13 research outputs found
OptimalTTF-1:Enhancing tumor treating fields therapy with skull remodeling surgery. A clinical phase I trial in adult recurrent glioblastoma
Status on 5-ALA fluorescence-guided surgery in the management of adult and pediatric gliomas
Raised intracranial pressure as a result of pansynostosis in a child with Albright's hereditary osteodystrophy
Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant gliomas--a new treatment modality
Spatial distribution of malignant tissue in gliomas:correlations of <sup>11</sup>C-L-methionine positron emission tomography and perfusion- and diffusion-weighted magnetic resonance imaging
Background The prognosis of glioma patients is contingent on precise target selection for stereotactic biopsies and the extent of tumor resection. 11C-L-methionine (MET) positron emission tomography (PET) demonstrates tumor heterogeneity and invasion with high diagnostic accuracy. Purpose To compare the spatial tumor distribution delineated by MET PET with that by perfusion- and diffusion-weighted magnetic resonance imaging (MRI), in order to understand the diagnostic value of these MRI methods, when PET is not available. Material and Methods Presurgical MET PET and MRI, including perfusion- and diffusion-weighted MRI, were acquired in 13 patients (7 high-grade gliomas, 6 low-grade gliomas). A quantitative volume of interest analysis was performed to compare the modalities objectively, supplemented by a qualitative evaluation that assessed the clinical applicability. Results The inaccuracy of conventional MRI was confirmed (area under the curve for predicting voxels with high MET uptakeâ=â0.657), whereas cerebral blood volume (CBV) maps calculated from perfusion data improved accuracy (area under the curveâ=â0.760). We considered CBV maps diagnostically comparable to MET PET in 5/7 cases of high-grade gliomas, but insufficient in all cases of low-grade gliomas when evaluated subjectively. Cerebral blood flow and apparent diffusion coefficient maps did not contribute to further accuracy. Conclusion Adding perfusion-weighted MRI to the presurgical protocol can increase the diagnostic accuracy of conventional MRI and is a simple and well-established method compared to MET PET. However, the definition of low-grade gliomas with subtle or no alterations on cerebral blood volume maps remains a diagnostic challenge for stand-alone MRI. </jats:sec