Delineation of Gliomas with Magnetic Resonance Imaging Using Gd-DTPA in Comparison with Computed Tomography and Positron Emission Tomography

Tovi, Metin; Lilja, Anders; Bergström, Mats; Ericsson, Anders; Bergström, K; Hartman, M.

doi:10.1177/028418519003100501

Cited by 34 publications

(1 citation statement)

References 26 publications

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“…It is considered essential in the diagnosis of many brain disorders. From the introduction of paramagnetic contrast media in the mid-1980s, intravenous paramagnetic contrast media have been increasingly used to improve diagnostic accuracy in selected cases, 4 in the decision-making process for treatment, in guiding stereotactic biopsy and radiosurgery, 5 in estimating tumor grading, 6 and in monitoring effectiveness and possible complications of therapies. 7 Post-contrast T1-w imaging has also been proven to be able to reveal small enhancing lesions undetectable in unenhanced MRI because of their location, very small dimensions, and/or their lack of mass effect or visible edema, such as small brain metastasis.…”

Section: Introductionmentioning

confidence: 99%

Detection of pathological contrast enhancement with synthetic brain imaging from quantitative multiparametric MRI

Donatelli,

Migaleddu,

Cencini

et al. 2024

Journal of Neuroimaging

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Background and PurposeWe aimed to test whether synthetic T1‐weighted imaging derived from a post‐contrast Quantitative Transient‐state Imaging (QTI) acquisition enabled revealing pathological contrast enhancement in intracranial lesions.MethodsThe analysis included 141 patients who underwent a 3 Tesla‐MRI brain exam with intravenous contrast media administration, with the post‐contrast acquisition protocol comprising a three‐dimensional fast spoiled gradient echo (FSPGR) sequence and a QTI acquisition. Synthetic T1‐weighted images were generated from QTI‐derived quantitative maps of relaxation times and proton density. Two neuroradiologists assessed synthetic and conventional post‐contrast T1‐weighted images for the presence and pattern of pathological contrast enhancement in intracranial lesions. Enhancement volumes were quantitatively compared.ResultsUsing conventional imaging as a reference, synthetic T1‐weighted imaging was 93% sensitive in revealing the presence of contrast enhancing lesions. The agreement for the presence/absence of contrast enhancement was almost perfect both between readers (k = 1 for both conventional and synthetic imaging) and between sequences (k = 0.98 for both readers). In 91% of lesions, synthetic T1‐weighted imaging showed the same pattern of contrast enhancement visible in conventional imaging. Differences in enhancement pattern in the remaining lesions can be due to the lower spatial resolution and the longer acquisition delay from contrast media administration of QTI compared to FSPGR. Overall, enhancement volumes appeared larger in synthetic imaging.ConclusionsQTI‐derived post‐contrast synthetic T1‐weighted imaging captures pathological contrast enhancement in most intracranial enhancing lesions. Further comparative studies employing quantitative imaging with higher spatial resolution is needed to support our data and explore possible future applications in clinical trials.

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Section: Introductionmentioning

confidence: 99%

Detection of pathological contrast enhancement with synthetic brain imaging from quantitative multiparametric MRI

Donatelli,

Migaleddu,

Cencini

et al. 2024

Journal of Neuroimaging

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A 31-Year-Old Woman With a Transformed Low-grade Glioma

Warnke¹

2010

JAMA

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Low-grade gliomas in adults have an incidence of 0.8 to 1.2 per 100,000, and their causes are unknown. Despite their histological classification as low-grade, they cannot be cured by any current treatment mode, and no class I evidence exists to guide initial treatment of these tumors. Median survival ranges between 7.5 years and 10 years, with a 5-year survival probability between 55% and 86%. The prognosis depends on age, World Health Organization (WHO) tumor grade, Karnofsky performance score, cytological type (oligodendroglioma vs astrocytoma), and, potentially, the extent of resection. Oligodendrogliomas with loss of heterozygosity on chromosomes 1p and 19q have a distinctly more favorable prognosis and therapeutic response rate. Low-grade tumors progress to high-grade gliomas with aggressive biological behavior at increasing frequency with advancing age. Ms P is a young woman with a previously treated oligodendroglioma, WHO grade II, with loss of heterozygosity on chromosomes 1p and 19q, which at a third resection had transformed into an oligodendroglioma of WHO grade III. She wants to know her current and future therapeutic options.

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The increasing incidence of malignant gliomas and primary central nervous system lymphoma in the elderly

Werner

Phuphanich

Lyman

1995

Cancer

101

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Background. Studies indicate that the incidence of primary malignant brain tumors in the elderly is increasing, but this may reflect increased case ascertainment due to the introduction of computed tomography (CT) scanning. In addition, tumor histology was not available in these studies. This study was conducted to determine whether the incidence of primary malignant brain tumors in the elderly in Florida is increasing and to verify the histology of these increases. Methods. Using the number of primary malignant brain tumors reported to the Florida Cancer Data System (FCDS) when CT scanning was available, incidence rates per 100,000 people were calculated. Incidence density ratios (IDRs) were calculated for 1986–1989 relative to 1981‐1984. Results. Tumor incidence at ages 20–64 years increased from 5.7 in 1981–1984 to 5.9 in 1986–1989, with an IDR of 1.05 (not significant). The incidence in those aged 65 years or older rose from 14.8 to 18.3, with an IDR of 1.23 (P < 0.001). The increase was 15% in those aged 65–69, 16% in those 70–74 years, 30% in those 75–79 years, 36% in those 80–84 years, and 254% in those 85 years or older. Indicence density ratios in those aged 65 years or older were 0.92 (not significant) for astrocytoma, 2.7 (p < 0.001) for anaplastic astrocytoma, 1.32 (p < 0.001) for glioblastoma and 3.56 (p < 0.001) for lymphoma. In those aged 65+ the incidence of all cancers rose 7.6% (not significant), and the incidence of pancreatic cancer (another neoplasm that requires CT scanning for diagnosis) rose 0.34% (not significant). Conclusions. The incidence of primary brain tumors in elderly Floridians has increased. This increase is independent of increased case ascertainment associated with the introduction of CT scanning and independent of a general increase of all cancers. The rise in brain tumor incidence is observed in anaplastic astrocytoma, glioblastoma, and lymphoma but not astrocytoma. This study confirms the increase is histologically specific and not due to increased case ascertainment. Further investigation into the etiology of this increase is warranted. Cancer 1995; 76:1634–42.

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Delineation of Gliomas with Magnetic Resonance Imaging Using Gd-DTPA in Comparison with Computed Tomography and Positron Emission Tomography

Cited by 34 publications

References 26 publications

Detection of pathological contrast enhancement with synthetic brain imaging from quantitative multiparametric MRI

Detection of pathological contrast enhancement with synthetic brain imaging from quantitative multiparametric MRI

A 31-Year-Old Woman With a Transformed Low-grade Glioma

The increasing incidence of malignant gliomas and primary central nervous system lymphoma in the elderly

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