Journal of Neuro-Oncology

, Volume 137, Issue 3, pp 631–638 | Cite as

Increasing FLAIR signal intensity in the postoperative cavity predicts progression in gross-total resected high-grade gliomas

  • Guan-Min Quan
  • Yong-Li Zheng
  • Tao Yuan
  • Jian-Ming Lei
Clinical Study


To evaluate the prognostic value of fluid-attenuated inversion recovery (FLAIR) signal intensity of postoperative cavity on progression free survival (PFS) and overall survival (OS) in patients with high-grade gliomas (HGG). This study retrospectively enrolled 45 consecutive HGG patients. These patients had chemoradiotherapy after gross-total resection of tumors. Quantitative analysis of the FLAIR signal intensity in postoperative cavity and background was made. We evaluated the threshold value, accuracy, sensitivity, specificity, and survival state with this technique. The patients who progressed and patients who did not progress were 33 and 12 cases separately. The ratio of postoperative cavity and background (C–B) on FLAIR sequence in patients who progressed was higher than that of patients who did not progress (P = 0.014). The PFS of the patients who progressed was shorter than that of patients who did not progress (P = 0.008). The area under ROC curve, threshold, sensitivity, specificity of C–B ratio for predicting tumor progression were 0.875, 62.3, 69.7, 0.84, and 0.50% respectively. The PFS of lower signal group was much longer than that of higher signal group (P = 0.004). The OS of the patients with higher signal was shorter than that of patients with lower signal (P = 0.034). The increase of gray value of FLAIR in postoperative cavity may be used as an imaging marker for predicting tumor progression.


Glioma Chemoradiotherapy Outcome Magnetic resonance imaging FLAIR 



We would like to thank Dr. Duo Gao for language editing the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Medical ImagingThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
  2. 2.Department of RadiologyThe Third Hospital of Hebei Medical UniversityShijiazhuangChina

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