Heterogeneity of glioblastoma with gliomatosis cerebri growth pattern on diffusion and perfusion MRI

Background and purposeGliomatosis cerebri (GC) is a rare growth pattern of glioblastoma whose diffuse nature is reflected by unspecific, relatively uniform findings on conventional MRI. In the present study we sought to evaluate the additional value of diffusion (DWI) and perfusion weighted (PWI) MR...

Full description

Saved in:
Bibliographic Details
Main Authors: Förster, Alex (Author) , Brehmer, Stefanie (Author) , Seiz-Rosenhagen, Marcel (Author) , Mildenberger, Iris (Author) , Giordano, Frank Anton (Author) , Wenz, Holger (Author) , Reuss, David (Author) , Hänggi, Daniel (Author) , Groden, Christoph (Author)
Format: Article (Journal)
Language:English
Published: 2019
In: Journal of neuro-oncology
Year: 2018, Volume: 142, Issue: 1, Pages: 103-109
ISSN:1573-7373
DOI:10.1007/s11060-018-03068-w
Online Access:Verlag, Volltext: https://doi.org/10.1007/s11060-018-03068-w
Get full text
Author Notes:Alex Förster, Stefanie Brehmer, Marcel Seiz-Rosenhagen, Iris Mildenberger, Frank A. Giordano, Holger Wenz, David Reuss, Daniel Hänggi, Christoph Groden
Description
Summary:Background and purposeGliomatosis cerebri (GC) is a rare growth pattern of glioblastoma whose diffuse nature is reflected by unspecific, relatively uniform findings on conventional MRI. In the present study we sought to evaluate the additional value of diffusion (DWI) and perfusion weighted (PWI) MRI for a more detailed characterization.MethodsWe analyzed the MRI findings in patients with histologically proven glioblastoma with GC growth pattern with a specific emphasis on T2 lesion pattern, volume, relative apparent diffusion coefficient (rACD), and relative cerebral blood volume (rCBV) and compared these to age-/gender-matched patients with localized glioblastoma.ResultsOverall, 16 patients (median age 59.5 years, 4 male) were included in the study. Of these, 8 patients had a glioblastoma with GC growth pattern, and 8 a classical localized growth pattern. While the median rADC (1.27 [IQR 1.12-1.41]) within the T2 lesion was significant lower in glioblastoma with GC growth pattern compared to localized glioblastoma (1.74 [IQR 1.45-1.96]; p = 0.003), the median T2 lesion volume and rCBV within the T2 lesion did not differ significantly. Furthermore, six patients with glioblastoma with GC growth pattern showed focal areas with significantly reduced rADC (p = 0.043), and/or increased rCBV (p = 0.028).ConclusionsLower rADC in glioblastoma with GC growth pattern might reflect the diffuse tumor cell infiltration whereas focal areas with decreased rADC and/or increased rCBV probably indicate high tumor cell density and/or abnormal tumor vessels which may be useful for biopsy guidance.
Item Description:Published online: 18 December 2018
Gesehen am 14.05.2019
Physical Description:Online Resource
ISSN:1573-7373
DOI:10.1007/s11060-018-03068-w