MR EVALUATION OF GLIOBLASTOMA WITH TRIPLE -DOSE GADOLINIUM-DO3A-BUTRIOL - IMPROVED DELINEATION OF INFILTRATING TUMOR

Purpose: To assess the efficacy of high-dose contrast enhanced magneti c resonance imaging (MRI) in detection and delineation of infiltrating tumour in glioblastoma. Material and methods: In a phase II clinical trial 14 patients with suspected supratentorial glioblastoma underwent MRI with Gd-DO3A-butriol (Gadovist(R), Schering AG, Berlin) with dose s of 0.1 up to 0.3 mmol/kg. Results: Increasing the dose of Gd-DO3A-bu triol resulted in improved enhancement (14/14) and better delineation of infiltrating tumour (9/14) up to 2 cm beyond enhancement after stan dard dose. In two of the 9 patients additional enhancement in the peri tumoural oedema was only seen after the third injection. Conclusions: Successful surgery requires precise preoperative delineation of tumour borders. After high-dose MRI it might be possible to select those pat ients who would benefit from more radical attempts at eradicating the macroscopic as well as most of the microscopic compartment of glioblas toma.