Frontiers in Neurology (Feb 2022)

T2/FLAIR Abnormity Could be the Sign of Glioblastoma Dissemination

  • Mingxiao Li,
  • Mingxiao Li,
  • Wei Huang,
  • Wei Huang,
  • Hongyan Chen,
  • Haihui Jiang,
  • Chuanwei Yang,
  • Chuanwei Yang,
  • Shaoping Shen,
  • Shaoping Shen,
  • Yong Cui,
  • Yong Cui,
  • Gehong Dong,
  • Xiaohui Ren,
  • Xiaohui Ren,
  • Xiaohui Ren,
  • Song Lin,
  • Song Lin,
  • Song Lin

DOI
https://doi.org/10.3389/fneur.2022.819216
Journal volume & issue
Vol. 13

Abstract

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PurposeNewly emerged or constantly enlarged contrast-enhancing (CE) lesions were the necessary signs for the diagnosis of glioblastoma (GBM) progression. This study aimed to investigate whether the T2-weighted-Fluid-Attenuated Inversion Recovery (T2/FLAIR) abnormal transformation could predict and assess progression for GBMs, especially for tumor dissemination.MethodsA consecutive cohort of 246 GBM patients with regular follow-up and sufficient radiological data was included in this study. The series of T2/FLAIR and T1CE images were retrospectively reviewed. The patients were separated into T2/FLAIR and T1CE discordant and accordant subgroups based on the initial progression images.ResultsA total of 170 qualified patients were finally analyzed. The incidence of discordant T2/FLAIR and T1CE images was 25.9% (44/170). The median time-span of T2/FLAIR indicated tumor progression was 119.5 days (ranging from 57 days-unreached) prior to T1CE. Nearly half of patients (20/44, 45.5%) in the discordant subgroup suffered from tumor dissemination, substantially higher than accordant patients (23/126, 20.6%, p < 0.001). The median time to progression (TTP), post-progression survival (PPS), and overall survival (OS) were not statistically different (all p > 0.05) between discordant and accordant patients.ConclusionsT2/FLAIR abnormity could be the sign of GBM progression, especially for newly emerged lesions disseminating from the primary cavity. Physicians should cast more attention on the dynamic change of T2/FLAIR images, which might be of great significance for progression assessment and subsequent clinical decision-making.

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