T1-Weighted Contrast Enhancement, Apparent Diffusion Coefficient, and Cerebral-Blood-Volume Changes after Glioblastoma Resection: MRI within 48 Hours vs. beyond 48 Hours

Background: The aim of the study is to identify the advantages, if any, of post-operative MRIs performed at 48 h compared to MRIs performed after 48 h in glioblastoma surgery. Materials and Methods: To assess the presence of a residual tumor, the T1-weighted Contrast Enhancement (CE), Apparent Diffusion Coefficient (ADC), and Cerebral Blood Volume (rCBV) in the proximity of the surgical cavity were considered. The rCBV ratio was calculated by comparing the rCBV with the contralateral normal white matter. After the blind image examinations by the two radiologists, the patients were divided into two groups according to time window after surgery: ≤48 h (group 1) and >48 h (group 2). Results: A total of 145 patients were enrolled; at the 6-month follow-up MRI, disease recurrence was 89.9% (125/139), with a mean patient survival of 8.5 months (SD 7.8). The mean ADC and rCBV ratio values presented statistical differences between the two groups (p < 0.05). Of these 40 patients in whom an ADC value was not obtained, the rCBV values could not be calculated in 52.5% (21/40) due to artifacts (p < 0.05). Conclusion: The study showed differences in CE, rCBV, and ADC values between the groups of patients undergoing MRIs before and after 48 h. An MRI performed within 48 h may increase the ability of detecting GBM by the perfusion technique with the calculation of the rCBV ratio

T1-Weighted Contrast Enhancement, Apparent Diffusion Coefficient, and Cerebral-Blood-Volume Changes after Glioblastoma Resection: MRI within 48 Hours vs. beyond 48 Hours

Background: The aim of the study is to identify the advantages, if any, of post-operative MRIs performed at 48 h compared to MRIs performed after 48 h in glioblastoma surgery. Materials and Methods: To assess the presence of a residual tumor, the T1-weighted Contrast Enhancement (CE), Apparent Diffusion Coefficient (ADC), and Cerebral Blood Volume (rCBV) in the proximity of the surgical cavity were considered. The rCBV ratio was calculated by comparing the rCBV with the contralateral normal white matter. After the blind image examinations by the two radiologists, the patients were divided into two groups according to time window after surgery: 48 h (group 2). Results: A total of 145 patients were enrolled; at the 6-month follow-up MRI, disease recurrence was 89.9% (125/139), with a mean patient survival of 8.5 months (SD 7.8). The mean ADC and rCBV ratio values presented statistical differences between the two groups (p < 0.05). Of these 40 patients in whom an ADC value was not obtained, the rCBV values could not be calculated in 52.5% (21/40) due to artifacts (p < 0.05). Conclusion: The study showed differences in CE, rCBV, and ADC values between the groups of patients undergoing MRIs before and after 48 h. An MRI performed within 48 h may increase the ability of detecting GBM by the perfusion technique with the calculation of the rCBV ratio

Choroid Plexus Carcinoma in Adults: Literature Review and First Report of a Location into the Third Ventricle

Choroid plexus carcinoma (CPC) is a rare intraventricular neoplasm originating from choroid plexus. CPC is the most aggressive choroid plexus tumor. Almost all the CPCs are detected in children, and the preferred location is the lateral ventricle. We reviewed the literature to evaluate the state of the art concerning the management of CPC in adults and report the first case described of the extremely rare localization into the third ventricle. A 38-year-old woman presented a medical history of Parinaud syndrome and occasional facial weakness. Brain magnetic resonance imaging revealed a mass lesion in the pineal region and posterior part of the third ventricle with obstructive hydrocephalus. She underwent subtotal resection through a supracerebellar infratentorial approach. After the histopathological diagnosis of CPC, the patient underwent a second surgery with gross total resection and adjuvant radiotherapy. CPC in adults, given its extreme rarity, does not have a standardized treatment. Gross total resection should be the first step of the treatment: however, according to the literature, gross total resection is achieved only in 40-75% of cases in CPC as opposed to 95% in choroid plexus papilloma, mainly due to the difficulty in managing a highly vascularized tumor in such a deep location. Chemotherapy has not an established role and adjuvant treatment is based on radiotherapy. In the case described hereby the gross total resection associated with surgical treatment of hydrocephalus and adjuvant radiotherapy has achieved a good clinical and radiological outcome

Preliminary validation of FoRCaSco: a new Grading System for Cerebral and Cerebellar Cavernomas.

30sinoneMarco M Fontanella, Luca Zanin, PierPaolo Panciani, Francesco Belotti, Francesco Doglietto, Alice Cremonesi, Karol Migliorati, Elena Roca, Lucio De Maria, Alberto Franzin, Oscar Vivaldi, Federico Griva, Alessandro Narducci, Riccardo Draghi, Fabio Calbucci, Ignazio Borghesi, Emanuela Crobeddu, Christian Cossandi, Antonio Fioravanti, Jahard Aliaga Arias, Alba Scerrati, Pasquale De Bonis, Davide Locatelli, Edoardo Agosti, Pierlorenzo Veiceschi, Marco Ceraudo , Gianluigi Zona, Roberto Gasparotti, Lodovico Terzi di Bergamo, Daniele RigamontiM Fontanella, Marco; Zanin, Luca; Panciani, Pierpaolo; Belotti, Francesco; Doglietto, Francesco; Cremonesi, Alice; Migliorati, Karol; Roca, Elena; DE MARIA, Lucio; Franzin, Alberto; Vivaldi, Oscar; Griva, Federico; Narducci, Alessandro; Draghi, Riccardo; Calbucci, Fabio; Borghesi, Ignazio; Crobeddu, Emanuela; Cossandi, Christian; Fioravanti, Antonio; ALIAGA ARIAS, JAHARD MIJAIL; Scerrati, Alba; De Bonis, Pasquale; Locatelli, Davide; Agosti, Edoardo; Veiceschi, Pierlorenzo; Ceraudo, Marco; Zona, Gianluigi; Gasparotti, Roberto; Terzi di Bergamo, Lodovico; Rigamonti, Daniel