Intervention
Interventional neuroradiology may play an important role in the future treatment of astrocytoma with intratumoral chemotherapy. In general, current treatment is limited to traditional approaches.
Medicolegal Pitfalls
- Medical and legal pitfalls of imaging of astrocytoma primarily consist of missed or delayed diagnosis.
- With CT, the scarcity of edema and mass effect with low-grade lesions may make the true extent of pathology difficult to ascertain. Furthermore, small lesions may not be visible if contrast material is not used.
- As many as 4% of grade III or IV lesions do not enhance on imaging.
- Finally, because of the inhomogeneity of high-grade tumors, stereotactic biopsy of an area of necrosis instead of the tumor can delay accurate diagnosis.
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References
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Bing F, Kremer S, Lamalle L, Chabardes S, Ashraf A, Pasquier B, et al. [Value of perfusion MRI in the study of pilocytic astrocytoma and hemangioblastoma: preliminary findings]. J Neuroradiol. May 2009;36(2):82-7. [Medline].
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Further Reading
Clinical guidelines
Radiotherapy for newly diagnosed malignant glioma in adults: a clinical practice guideline.
Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]. 2000 Sep 19 (revised 2005 Nov 2). 32 pages. NGC:004954
Gliadel wafers in the treatment of malignant glioma: a clinical practice guideline.
Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]. 2006 Aug 15. 19 pages. NGC:005649
Adjuvant systemic chemotherapy, following surgery and external beam radiotherapy, for adults with newly diagnosed malignant glioma: a clinical practice guideline.
Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]. 2004 Mar 10 (revised 2006 May 8). 23 pages. NGC:005092
Clinical trials
Intracerebral Clysis in Treating Patients With Recurrent Primary Brain Tumors
Temozolomide and Radiation Therapy in Treating Patients With Newly Diagnosed Glioblastoma Multiforme or Anaplastic Astrocytoma
Antineoplaston Therapy in Treating Children With Low-Grade Astrocytoma
Related eMedicine topics
Astrocytoma (Pediatrics)
Glioblastoma Multiforme (Neurology)
Glioblastoma Multiforme (Radiology)
Glioblastoma Multiforme (Oncology)
Low-Grade Astrocytoma
Keywords
brain astrocytoma, primary intra-axial brain tumors, primary intraaxial brain tumors, gliomas, supratentorial tumors, grade I astrocytomas, pilocytic astrocytoma, subependymal giant cell astrocytoma, giant-cell astrocytoma, pleomorphic xanthoastrocytoma, grade II astrocytomas, protoplasmic astrocytomas, gemistocytic astrocytomas, fibrillary astrocytomas, grade III astrocytomas, anaplastic astrocytomas, grade IV astrocytomas, glioblastoma multiforme, GBM, giant cell glioblastomas, giant-cell glioblastomas, gliosarcoma variants, low-grade astrocytomas, PTEN/MMAC1, DMBT1, EGFR, p53, TP53, p16, PDGFR, retinoblastoma cell-cycle regulatory genes
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