Assessment of the Generally Valid as Predictable Progression/Recurrence Marker by Using Increased Signal Intensity Fluid-Attenuated Inversion Recovery (FLAIR) Within the Postoperative Resection Cavity of Gliomas

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Wiboon Suriyajakryuththana
Theeraphol Panyaping
Sirinut Wattanapaiboonsuk
Peerapong Lueangapapong


Background: Monitoring progression/recurrence brain glioma after surgery is the most important for therapeutic planning.

Objective: To verify that an increased signal intensity (SI) in resection cavity of brain glioma by fluid-attenuated inversion recovery (FLAIR) can be predictor of tumor progression/recurrence.

Methods: A retrospective cross-sectional study in patients who underwent surgery at Ramathibodi Hospital with pathological proven brain gliomas (grade II, III, and IV) from January 1, 2010, to July 31, 2016, was performed. Postoperative magnetic resonance imaging (MRI) after 3 months was analyzed and measured for SI in surgical cavity, compared with SI of cerebrospinal fluid (CSF) in the contralateral frontal horn.

Results: Sixteen men and sixteen women with mean age 41.25 years were included. Thirty-one cases had partial resection and one case complete resection. The pathological diagnosis were 20 cases of high-grade gliomas and 12 cases of low-grade gliomas. Chemotherapy and radiotherapy were given in 16 cases. An increased SI in the surgical cavity by FLAIR had sensitivity of 77.3% and specificity of 50%.

Conclusions: Fair specificity and sensitivity of increased FLAIR SI for detection of tumor progression/recurrence was found. However, FLAIR is usually performed in standard MRI with no additional time or radiation hazard.



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Suriyajakryuththana, W., Panyaping, T., Wattanapaiboonsuk, S., & Lueangapapong, P. (2018). Assessment of the Generally Valid as Predictable Progression/Recurrence Marker by Using Increased Signal Intensity Fluid-Attenuated Inversion Recovery (FLAIR) Within the Postoperative Resection Cavity of Gliomas. Ramathibodi Medical Journal, 41(3), 30-41.
Original Articles


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