RADIOLOGICAL ASSESSMENT OF NECROSIS IN GLIOBLASTOMA - VARIABILITY ANDPROGNOSTIC VALUE

In a previous study, we found that the extent of necrosis was the only radiological feature which correlated significantly with survival in patients with glioblastoma. The aim of this paper was to evaluate the variability and prognostic value of the extent of the necrotic area as seen on contrast-enhanced MRI and CT in a larger series. We studied 7 2 patients who underwent surgical removal of supratentorial glioblasto mas and had CT and/or MRI with contrast medium before surgery; 38, all undergoing the same treatment (surgery plus radiotherapy), were follo wed clinically. Necrosis within the tumour varied greatly, ranging fro m none (only 1 case) to involvement of 76% of the tumour. Survival dat a in the subgroup suggested that only patients with a small area of ne crosis (less than 35% of the tumour) had a significantly longer surviv al time. When necrosis involved more than 35% of the mass, patients ha d a shorter survival time, without any further correlation with the ex tent of necrosis.