/month). Positive values mean growth towards the tumor.

Conclusion: This study suggests a new strategy to predict tumor regrowth patterns, which could improve the surgical but also radiotherapy planning.