MRI Grading versus Histology: Predicting Survival of World Health Organization Grade II-IV Astrocytomas (original) (raw)
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Neuroradiology, 1992
MR images in 54 patients with biopsy-proven diffuse or "fibrillary" astrocytomas were analyzed and compared with the histopathologic features in order to determine which histopathologic characteristics underlie the radiographic findings in these gliomas and whether radiographic findings are more closely correlated with individual histopathologic characteristics than with histologically determined tumor grade. The MRI features studied included tumor heterogeneity, edema, mass effect, border sharpness, "anatomic invasion", contrast enhancement, hemorrhage, and the presence of flow voids, calcium and cyst formation. The histopathologic characteristics studied included cellular atypia, mitoses, cellularity, endothelial proliferation, necrosis and tumor grade. Edema (P < 0.01), flow voids (P = 0.02) and contrast enhancement (P < 0.01) demonstrated a direct correlation with tumor grade, but edema (P < 0.01) and contrast enhancement (P < 0.01) also demonstrated a significant correlation to tumor cellularity. Tumor heterogeneity was associated with the presence of necrosis (P = 0.01). Hemorrhage occurred only in high grade tumors, where it correlated with endothelial proliferation (P = 0.04).
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2015
Background: Although radiological imaging and surgical techniques have substantially improved, assessment of prognosis by grading astrocytoma has been challenging task for pathologists. We have tried to assess these tumours intraoperatively for rapid diagnosis. Also MIB-1Labelling index (MIB-1 LI) was done to study their proliferative activity. Aims: To compare and grade squash smear technique with histopathology to study its utility in diagnosis of astrocytomas. Further, to study correlation of various grades with their MIB-1 labelling index. Setting and Designs: This study was carried out in the Department of Pathology, SMS Medical College, Jaipur over a period of one year. Materials and Methods: Forty five cases of radiologically suspected astrocytomas were submitted for intraoperative cytology and later for histopathology. Two techniques were compared for ability to diagnose as well as grade the tumour. Also, MIB-1 LI were performed in biopsy tissue. Histopathological and immunological grades were compared. Results: Out of 45 cases 44(97.7%) correctly diagnosed by squash smear technique. Further significant differences seen in values of MIB-1 LI of high-grade and low-grade astrocytomas. A progressive increase in the MIB-1 LI was observed with increasing grades. In grade I astrocytoma MIB-1 LI was <0.05%. In grade II astrocytoma it varied from 0.8-2.6% except in one case where it was 3.2% who presented with a recurrent mass. In grade III, MIB-1 LI was 3.5% to 7.5%. In grade IV was 10-20%. Conclusion: Intraoperative cytology is fairly accurate and useful in intraoperative consultation. Also, MIB-1 LI can be a useful adjunct for grading particularly in small biopsies.
Supratentorial diffuse astrocytic tumours: proposal of an MRI classification
European Radiology, 1997
The aim of this study was to obtain an MRI severity-related classification of diffuse astrocytic tumours able to integrate the histological data in the grading of such tumours. We studied presurgical MR images of 91 patients with a histological diagnosis of astrocytoma, anaplastic astrocytoma and glioblastoma. A score ranging from 1 to 3 was assigned by two independent readers to each of the following MR features: oedema, mass effect, contrast enhancement, borders, signal homogeneity, necrosis, haemorrhage and flow void. Statistical analysis showed significant differences in the mean MRI scores between the three histological grades. Contrast enhancement was found to be the best predictor of the histological grade followed by necrosis, signal homogeneity and border scores. This classification represents a simple and reproducible means of carefully evaluating some macroscopic characteristics of these tumours. It could be used to integrate histological data especially in cases in which tissue sampling defects may affect the validity of this examination.
SWI by 7T MR Imaging for the Microscopic Imaging Diagnosis of Astrocytic and Oligodendroglial Tumors
American Journal of Neuroradiology
BACKGROUND AND PURPOSE: Despite advances in molecular imaging, preoperative diagnosis of astrocytomas and oligodendrogliomas can be challenging. In the present study, we assessed whether 7T SWI can be used to distinguish astrocytomas and oligodendrogliomas and whether malignant grading of gliomas is possible. MATERIALS AND METHODS: 7T SWI was performed on 21 patients with gliomas before surgery with optimization for sharp visualization of the corticomedullary junction. Scoring for cortical thickening and displacement of medullary vessels, characteristic of oligodendroglial tumors, and cortical tapering, characteristic of astrocytic tumors, was performed. Additionally, characteristics of malignancy, including thickening of the medullary veins, the presence of microbleeds, and/or necrosis were scored. RESULTS: Scoring for oligodendroglial (highest possible score, 13) and astrocytic (lowest score possible, À3) characteristics yielded a significant difference between astrocytomas and oligodendrogliomas (mean, À1.93 versus 11.71, P , .01). Scoring for malignancy was significantly different among the World Health Organization grade II (n ¼ 10), grade III (n ¼ 4), and grade IV (n ¼ 7) tumors (mean, 0.20 versus 1.38 versus 2.79). Cortical thickening was observed significantly more frequently in oligodendrogliomas (P , .02), with a sensitivity of 71.4% and specificity of 85.7%; observation of tapering of the cortex was higher in astrocytomas (P , .01) with a sensitivity of 85.7% and specificity of 100%. CONCLUSIONS: Visualization of the corticomedullary junction by 7T SWI was useful in distinguishing astrocytomas and oligodendrogliomas. Observation of tapering of the cortex was most sensitive and specific for diagnosing astrocytomas. Reliably predicting malignant grade was also possible by 7T SWI.
Journal of Neurosciences in Rural Practice
Abstarct Objective Gliomas, the most frequent primary brain tumors, have various grades, among which grade II, III, and IV are diffusely infiltrating astrocytomas. As therapeutic approaches and outcome differ considerably, depending on the grade of these tumors, prediction is important regarding outcome. Magnetic resonance spectroscopy (MRS) can be of help in understanding of the biochemical changes of pathological state to study, monitor, predict grading and outcome of gliomas. Materials and Methods All the 30 patients in the study with intracranial diffusely infiltrating astrocytoma had MRS study using 1.5 Tesla MR scanner. The study population was divided into three groups on the basis of the grades of the tumor according to histopathology. Mean height of choline (Ch), N-acetyl aspartate (NAA), creatine (Cr) peak, and choline/creatine (Ch/Cr) ratio was documented. Mean value of each variable among three grades was analyzed and compared with analysis of variance (ANOVA) test (F-te...
AJNR. American journal of neuroradiology, 2005
Histopathologic evaluation remains the reference standard for diagnosis of glioma and classification of histologic subtypes, but is challenged by subjective criteria, tissue sampling error, and lack of specific tumor markers. Anatomic imaging is essential for surgical planning of gliomas but is limited by its nonspecificity and its inability to depict beyond morphologic aberrations. The purpose of our study was to investigate dynamic susceptibility contrast-enhanced (DSC) MR imaging characteristics of the two most common subtypes of low-grade infiltrating glioma: astrocytoma and oligodendroglioma. We hypothesized that tumor blood-volume measurements, derived from DSC MR imaging, would help differentiate the two on the basis of differences in tumor vascularity. We studied 25 consecutive patients with treatment-naive, histopathologically confirmed World Health Organization grade II astrocytoma (n = 11) or oligodendroglioma (n = 14). All patients underwent anatomic and DSC MR imaging i...