Tumor infiltration in enhancing and non-enhancing parts of glioblastoma: a correlation with histopathology

Purpose To correlate histopathologic findings from biopsy specimens with their corresponding location within enhancing areas, non-enhancing areas and necrotic areas on contrast enhanced T1-weighted MRI scans (cT1). Materials and Methods In 37 patients with newly diagnosed glioblastoma who underwent...

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Hauptverfasser: Eidel, Oliver (VerfasserIn) , Burth, Sina (VerfasserIn) , Neumann, Jan-Oliver (VerfasserIn) , Kieslich, Pascal J. (VerfasserIn) , Sahm, Felix (VerfasserIn) , Jungk, Christine (VerfasserIn) , Vollmuth, Philipp (VerfasserIn) , Bickelhaupt, Sebastian (VerfasserIn) , Mundiyanapurath, Sibu (VerfasserIn) , Bäumer, Philipp (VerfasserIn) , Wick, Wolfgang (VerfasserIn) , Schlemmer, Heinz-Peter (VerfasserIn) , Kiening, Karl (VerfasserIn) , Unterberg, Andreas (VerfasserIn) , Bendszus, Martin (VerfasserIn) , Radbruch, Alexander (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: January 19, 2017
In: PLOS ONE
Year: 2017, Jahrgang: 12, Heft: 1
ISSN:1932-6203
DOI:10.1371/journal.pone.0169292
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1371/journal.pone.0169292
Verlag, Volltext: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169292
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Verfasserangaben:Oliver Eidel, Sina Burth, Jan-Oliver Neumann, Pascal J. Kieslich, Felix Sahm, Christine Jungk, Philipp Kickingereder, Sebastian Bickelhaupt, Sibu Mundiyanapurath, Philipp Bäumer, Wolfgang Wick, Heinz-Peter Schlemmer, Karl Kiening, Andreas Unterberg, Martin Bendszus, Alexander Radbruch

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245 1 0 |a Tumor infiltration in enhancing and non-enhancing parts of glioblastoma  |b a correlation with histopathology  |c Oliver Eidel, Sina Burth, Jan-Oliver Neumann, Pascal J. Kieslich, Felix Sahm, Christine Jungk, Philipp Kickingereder, Sebastian Bickelhaupt, Sibu Mundiyanapurath, Philipp Bäumer, Wolfgang Wick, Heinz-Peter Schlemmer, Karl Kiening, Andreas Unterberg, Martin Bendszus, Alexander Radbruch 
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520 |a Purpose To correlate histopathologic findings from biopsy specimens with their corresponding location within enhancing areas, non-enhancing areas and necrotic areas on contrast enhanced T1-weighted MRI scans (cT1). Materials and Methods In 37 patients with newly diagnosed glioblastoma who underwent stereotactic biopsy, we obtained a correlation of 561 1mm3 biopsy specimens with their corresponding position on the intraoperative cT1 image at 1.5 Tesla. Biopsy points were categorized as enhancing (CE), non-enhancing (NE) or necrotic (NEC) on cT1 and tissue samples were categorized as “viable tumor cells”, “blood” or “necrotic tissue (with or without cellular component)”. Cell counting was done semi-automatically. Results NE had the highest content of tissue categorized as viable tumor cells (89% vs. 60% in CE and 30% NEC, respectively). Besides, the average cell density for NE (3764 ± 2893 cells/mm2) was comparable to CE (3506 ± 3116 cells/mm2), while NEC had a lower cell density with 2713 ± 3239 cells/mm2. If necrotic parts and bleeds were excluded, cell density in biopsies categorized as “viable tumor tissue” decreased from the center of the tumor (NEC, 5804 ± 3480 cells/mm2) to CE (4495 ± 3209 cells/mm2) and NE (4130 ± 2817 cells/mm2). Discussion The appearance of a glioblastoma on a cT1 image (circular enhancement, central necrosis, peritumoral edema) does not correspond to its diffuse histopathological composition. Cell density is elevated in both CE and NE parts. Hence, our study suggests that NE contains considerable amounts of infiltrative tumor with a high cellularity which might be considered in resection planning. 
650 4 |a Magnetic resonance imaging 
650 4 |a Biopsy 
650 4 |a Blood cells 
650 4 |a Cancer detection and diagnosis 
650 4 |a Glioblastoma multiforme 
650 4 |a Histology 
650 4 |a Necrosis 
650 4 |a Tumor resection 
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