Resorption of peritumoural oedema in cerebral gliomas during dexamethasone treatment evaluated by NMR relaxation time imaging

Abstract

Peritumoural brain oedema is a prominent feature of malignant brain tumours. Glucocorticoids diminish the neurological symptoms and signs caused by the oedema and reduce the abnormally high cerebral water content. The exact mechanisms of action of the glucocorticoids are unknown. The present study investigates the influence of dexamethasone on NMR relaxation time T1 in peritumoural oedema in 13 patients with gliomas. It is shown that NMR T1 images can be used as a potent monitor of brain oedema, and that dexamethasone significantly reduces mean T1 after 1, 3, and 7 days of treatment by 2%, 6%, and 13% respectively. Using an image histogram analysis technique the term "super-oedema" was defined as the 50% of the total oedema area with the highest T1, corresponding to the highest water content. It is shown, that with this technique the treatment effect of steroids on super-oedema was a reduction of 13%, 33%, and 57% after 1, 3, and 7 days of treatment respectively. The mean change after 24 hours of treatment was statistically significant (p < 0.01). The method can be used in all situations where the anti-oedematous effect of a given treatment is to be monitored.