eMedicine Specialties > Radiology > Brain/Spine

Astrocytoma, Brain: Follow-up

Author: Felice J Esposito, DO, Staff Physician, Department of Radiology, Mercy Catholic Medical Center
Coauthor(s): Stephen Pirrone, ; Rajesh Mithalal, MD, Staff Physician, Department of Radiology, Mercy Catholic Medical Center; Michele Papa, MD, Professor, Department of Neuroanatomy, Second University of Naples, Italy; Mimi Huynh Pinto, DO, Staff Physician, Department of Radiology, Mercy Catholic Medical Center; Djamil Fertikh, MD, ATTENDING, Radiology Division, Association of Alexandria Radiologists; Michael L Brooks, MD, Director of Neuroradiology, Mercy Diagnostic Imaging; Medical Director, Department of Radiology, Mercy Catholic Medical Center
Contributor Information and Disclosures

Updated: Jun 27, 2006

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.
 


More on Astrocytoma, Brain

Overview: Astrocytoma, Brain
Imaging: Astrocytoma, Brain
Follow-up: Astrocytoma, Brain
Multimedia: Astrocytoma, Brain
References

References

  1. Alavi JB, Alavi A, Chawluk J, et al. Positron emission tomography in patients with glioma. A predictor of prognosis. Cancer. Sep 15 1988;62(6):1074-8.

  2. Brown P, Wald J, McDermott M. Adult Central Nervous System Neoplasms. RadioGraphics. 2003;23:1591-611.

  3. Brown PD, Wald JT, McDermott MW, et al. Oncodiagnosis panel: 2002. Optic nerve glioma or optic nerve meningioma. Radiographics. Nov-Dec 2003;23(6):1591-611.

  4. CBTRUS. Central Brain Tumor Registry of the United States. Primary Brain Tumors in the United States: Statistical Report 1995-1999 Years Data Collected. Hinsdale, Ill;CBTRUS:2002-2003. [Full Text].

  5. Castillo M. The Core Curriculum: Neuroradiology. Philadelphia, Pa:. Lippincott Williams & Wilkins;2002.

  6. Cotran R, Kumar V, Collins T. The Pathological Basis of Disease. 6th ed. New York: WB Saunders;1999.

  7. Davis FG, Kupelian V, Freels S, et al. Prevalence estimates for primary brain tumors in the United States by behavior and major histology groups. Neuro-oncol. Jul 2001;3(3):152-8. [Medline].

  8. Grainger R, Allison D, Andreas A, et al, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 4th ed. London: Churchill Livingstone;2001.

  9. Hanson MW, Glantz MJ, Hoffman JM, et al. FDG-PET in the selection of brain lesions for biopsy. J Comput Assist Tomogr. Sep-Oct 1991;15(5):796-801.

  10. Harrer JU, Parker GJ, Haroon HA, et al. Comparative study of methods for determining vascular permeability and blood volume in human gliomas. J Magn Reson Imaging. Nov 2004;20(5):748-57.

  11. Hsu YY. Metabolism, perfusion and diffusion MR images of cerebral gliomas. Acta Neurol Taiwan. 2002;11:173-180.

  12. Kaye AH, Laws ER Jr. Brain Tumors: An Encyclopedic Approach. 2nd ed. Philadelphia, Pa: Churchill Livingstone;2001.

  13. Levivier M, Wikler D, Massager N, et al. The integration of metabolic imaging in stereotactic procedures including radiosurgery: a review. J Neurosurg. Dec 2002;97(5 Suppl):542-50.

  14. Loevner LA. Case Review: Brain Imaging. St Louis, Mo: Mosby;1999.

  15. Meyerand ME, Pipas JM, Mamourian A, et al. Classification of biopsy-confirmed brain tumors using single-voxel MR spectroscopy. AJNR Am J Neuroradiol. Jan 1999;20(1):117-23.

  16. Ries LG, Eisner MP, Kosary CL, et al, eds. Seer Cancer Statistics Review, 1973-1999 [National Cancer Institute Web site]. 2002;[Full Text].

  17. Runge V. Clinical MRI. Philadelphia, Pa: WB Saunders;2002.

  18. Schwartz RB, Hsu L, Wong TZ, et al. Intraoperative MR imaging guidance for intracranial neurosurgery: experience with the first 200 cases. Radiology. May 1999;211(2):477-88. [Medline].

  19. Tien RD, Lai PH, Smith JS, Lazeyras F. Single-voxel proton brain spectroscopy exam (PROBE/SV) in patients with primary brain tumors. AJR Am J Roentgenol. Jul 1996;167(1):201-9.

  20. Walker DG, Kaye AH. Low grade glial neoplasms. J Clin Neurosci. Jan 2003;10(1):1-13.

  21. Weissleder R. Primer of Diagnostic Imaging. 3rd ed. St Louis, Mo: Mosby-Year Book;2003.

Further Reading

Keywords

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

Contributor Information and Disclosures

Author

Felice J Esposito, DO, Staff Physician, Department of Radiology, Mercy Catholic Medical Center
Felice J Esposito, DO is a member of the following medical societies: American College of Radiology, American Medical Association, American Osteopathic Association, American Roentgen Ray Society, and Pennsylvania Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Stephen Pirrone, 
Disclosure: Nothing to disclose.

Rajesh Mithalal, MD, Staff Physician, Department of Radiology, Mercy Catholic Medical Center
Disclosure: Nothing to disclose.

Michele Papa, MD, Professor, Department of Neuroanatomy, Second University of Naples, Italy
Disclosure: Nothing to disclose.

Mimi Huynh Pinto, DO, Staff Physician, Department of Radiology, Mercy Catholic Medical Center
Disclosure: Nothing to disclose.

Djamil Fertikh, MD, ATTENDING, Radiology Division, Association of Alexandria Radiologists
Djamil Fertikh, MD is a member of the following medical societies: American College of Radiology, American Medical Association, and Radiological Society of North America
Disclosure: Nothing to disclose.

Michael L Brooks, MD, Director of Neuroradiology, Mercy Diagnostic Imaging; Medical Director, Department of Radiology, Mercy Catholic Medical Center
Disclosure: Nothing to disclose.

Medical Editor

Chi-Shing Zee, MD, Chief of Neuroradiology, Professor, Departments of Radiology and Neurosurgery, University of Southern California School of Medicine
Chi-Shing Zee, MD is a member of the following medical societies: American Society of Neuroradiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Val Runge, MD, Robert and Alma Moreton Centennial Chair in Radiology, Professor, Editor-in-Chief of Investigative Radiology, Department of Radiology, Scott and White Clinic and Hospital
Val Runge, MD is a member of the following medical societies: Society for Health and Human Values
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

L Gill Naul, MD, Professor and Head, Department of Radiology, Texas A&M University College of Medicine; Chair, Department of Radiology, Chief, Section of Magnetic Resonance Imaging, Scott and White Memorial Hospital and Clinic
L Gill Naul, MD is a member of the following medical societies: American College of Radiology, American Medical Association, American Roentgen Ray Society, Radiological Society of North America, and Texas Medical Association
Disclosure: Nothing to disclose.

 
 
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