Stereotactic biopsy guidance in adults with supratentorial nonenhancing gliomas: role of perfusion-weighted magnetic resonance imaging

Maia, Antônio Carlos Martins; Malheiros, Suzana Mária Fleury; Rocha, Antônio José da; Stávale, João N.; Guimarães, Iara F.; Borges, Lia Raquel Rodrigues; Santos, Adrialdo José; Silva, Carlos J. da; Melo, Julieta G. S. P. de; Lanzoni, Oreste Paulo; Gabbai, Alberto A.; Ferraz, Fernando Antônio Patriani

doi:10.3171/jns.2004.101.6.0970

Cited by 77 publications

(43 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,3,[10][11][12]20,[24][25][26][27] Measurement of regional cerebral blood volume (rCBV) was reported as showing close correlation with histopathologic grade in gliomas. 11,12,24 Because the rCBV measurement by using an MR perfusion study can reflect tumoral physiologic information such as the degree of neovascularity and angiogenesis, it might be very helpful to grade gliomas correctly preoperatively. Therefore, further studies focusing on the lowest ADC areas with MR perfusion study parameters including rCBV may improve correct preoperative glioma grading.…”

Section: 10mentioning

confidence: 99%

Preoperative Grading of Presumptive Low-Grade Astrocytomas on MR Imaging: Diagnostic Value of Minimum Apparent Diffusion Coefficient

Lee¹,

Lee²,

Agid³

et al. 2008

AJNR Am J Neuroradiol

138

View full text Add to dashboard Cite

show abstract

Section: 10mentioning

confidence: 99%

Preoperative Grading of Presumptive Low-Grade Astrocytomas on MR Imaging: Diagnostic Value of Minimum Apparent Diffusion Coefficient

Lee¹,

Lee²,

Agid³

et al. 2008

AJNR Am J Neuroradiol

138

View full text Add to dashboard Cite

show abstract

“…Importantly, vascular density can be measured in vivo with imaging techniques that map regional blood volume. Numerous studies have established a tight relationship between angiogenesis and regional blood volume (13-17), including in the brain where regional angiogenesis is coupled to regional cerebral blood volume (CBV) (18)(19)(20)(21)(22)(23)(24)(25)(26).…”

mentioning

confidence: 99%

An in vivo correlate of exercise-induced neurogenesis in the adult dentate gyrus

Pereira¹,

Huddleston²,

Brickman³

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

1,139

913

View full text Add to dashboard Cite

With continued debate over the functional significance of adult neurogenesis, identifying an in vivo correlate of neurogenesis has become an important goal. Here we rely on the coupling between neurogenesis and angiogenesis and test whether MRI measurements of cerebral blood volume (CBV) provide an imaging correlate of neurogenesis. First, we used an MRI approach to generate CBV maps over time in the hippocampal formation of exercising mice. Among all hippocampal subregions, exercise was found to have a primary effect on dentate gyrus CBV, the only subregion that supports adult neurogenesis. Moreover, exercise-induced increases in dentate gyrus CBV were found to correlate with postmortem measurements of neurogenesis. Second, using similar MRI technologies, we generated CBV maps over time in the hippocampal formation of exercising humans. As in mice, exercise was found to have a primary effect on dentate gyrus CBV, and the CBV changes were found to selectively correlate with cardiopulmonary and cognitive function. Taken together, these findings show that dentate gyrus CBV provides an imaging correlate of exercise-induced neurogenesis and that exercise differentially targets the dentate gyrus, a hippocampal subregion important for memory and implicated in cognitive aging.hippocampus ͉ in vivo imaging ͉ cerebral blood volume ͉ angiogenesis T he hippocampal formation, a brain circuit made up of separate but interconnected subregions (1), is vital for memory function (2) and is targeted by the aging process (3). The dentate gyrus is the only hippocampal subregion that supports neurogenesis in the adult brain (4-6). Nevertheless, because neurogenesis can only be assessed in postmortem tissue, its functional significance remains undetermined. With this limitation in mind, we have explored different imaging approaches applicable to rodents and humans that might provide an in vivo correlate of neurogenesis.Although imaging radioligands designed to bind newly dividing cells is an attractive approach, positron emission tomography imaging suffers inherently poor resolution and cannot visualize the dentate gyrus. Additionally, radiolabeling newborn cells introduces potential safety concerns. For these reasons, we have focused on MRI technologies instead. Notably, a coupling has been established between neurogenesis and angiogenesis (7,8). The process of angiogenesis, in turn, gradually gives rise to the formation of new blood vessels, increasing regional microvascular density (9-12). Importantly, vascular density can be measured in vivo with imaging techniques that map regional blood volume. Numerous studies have established a tight relationship between angiogenesis and regional blood volume (13-17), including in the brain where regional angiogenesis is coupled to regional cerebral blood volume (CBV) (18)(19)(20)(21)(22)(23)(24)(25)(26).Because CBV can be measured with MRI, we hypothesized that a regionally selective increase in hippocampal CBV might provide an imaging correlate of neurogenesis. This hypothesis was tested in...

show abstract

“…Maia et al [20] found that high rCBV correlated with histological findings of oligodendroglioma or anaplastic astrocytoma, with oligoastrocytomas having intermediate values. When compared with the contralateral side, a rCBV ratio $1.2 was 80% sensitive and 100% specific for these tumours [20]. Maia et al [20] concluded rCBV improves selection of targets by reducing sampling error.…”

Section: Perfusionmentioning

confidence: 99%

“…When compared with the contralateral side, a rCBV ratio $1.2 was 80% sensitive and 100% specific for these tumours [20]. Maia et al [20] concluded rCBV improves selection of targets by reducing sampling error. Sadeghi et al [21] looked at 14 patients with MRI, PET and co-registered biopsy and found that both MR-derived CBV and methionine PET gave similar information and correlated with endothelial proliferation and mitotic activity (p, 0.01), suggesting they both provide indices of focal malignant activity.…”

Section: Perfusionmentioning

confidence: 99%

“…Maia et al [20] examined 21 patients and used relative cerebral blood volume (rCBV) maps to target sample collection. Maia et al [20] found that high rCBV correlated with histological findings of oligodendroglioma or anaplastic astrocytoma, with oligoastrocytomas having intermediate values. When compared with the contralateral side, a rCBV ratio $1.2 was 80% sensitive and 100% specific for these tumours [20].…”

Section: Perfusionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical applications of imaging biomarkers. Part 2. The neurosurgeon's perspective

Brodbelt¹

2011

BJR

View full text Add to dashboard Cite

ABSTRACT. Advances in imaging, including multivoxel spectroscopy, tractography, functional MRI and positron emission spectroscopy, are being used by neurosurgeons to target aggressive areas in gliomas, and to help identify tumour boundaries, functional areas and tracts. Neuro-oncological surgeons need to understand these techniques to help maximise tumour resection, while minimising morbidity in an attempt to improve the quality of patient outcome. This article reviews the evidence for the practical use of multimodal imaging in modern glioma surgery. DOI: 10.1259/bjr/19282704 ' 2011 The British Institute of RadiologyWhat are the aims of glioma surgery? Despite exciting advances in MRI biomarkers, surgery is still needed to provide representative specimens for histological and molecular examination, for tumour debulking and sometimes chemotherapeutic access. Multimodal MRI can have a role in all surgical aspects of tumour management.Gliomas are heterogeneous tumours that can lead to inaccuracies in diagnosis [1]. Areas of normal brain, inflammation, oedema, necrosis and active tumour of varying grades may coexist in a single patient [1][2][3]. Appropriate treatment requires representative sampling of the most aggressive part of the tumour. In enhancing tumours on CT or MRI, a portion of the contrast-enhanced section is targeted, whereas in unenhancing lesions perfusion, diffusion and spectroscopy can aid objective selection.There continues to be debate regarding the role of debulking surgery for glioma [4][5][6][7][8][9][10][11][12][13][14][15]. There is Class 2 evidence that resectional surgery (as defined on postoperative MRI) in high-grade glioma correlates with improved prognosis [4][5][6][7][8][9]. In low-grade gliomas, the evidence is less convincing, but many authors contend that macroscopic resection does provide benefit [10][11][12]. A significant reduction in tumour burden without morbidity is the surgical aim.Tumour boundaries are not clearly demonstrated by current clinical imaging techniques. McKnight et al [2] studied 68 patients with high-grade glioma using magnetic resonance spectroscopy (MRS) and targeted biopsies, and suggested that between one-third and one-half of the altered T 2 weighted signal seen on MRI is tumour. Price et al [16] have shown that tumour is present outside the T 2 weighted boundary. Silbergeld and Chicoine [17] were able to culture malignant glioma cells from histologically normal brain taken 4 cm from the contrastenhancing edge of high-grade gliomas. Spectroscopy, perfusion, diffusion and positron emission tomography (PET) imaging can help define tumour presence not seen on conventional imaging [2,3,16,18].Compounding factors for surgery include anatomical functional variability and, the distorting and infiltrating effects of tumours. The surgical procedure produces distortions. Coenen et al [19] demonstrated up to 12 mm of brain shift during surgery. Image guidance, with preoperative conventional MRI, can be helped by tractography, functional MRI and intraoperative re...

show abstract

Stereotactic biopsy guidance in adults with supratentorial nonenhancing gliomas: role of perfusion-weighted magnetic resonance imaging

Abstract: Perfusion-weighted imaging is a feasible method of reducing the sampling error in the histopathological diagnosis of a presumed LGG, particularly by improving the selection of targets for stereotactic biopsy.

Cited by 77 publications

References 41 publications

Preoperative Grading of Presumptive Low-Grade Astrocytomas on MR Imaging: Diagnostic Value of Minimum Apparent Diffusion Coefficient

Preoperative Grading of Presumptive Low-Grade Astrocytomas on MR Imaging: Diagnostic Value of Minimum Apparent Diffusion Coefficient

An in vivo correlate of exercise-induced neurogenesis in the adult dentate gyrus

Clinical applications of imaging biomarkers. Part 2. The neurosurgeon's perspective

Contact Info

Product

Resources

About