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How often are nonenhancing supratentorial gliomas malignant? A population study
J N Scott1, P M A Brasher, R J Sevick
1Department of Diagnostic Imaging, University of Calgary, Alberta, Canada.
Neurology
|September 26, 2002
Summary
Contrast enhancement in brain tumors can indicate malignancy. However, some nonenhancing gliomas are malignant, particularly in older patients, necessitating histologic confirmation for accurate diagnosis.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Contrast enhancement on preoperative neuroimaging is typically associated with malignant brain tumors.
- This assumption may not hold true for all glial neoplasms, necessitating further investigation.
Purpose of the Study:
- To evaluate the malignancy rate of nonenhancing supratentorial glial neoplasms.
- To determine if patient age influences the likelihood of malignancy in nonenhancing gliomas.
Main Methods:
- Retrospective analysis of 314 patients with supratentorial glial neoplasms (malignant and low-grade).
- Identification of patients (58) whose tumors lacked contrast enhancement on preoperative imaging.
- Correlation of nonenhancement with malignancy and patient age.
Main Results:
- Approximately one third of nonenhancing gliomas were found to be malignant.
- Malignancy in nonenhancing gliomas was more prevalent in older patients.
- This highlights a subset of gliomas where imaging alone is insufficient for grading.
Conclusions:
- Nonenhancing gliomas can be malignant, challenging the traditional interpretation of contrast enhancement.
- Histologic confirmation is crucial for diagnosing all suspected primary glial neoplasms, regardless of imaging findings.
- Consideration of patient age may aid in risk stratification for nonenhancing gliomas.
