Question 2768
{"accessible":false,"alternatives":[{"id":13511,"text":"assess for immediate post-operative complications"},{"id":13512,"text":"assess for residual enhancing tumor"},{"id":13510,"text":"distinguish progression from pseudoprogression"},{"id":13513,"text":"plan for radiotherapy"}],"archived":false,"correctAlternativeId":13512,"explanation":"\u003cp\u003eThe primary reason to obtain an immediate post-operative scan in the first 24-48 hours is to allow the detection or residual enhancing tumor which may, depending on location, warrant further resection, as safe maximal macroscopic resection has been shown to improve progression-free survival. \u003c/p\u003e\u003cp\u003eAfter glioblastoma resection, granulation tissue forms at the surgical site. This tissue contains new blood vessels and inflammation that mimic residual tumor on the postoperative MRI scan. After the first 72 hours, this granulation tissue can be visualized on imaging. By obtaining the postoperative scan within the first 72 hours, the extent of resection and the presence of residual tumor can be more accurately assessed.\u003c/p\u003e\u003cp\u003ePseudoprogression occurs after radiotherapy and therefore won't be a diagnostic consideration on the first scan. Yes, post-operative complications can be seen, however, that this not the purpose of routine imagine and CT would typically be used if hemorrhage or other serious unexpected deterioration occurs. \u003c/p\u003e\u003cp\u003ePlanning for radiotherapy typically occurs later than that as it is important to allow the resection cavity to stabilize in shape and size, fluid and gas to resorb and mass effect to resolve, otherwise the field may be poorly aligned with tumor. \u003c/p\u003e","id":2768,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2768","nextQuestionPath":"/articles/glioblastoma-idh-wildtype/questions/2336","relatedArticles":[],"alsoUsedIn":[{"id":1722,"kind":"Course","title":"2023 Virtual Conference Private Use - page 1722","link":"https://radiopaedia.org/courses/2023-virtual-conference-private-use/pages/1722"},{"id":365,"kind":"LiveSchedule","title":"365","link":"https://radiopaedia.org/admin/live_schedules/365"},{"id":275,"kind":"LiveSchedule","title":"275","link":"https://radiopaedia.org/admin/live_schedules/275"},{"id":1466,"kind":"Course","title":"2023 Virtual Conference Private Use - page 1466","link":"https://radiopaedia.org/courses/2023-virtual-conference-private-use/pages/1466"},{"id":1466,"kind":"Course","title":"2024 Virtual Conference Private Use - page 1466","link":"https://radiopaedia.org/courses/2024-virtual-conference-private-use/pages/1466"},{"id":1466,"kind":"Course","title":"Neuroradiology Lectures - page 1466","link":"https://radiopaedia.org/courses/neuroradiology-lectures/pages/1466"},{"id":1466,"kind":"Course","title":"New test course - page 1466","link":"https://radiopaedia.org/courses/new-test-course/pages/1466"}],"stem":"\u003cp\u003eThe immediate post-operative scan following glioblastoma resection should be obtained before 72 hours (preferably in the first 24-48 hours) post-surgery to...\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2768"}],"attemptsPercentages":[{"alternativeId":"13513","percentage":7},{"alternativeId":"13512","percentage":76},{"alternativeId":"13511","percentage":10},{"alternativeId":"13510","percentage":8}],"promptToLogin":false,"questionManager":false,"articleId":"glioblastoma-idh-wildtype"}