Neuroradiological Viewpoint on the Diagnostics of Space-Occupying Brain Lesions

Abstract

Conventional magnetic resonance (MR) imaging of space-occupying lesions may answer most of the questions concerning the diagnosis and subsequent treatment strategies if patient age, clinical and paraclinical findings are considered as well. However, crucial and relevant differential diagnoses require additional MR methods, such as diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI) and magnetic resonance spectroscopy (MRS). In necrotic ring-enhancing lesions DWI may detect inflammatory processes, whereas characteristics of the peritumoral area may help to distinguish between metastases and glioblastomas. In solid tumors DWI, PWI and MRS may also aid the differentiation between low-grade gliomas and malignant tumors, such as gliomas WHO (World Health Organization) grade III and IV and lymphomas. This review briefly explains special MR methods with respect to brain tumors and illustrates the diagnostic pathways necessary for supplying a reliable diagnosis as well as optimal pre-operative imaging of space-occupying brain lesions.

Rapid immunohistochemistry based on alternating current electric field for intraoperative diagnosis of brain tumors

“…Recently, in addition to the usefulness of CT and MRI images, additional multi-modal imaging techniques such as PET have improved the diagnostic accuracy. However, there are still limitations in obtaining an exact preoperative diagnosis [2] [3].…”

Discrete Wavelet Transform-Based Whole-Spectral and Subspectral Analysis for Improved Brain Tumor Clustering Using Single Voxel MR Spectroscopy

“…The misclassification of these tumour spectra may be due to the fact that our ground truth is defined by local biopsy or resected tumour samples that do not accurately represent the tissue that has been investigated by MRS. The tumour biopsy samples used for histopathology have typical volumes in mm 3 , whereas the SV MRS data are acquired from a volume in cm 3 [14]. In particular, the highest grade tumour cells observed in the biopsy determine the clinical assignation of tumour grade and may only represent a small proportion of the tissue in the MRS voxel.…”

“…The choice of the window sizes ( ) for different metabolites can influence the performance of the system. In addition, the window size must be kept small to avoid Sym1 [1][2][3][4][5][6][7][8][9][10][11][12] 83.2% ± 1.6% 92.5% (with Sym1 and 7 or 9 levels of decomposition) Sym2 [1][2][3][4][5][6][7][8][9][10][11][12] 83.2% ± 1.6% Sym3 [1][2][3][4][5][6][7][8][9][10][11][12] 83.1% ± 1.6% Table 2). The window size for each metabolite was varied in turn with the window sizes of the remaining metabolites kept fixed, and inherent to this process is the assumption that the window sizes are independent in terms of optimisation.…”

Advanced neuroimaging in the clinic: critical appraisal of the evidence base

“…Regarding critical appraisal worksheet grades for DTI-mTBI detection reviews, 1 review achieved Grade A, 29 8 reviews achieved Grade B 8,24,25,36,39,41,42,44 and 14 reviews achieved Grade C. 6,[26][27][28][30][31][32][33][34][35]37,38,40,43 Of the reviews of DTI-mTBI outcome prediction, three reviews achieved Grade B 25,39,41 and the remaining reviews were Grade C. 6,[26][27][28][30][31][32]37,40 Of the reviews of DSC-glioma detection, 1 review achieved Grade A, 7 1 review achieved Grade B 62 and 24 reviews achieved Grade C. 9,12,[45][46][47][48][49][50][51][52][53][54]…”

“…9,11 DSC-MRI, however, detects glioma infiltration as elevated CBV due to tumour neoangiogenesis within the normal-appearing white matter of the peritumoral region. [12][13][14] Both of these techniques may aid in diagnosis, prognosis and treatment.…”