Learning objectives
The purpose of this exhibit is:
1.
To review the pathologic and clinical findingsof low-grade gliomas and the modern therapeutic management.
2.
To describe the main imaging findings that lead us to diagnose a low-grade glioma and their different subtypes.
3.
To explain how to do the pre-surgical MRstudy and the post-surgical follow-up.
Background
-The low-grade glioma is relatively common tumor in young patients astrocyte origin.
Different histological types: gemistocytic,
protoplasmic and fibrillary.
-In recent years has changed the therapeutic managementwith a tendency to make aggressive treatment,
with ambitious resection versus conservative treatment.
However,
this approach is limited by the functional consequences are avoided as far as possible by using functional techniques (tractography bold) and their correlation with intraoperative mapping.
-Therefore imaging techniques play a key role in both the diagnosis and control of the development,
the use of...
Findings and procedure details
DEFINITION
-CONCEPT:
Primary brain tumor of astrocytic origin with intrinsic tendency for malignant progression,
degeneration into anaplasic astrocytoma.
Well-differentiated but infiltrating neoplasm,
slow growth pattern.
-SYNONYMS: Diffuse astrocytoma,
grade II astrocytoma,
fibrillary astrocytoma,
low grade astrocytoma.
-ETIOPATHOLOGY:
◦Arise from differentiated astrocytes or astrocytic precursor cells with high degree of cellular differentiation,
slow growth and
diffuse infiltration of adjacent structures.
◦GENETIC:
–TP53 mutation >60%.
–Overexpresion of platelet-derived growth factor receptor- (PDGFRA).
–Chromosomal abnormalities: Gain of 7q; 8q amplification; LOH10p,
22q;,
chromosome 6 deletions.
MICROSCOPIC FEATURES:
-Well-differentiated...
Conclusion
Low-grade glioma is a frequent and important brain neoplasm and a deep knowledge ofthe mainpathologic and clinical presentations may provide a better radiologic diagnosis.
Recent changes in the advanced therapeutic management of patients with low grade gliomas has changed the role of imagingprotocols for diagnosis and follow-up.
References
-Cerebral blood volumen measurements by perfusion-weighted MRi maging in gliomas:ready fo rprime time in predicting short-term out come and recurrent disease AJNR Am JNeuroradiol.
30(4):681-8,
2009.
-Aspectos controvertidos en el manejo de gliomas hemisféricos OMS grado II: revisión de la bibliografía reciente E.
Ruedsa,
M.
Sierra,
J.
Infante,
J.
Berciano,
A.
Vázquez-Barquero,
R.
Ciordia,
J.
Martino.[REV NEUROL 2011;53:747-757]
-Gasparetto EL et al: Posttreatment recurrence of malignant brain neoplasm: accuracy of relative cerebral blood volume fraction in discriminating low from high malignant histologic volume fraction.
Radiology....
