Stereotactic Histologic Correlations of Computed Tomography- and Magnetic Resonance Imaging-Defined Abnormalities in Patients With Glial Neoplasms

Kelly, Patrick J.; Daumas-Duport, Cathérine; Scheithauer, Bernd W.; Kall, Bruce A.; Kispert, David B.

doi:10.1016/s0025-6196(12)65470-6

Cited by 363 publications

(143 citation statements)

References 11 publications

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“…Endothelial proliferation and necrosis are associated with breakdown of the blood-brain barrier and often show contrast enhancement in MRI or CT (3,29). Twenty-nine of 53 specimens in malignant astrocytoma grade 3 and 4 presented with no signs of contrast enhancement but showed increased [ 11 C]MET uptake similar to findings of Bergstrom et al (29) who demonstrated that Ͼ50% of the tumor would have not been detected on contrast enhanced CT alone.…”

Section: Discussionsupporting

confidence: 52%

“…It is falsely negative in viable tumor parts that do not show blood-brain barrier breakdown, and it is falsely positive in necrotic or inflamed areas with blood-brain barrier disruption. Serial biopsies of patients undergoing craniotomy for malignant gliomas have shown tumor cells at a distance of Ͼ3 cm away from CT contrast enhancement (2,3). Moreover, MRI spectroscopy data also suggest that standard T1-weighted contrast-enhanced MRI may underestimate the volume of metabolically active tumors (4).…”

Section: Introductionmentioning

confidence: 99%

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Delineation of Brain Tumor Extent with [11C]l-Methionine Positron Emission Tomography

Kracht

Miletić²,

Busch³

et al. 2004

Clinical Cancer Research

275

171

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Delineation of Brain Tumor Extent with [11C]l-Methionine Positron Emission Tomography

Kracht

Miletić²,

Busch³

et al. 2004

Clinical Cancer Research

275

171

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“…Three patterns of glioma spatial organisation have been defined: type I (solid bulk tumour), type II (solid tumour plus a diffuse halo of infiltrating cells), and type III structures (diffuse cloud of cells, no solid bulk) (Kelly et al, 1987). The different ratios of infiltration and proliferation of grade II and III Ols and As Figure 6 Factor scores of grade II and III As and Ols for the principal components extracted (Table 1): 'vascular in situ proliferating' (factor 1), 'hypercellular and compact' (factor 2), and 'noninvasive, characteristic of tumours with 1p/19q loss' (factor 3).…”

Section: Discussionmentioning

confidence: 99%

Correlation of in vitro infiltration with glioma histological type in organotypic brain slices

et al. 2004

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Diffuse invasion of the brain, an intrinsic property of gliomas, renders these tumours incurable, and is a principal determinant of their spatial and temporal growth. Knowledge of the invasive potential of gliomas is highly desired in order to understand their behaviour in vivo. Comprehensive ex vivo invasion studies including tumours of different histological types and grades are however lacking, mostly because reliable physiological invasion assays have been difficult to establish. Using an organotypic rodent brain slice assay, we evaluated the invasiveness of 42 grade II -IV glioma biopsy specimens, and correlated it with the histological phenotype, the absence or presence of deletions on chromosomes 1p and 19q assessed by fluorescent in situ hybridisation, and proliferation and apoptosis indices assessed by immunocytochemistry. Oligodendroglial tumours with 1p/19q loss were less invasive than astrocytic tumours of similar tumour grade. Correlation analysis of invasiveness cell proliferation and apoptosis further suggested that grade II -III oligodendroglial tumours with 1p/19q loss grow in situ as relatively circumscribed compact masses in contrast to the more infiltrative and more diffuse astrocytomas. Lower invasiveness may be an important characteristic of oligodendroglial tumours, adding to our understanding of their more indolent clinical evolution and responsiveness to therapy.

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“…Burger (1987) and Halperin et al (1988) cite numerous instances of neoplastic cells far distant from the main tumor. Kelly et al (1987) have similarly reported, using sequential stereotaxic biopsies, tumor in®ltration well beyond the border of the MRI-contrast enhancing margin of the lesion. In contrast to the view that the malignant glioma is a diffuse, in®ltrative process, a number of authors contend that the process is focal in nature (Dyck et al, 1983;Gutin and Leibel, 1985;Hochberg and Pruitt, 1980).…”

Section: Malignant Glioma: Focal Versus Diffusementioning

confidence: 88%

Management of malignant glioma: role of surgery in relation to multimodality therapy

Black

1998

J Neurovirol

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The goals of surgery for malignant glioma are to establish a histological diagnosis and to achieve mechanical cytoreduction to reduce intracranial pressure (ICP) and possibly alter tumor kinetics. There is controversy concerning the question whether the glioma is a focal or diffuse process; it appears that there may be variability between the two extremes in individual cases. The question of the value of surgery has also been controversial. Review of the literature suggests that both early and long-term postoperative outcome after radical surgical resection are better than the results of either partial resection or simple biopsy, in terms of neurological status and duration of survival. Similarly, reoperation for recurrence of glioma offers reasonable extension of quality survival. Despite the desirability of extensive cytoreductive surgery for malignant gliomas, the presence of viable in®ltrative cells beyond the margins of the resection necessitate that surgery be a part of an aggressive multimodality therapeutic approach. Adjunctive measures to control the in®ltrative component include newer forms of radiotherapy (such as stereotaxic radiosurgery) and newer delivery techniques for chemotherapy (agents impregnated in biodegradable polymers implanted in the tumor bed after surgical resection), and possibly immunotherapy and gene therapy as they may become feasible in the future. The strategy for management of malignant glioma thus consists of a combination of extensive surgical resection to reduce the accessible tumor burden, followed in rapid sequence by measures to control the in®ltrative portion of the tumor. It is recommended that these measures be offered`up front' rather than delaying treatment until there is clinical or radiographic evidence of tumor recurrence.

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Stereotactic Histologic Correlations of Computed Tomography- and Magnetic Resonance Imaging-Defined Abnormalities in Patients With Glial Neoplasms

Cited by 363 publications

References 11 publications

Delineation of Brain Tumor Extent with [11C]l-Methionine Positron Emission Tomography

Delineation of Brain Tumor Extent with [11C]l-Methionine Positron Emission Tomography

Correlation of in vitro infiltration with glioma histological type in organotypic brain slices

Management of malignant glioma: role of surgery in relation to multimodality therapy

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