A Comparison of CT Contrast Enhancement and BUDR Labeling Indices in Moderately and Highly Anaplastic Astrocytomas of the Cerebral Hemispheres

Abstract

ABSTRACT:Contrast enhancement on computerized tomography (CT) scans has been used in directing therapy for presumed intracranial gliomas. However, for moderately anaplastic astrocytomas (MOAAS) and highly anaplastic astrocytomas (HAAS), it provides no information about proliferative potential. The bromodeoxyuridine (BUDR) labeling index (LI), however, indicates proliferative potential, correlating with histologic malignancy and survival. An LI < 1% is a favorable indicator; LI > 5% suggests more aggressiveness. To determine the correlation, if any, between BUDR LI and contrast enhancement, CT scans of 71 patients with cerebral hemisphere tumors labeled with BUDR were retrospectively reviewed. Among 36 MOAAS, the BUDR LI was < 1% in 77% of enhanced tumors and 61% of unenhanced tumors. Among 35 HAAS, it was < 5% in 56% of enhanced tumors and 90% of unenhanced tumors. Therefore, contrast enhancement on CT scans does not always correctly predict proliferative potential in these tumors, and biopsy and labeling studies are recommended before therapy.

Patterns of Care for Adults With Newly Diagnosed Malignant Glioma

“…Patients with grade IV tumors were older on average than patients with grade III tumors. Grade IV tumors were more likely to demonstrate contrast enhancement on CT or MRI; as in previous studies, 15 this demonstration was not universal. Just more than half of patients presented with headache.…”