Volumetric Assessment of Glioma Removal by Intraoperative High-field Magnetic Resonance Imaging

Neurosurgery ◽  
2004 ◽  
Vol 55 (2) ◽  
pp. 358-371 ◽  
Author(s):  
Christopher Nimsky ◽  
Atsushi Fujita ◽  
Oliver Ganslandt ◽  
Boris von Keller ◽  
Rudolf Fahlbusch
Keyword(s):  
Magnetic Resonance ◽  
High Field ◽  
Tumor Volume ◽  
Tumor Resection ◽  
World Health ◽  
Low Grade ◽  
High Grade ◽  
Resonance Imaging ◽  
Glioma Surgery ◽  
Health Organization

Abstract OBJECTIVE: To investigate the contribution of high-field intraoperative magnetic resonance imaging (iMRI) for further reduction of tumor volume in glioma surgery. METHODS: From April 2002 to June 2003, 182 neurosurgical procedures were performed with a 1.5-T magnetic resonance system. Among patients who underwent these procedures, 47 patients with gliomas (14 with World Health Organization Grade I or II glioma, and 33 with World Health Organization Grade III or IV glioma) who underwent craniotomy were investigated retrospectively. Completeness of tumor resection and volumetric analysis were assessed with intraoperative imaging data. RESULTS: Surgical procedures were influenced by iMRI in 36.2% of operations, and surgery was continued to remove residual tumor. Additional further resection significantly reduced the percentage of final tumor volume compared with first iMRI scan (6.9% ± 10.3% versus 21.4% ± 13.8%; P < 0.001). Percentages of final tumor volume also were significantly reduced in both low-grade (10.3% ± 11.5% versus 25.8% ± 16.3%; P < 0.05) and high-grade gliomas (5.4% ± 9.9% versus 19.5% ± 13.0%; P < 0.001). Complete resection was achieved finally in 36.2% of all patients (low-grade, 57.1%; high-grade, 27.3%). Among the 17 patients in whom complete tumor resection was achieved, 7 complete resections (41.2%) were attributable to further tumor removal after iMRI. We did not encounter unexpected events attributable to high-field iMRI, and standard neurosurgical equipment could be used safely. CONCLUSION: Despite extended resections, introduction of high-field iMRI in conjunction with functional navigation did not translate into an increased risk of postoperative deficits. The use of high-field iMRI increased radicality in glioma surgery without additional morbidity.

Quantification of Glioma Removal by Intraoperative High-Field Magnetic Resonance Imaging: An Update

Neurosurgery ◽  
2011 ◽  
Vol 69 (4) ◽  
pp. 852-863 ◽  
Author(s):  
Daniela Kuhnt ◽  
Oliver Ganslandt ◽  
Sven-Martin Schlaffer ◽  
Michael Buchfelder ◽  
Christopher Nimsky
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Field ◽  
Tumor Volume ◽  
Tumor Resection ◽  
World Health ◽  
Incomplete Resection ◽  
Resonance Imaging ◽  
Glioma Surgery ◽  
Who Grade

Abstract BACKGROUND: The beneficial role of the extent of resection (EOR) in glioma surgery in correlation to increased survival remains controversial. However, common literature favors maximum EOR with preservation of neurological function, which is shown to be associated with a significantly improved outcome. OBJECTIVE: In order to obtain a maximum EOR, it was examined whether high-field intraoperative magnetic resonance imaging (iMRI) combined with multimodal navigation contributes to a significantly improved EOR in glioma surgery. METHODS: Two hundred ninety-three glioma patients underwent craniotomy and tumor resection with the aid of intraoperative 1.5 T MRI and integrated multimodal navigation. In cases of remnant tumor, an update of navigation was performed with intraoperative images. Tumor volume was quantified pre- and intraoperatively by segmentation of T2 abnormality in low-grade and contrast enhancement in high-grade gliomas. RESULTS: In 25.9% of all cases examined, additional tumor mass was removed as a result of iMRI. This led to complete tumor resection in 20 cases, increasing the rate of gross-total removal from 31.7% to 38.6%. In 56 patients, additional but incomplete resection was performed because of the close location to eloquent brain areas. Volumetric analysis showed a significantly (P < .01) reduced mean percentage of tumor volume following additional further resection after iMRI from 33.5% ± 25.1% to 14.7% ± 23.3% (World Health Organization [WHO] grade I, 32.8% ± 21.9% to 6.1% ± 18.8%; WHO grade II, 24.4% ± 25.1% to 10.8% ± 11.0%; WHO grade III, 35.1% ± 27.3% to 24.8% ± 26.3%; WHO grade IV, 34.2% ± 23.7% to 1.2% ± 16.2%). CONCLUSION: MRI in conjunction with multimodal navigation and an intraoperative updating procedure enlarges tumor-volume reduction in glioma surgery significantly without higher postoperative morbidity.

Tumor Volume Assessment in Low-Grade Gliomas: A Comparison of Preoperative Magnetic Resonance Imaging to Coregistered Intraoperative 3-Dimensional Ultrasound Recordings

Neurosurgery ◽  
2017 ◽  
Vol 83 (2) ◽  
pp. 288-296 ◽  
Author(s):  
Bodil Karoline Ravn Munkvold ◽  
Hans Kristian Bø ◽  
Asgeir Store Jakola ◽  
Ingerid Reinertsen ◽  
Erik Magnus Berntsen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Tumor Volume ◽  
Intraobserver Variability ◽  
Low Grade ◽  
Resonance Imaging ◽  
Glioma Surgery ◽  
Who Grade ◽  
Low Grade Gliomas ◽  
Tumor Delineation

Abstract BACKGROUND Image guidance based on magnetic resonance imaging (MRI) and/or ultrasound (US) is widely used to aid decision making in glioma surgery, but tumor delineation based on these 2 modalities does not always correspond. OBJECTIVE To analyze volumes of diffuse low-grade gliomas (LGGs) based on preoperative 3-D FLAIR MRIs compared to intraoperative 3-D US image recordings to quantitatively assess potential discrepancies between the 2 imaging modalities. METHODS Twenty-three patients with supratentorial WHO grade II gliomas undergoing primary surgery guided by neuronavigation based on preoperative FLAIR MRI and navigated 3-D US were included. Manual volume segmentation was performed twice in 3-D Slicer version 4.0.0 to assess intrarater variabilities and compare modalities with regard to tumor volume. Factors possibly related to correspondence between MRI and US were also explored. RESULTS In 20 out of 23 patients (87%), the LGG tumor volume segmented from intraoperative US data was smaller than the tumor volume segmented from the preoperative 3-D FLAIR MRI. The median difference between MRI and US volumes was 7.4 mL (range: −4.9-58.7 mL, P < .001) with US LGG volumes corresponding to a median of 74% (range: 42%-183%) of the MRI LGG volumes. However, there was considerable intraobserver variability for US volumes. The correspondence between MRI and US data was higher for astrocytomas (92%). CONCLUSION The tumor volumes of LGGs segmented from intraoperative US images were most often smaller than the tumor volumes segmented from preoperative MRIs. There was a much better match between the 2 modalities in astrocytomas.

scholarly journals GAMBARAN KLINIKOPATOLOGIK ASTROSITOMA HIGH GRADE

Medicinus ◽  
2018 ◽  
Vol 4 (9) ◽  
Author(s):  
Erna Kristiani
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
World Health Organization ◽  
Giant Cell ◽  
Granular Cell ◽  
Small Cell ◽  
World Health ◽  
High Grade ◽  
Resonance Imaging ◽  
Health Organization

<p>Astrositoma merupakan glioma tersering. Tumor ini bisa mengenai  dewasa dan anak-anak.<em>World Health Organization</em> (WHO) mengelompokkan astrositoma menjadi 4 <em>grade</em> berdasarkan karakteristik histologik. Astrositoma<em> high grade</em> terdiri atas astrositoma anaplastik (<em>grade</em> III) dan glioblastoma (<em>grade</em> IV).</p><p>Data Departemen Patologi Anatomik Rumah Sakit Cipto Mangunkusumo (RSCM) tahun 2001-2010 melaporkan kejadian astrositoma sebanyak 179 kasus atau sekitar 20% dari seluruh tumor intrakranial, astrositoma anaplastik ditemukan sebanyak 12 kasus, dan  glioblastoma 42 kasus.</p><p>Seperti pada tumor otak lain, astrositoma <em>high grade</em> mengakibatkan gejala dan tanda gangguan neurologik fokal dan umum. Pemeriksaan radiologik pilihan adalah dengan <em>Magnetic Resonance Imaging</em> (MRI). Astrositoma anaplastik memberikan gambaran <em>hypointense</em> pada T1 dan <em>hyperintense</em> pada T2 dengan efek massa yang bervariasi. Karakteristik glioblastoma pada MRI berupa lesi iregular menyangat kontras di sekeliling nekrosis sentral (<em>ring enhancement</em>) dan edema vasogenik luas di sekitar tumor.</p><p>Astrositoma anaplastik secara histopatologik dicirikan dengan atipia inti, peningkatan selularitas, serta aktivitas proliferasi yang nyata. Glioblastoma secara histopatologik serupa dengan astrositoma anaplastik, disertai adanya proliferasi vaskular dan/atau nekrosis. Astrositoma anaplastik dan khususnya glioblastoma mempunyai variasi gambaran histologik yang beragam, antara lain varian <em>small cell, granular cell, giant cell</em>, dan gliosarcoma.</p>

scholarly journals Genetic Abnormalities, Clonal Evolution, and Cancer Stem Cells of Brain Tumors

2018 ◽  
Vol 6 (4) ◽  
pp. 85 ◽  
Author(s):  
Ugo Testa ◽  
Germana Castelli ◽  
Elvira Pelosi
Keyword(s):  
Brain Tumors ◽  
Clonal Evolution ◽  
Pediatric Brain Tumors ◽  
Genetic Alterations ◽  
World Health ◽  
Driver Mutations ◽  
Low Grade ◽  
High Grade ◽  
Genetic Profiling ◽  
Health Organization

Brain tumors are highly heterogeneous and have been classified by the World Health Organization in various histological and molecular subtypes. Gliomas have been classified as ranging from low-grade astrocytomas and oligodendrogliomas to high-grade astrocytomas or glioblastomas. These tumors are characterized by a peculiar pattern of genetic alterations. Pediatric high-grade gliomas are histologically indistinguishable from adult glioblastomas, but they are considered distinct from adult glioblastomas because they possess a different spectrum of driver mutations (genes encoding histones H3.3 and H3.1). Medulloblastomas, the most frequent pediatric brain tumors, are considered to be of embryonic derivation and are currently subdivided into distinct subgroups depending on histological features and genetic profiling. There is emerging evidence that brain tumors are maintained by a special neural or glial stem cell-like population that self-renews and gives rise to differentiated progeny. In many instances, the prognosis of the majority of brain tumors remains negative and there is hope that the new acquisition of information on the molecular and cellular bases of these tumors will be translated in the development of new, more active treatments.

Prognostic value of initial magnetic resonance imaging growth rates for World Health Organization grade II gliomas

2006 ◽  
Vol 60 (3) ◽  
pp. 380-383 ◽  
Author(s):  
Johan Pallud ◽  
Emmanuel Mandonnet ◽  
Hugues Duffau ◽  
Michèle Kujas ◽  
Rémy Guillevin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
World Health Organization ◽  
Growth Rates ◽  
Prognostic Value ◽  
World Health ◽  
Resonance Imaging ◽  
Grade Ii ◽  
Health Organization

Role of magnetic resonance imaging in prediction of chondrosarcoma of bone grade

2021 ◽  
pp. 21-24
Author(s):  
A. V. Fedorova ◽  
N. V. Kochergina ◽  
A. B. Bludov ◽  
I. V. Boulycheva ◽  
E. A. Sushentsov ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Value ◽  
Low Grade ◽  
High Grade ◽  
Resonance Imaging ◽  
Accurate Definition ◽  
Definition Of ◽  
Decisive Rule

Purpose. Determining the diagnostic value of magnetic resonance imaging in the accurate definition of chondrosarcoma of bone grade at the pre-surgery examination. Material and methods. We analyzed examination data (magnetic resonance imaging with no contrast enhancement) of 70 patients with chondrosarcoma (35 patients with low-grade chondrosarcoma and 35 patients with high grade chondrosarcoma). Informative weighted coefficients were determined separately for ‘learning’ and ‘examination’ samples. On the basis of weighted coefficients, the decisive rule was created for differentiation between low-grade and high-grade chondrosarcoma. Results. The sensitivity of the method was 87.0%, specificity was 95.6%, total correct classification was 91.03%. Conclusion. Magnetic resonance imaging is a highly informative method for prediction of chondrosarcoma grade at the pre-surgery examination.

scholarly journals Lipomatous meningioma: A rare subtype of benign metaplastic meningiomas

2017 ◽  
Vol 08 (01) ◽  
pp. 140-142 ◽  
Author(s):  
Mehmet Onur Yüksel ◽  
Mehmet Sabri Gürbüz ◽  
Osman Tanrıverdi ◽  
Sevilay Akalp Özmen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
World Health ◽  
Histopathological Diagnosis ◽  
Resonance Imaging ◽  
Cranial Magnetic Resonance Imaging ◽  
World Health Organization Classification ◽  
The World ◽  
History Of ◽  
Health Organization

ABSTRACTLipomatous meningiomas are extremely rare subtypes of benign meningiomas and are classified as metaplastic meningioma in the World Health Organization classification. We present a 77-year-old man presented with the history of a gradually intensifying headache for the last 3 months. A right frontoparietal mass was detected on his cranial magnetic resonance imaging. The patient was operated on via a right frontoparietal craniotomy, and histopathological diagnosis was lipomatous meningioma. Distinctive characteristics of lipomatous meningiomas were discussed with special emphasis to importance of immunohistochemical examinations, particularly for its differentiation from the tumors showing similar histology though having more aggressive character.

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