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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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Early postoperative MRI to assess the extent of resection in brain metastasis – a single-centre experience

Frühes postoperatives MRT zur Evaluierung des Resektionsausmaßes bei Gehirnmetastasen – Erfahrung an einem spezialisierten Zentrum

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  • presenting/speaker Barbara Kiesel - Medizinische Universität Innsbruck, Wien, Austria
  • Julia Furtner - Medizinische Universität Innsbruck, Wien, Austria
  • Romana Prihoda - Medizinische Universität Innsbruck, Wien, Austria
  • Mario Mischkulnig - Medizinische Universität Innsbruck, Wien, Austria
  • Martin Borkovec - Medizinische Universität Innsbruck, Wien, Austria
  • Tom Rötzer - Medizinische Universität Innsbruck, Wien, Austria
  • Anna Berghoff - Medizinische Universität Innsbruck, Wien, Austria
  • Matthias Preusser - Medizinische Universität Innsbruck, Wien, Austria
  • Karl Rössler - Medizinische Universität Innsbruck, Wien, Austria
  • Georg Widhalm - Medizinische Universität Innsbruck, Wien, Austria

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP190

doi: 10.3205/20dgnc475, urn:nbn:de:0183-20dgnc4753

Published: June 26, 2020

© 2020 Kiesel 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

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Objective: Neurosurgical resection of brain metastasis represents an important treatment option in the multimodal patient management. The extent of resection according to early postoperative MRI is known to be a crucial factor for patient prognosis and overall survival in gliomas. In brain metastasis the value of early postoperative MRI still remains unclear and no standards for postoperative imaging have been established so far. The aim of our study is thus to analyze the extent of resection in brain metastasis after surgery with early postoperative MRI in a large patient cohort.

Methods: Our study cohort included all patients who underwent resection of a brain metastasis followed by an early postoperative MRI between 2008 and 2017 at the Department of Neurosurgery, Medical University Vienna. T1-weighted sequences with and without contrast media were used to assess the extent of resection. In addition, the intraoperative impression of the performing neurosurgeon with regard to the extent of resection were compared with postoperative imaging data.

Results: Altogether, 95 resections of 98 brain metastasis were performed in 94 patients. Lung cancer was the most frequent primary tumor (49%) followed by breast cancer (14%) and melanoma (12%). According to the neurosurgeon’s estimation, complete resection was achieved in 88% of cases. However, early postoperative MRI detected a distinct residual tumor in 30% of cases. Our data indicated an unexpected residual tumor on postoperative MRI in 27% of cases.

Conclusion: Our single center analysis demonstrate a high frequency of unexpected residual tumor after resection of brain metastasis. Since incomplete resection of brain metastasis affects patient prognosis, a standardized postoperative imaging protocol to routinely assess the extent of resection is warranted also in such tumors.