Stereotactic biopsy guidance in adults with supratentorial nonenhancing gliomas: role of perfusion-weighted magnetic resonance imaging

• DOI: 10.3171/jns.2004.101.6.0970
• Publication Date: 2009-05-13T18:03:03Z
• Authors: Antonio C. M. Maia; Suzana M. F. Malh...; Antonio J. da Rocha; João N. Stávale; Iara F. Guimarães; Lia R. R. Borges; Adrialdo J. Santos; Carlos J. da Silva; Julieta G. S. P. ...; Oreste P. Lanzoni; Alberto A. Gabbai; Fernando A. P. Fe...
• Keywords: Stereotactic biopsy; Anaplastic astrocytoma

Object. The diagnosis of low-grade glioma (LGG) cannot be based exclusively on conventional magnetic resonance (MR) imaging studies, and target selection for stereotactic biopsy is a crucial issue given the high risk sampling errors. authors hypothesized that perfusion-weighted could provide information microcirculation in presumed supratentorial LGGs. Methods. All adult patients with suspected (nonenhancing) LGGs MR between February 2001 2004 were included this study. Preoperative was performed using dynamic first-pass gadopentate dimeglumine—enhanced spin echo—echo planar sequence, tumors' relative cerebral blood volume (rCBV) measurements expressed relation to values observed contralateral white matter. In heterogeneous tumors higher perfusion areas before resection. Among 21 (16 men five women mean age 36 years, range 23–60 years), 10 had diffuse astrocytomas (World Health Organization Grade II) 11 other anaplastic gliomas. On images demonstrating tumors, rCBV focus found oligodendrogliomas or biopsy; during tumor resection, however, specimens characterized predominantly as astrocytomas. Diffuse associated significantly lower compared those two lesion groups (p < 0.01). ratio cutoff value permitted better discrimination 1.2 (80% sensitivity 100% specificity). Conclusions. Perfusion-weighted feasible method reducing error histopathological LGG, particularly by improving targets biopsy.