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Published on: June 7, 2020
The role of advanced MR imaging in understanding brain tumour pathology
1Academic Neurosurgery Division, Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK. sjp58@cam.ac.uk
Abstract:
Although MRI is the imaging modality of choice for brain tumours, the standard clinical sequences cannot tell us about certain features of brain tumours. Improvements in imaging technology now allow advanced sequences, once used exclusively for research, to be used clinically. Assessment of brain tumours with diffusion weighted MR (a marker of cellularity), diffusion tensor MR (shows integrity of surrounding white matter tracts), perfusion MR (marker of tumour vascularity and angiogenesis), MR spectroscopy (showing tumour metabolism) and functional MR (to identify eloquent cortex) provide information that is complementary to the structural information. These techniques can be used to improve identification of the tumour margin, tumour grading, reducing surgical risk and assessing the response to therapy. It is important for the neurosurgeon to understand what information can be obtained from these sequences, and that they ensure they are used to further develop the assessment and management of brain tumours.
Insights
Advanced MRI sequences offer crucial insights into brain tumour characteristics beyond standard imaging. These techniques aid in precise tumor margin identification, grading, surgical planning, and therapy response assessment for improved patient outcomes.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Standard MRI sequences have limitations in fully characterizing brain tumors.
- Advancements in MRI technology enable the clinical use of previously research-exclusive sequences.
Purpose of the Study:
- To highlight the complementary information provided by advanced MRI techniques for brain tumor assessment.
- To emphasize the importance of neurosurgeons understanding and utilizing these advanced sequences.
Main Methods:
- Diffusion-weighted MRI (cellularity)
- Diffusion tensor MRI (white matter tract integrity)
- Perfusion MRI (vascularity and angiogenesis)
- MR spectroscopy (metabolism)
- Functional MRI (eloquent cortex localization)
Main Results:
- Advanced MRI sequences provide complementary data to standard structural imaging.
- These techniques enhance tumor margin identification, grading, and surgical risk assessment.
- Utilizing advanced MRI aids in evaluating treatment response.
Conclusions:
- Advanced MRI techniques significantly improve the comprehensive assessment and management of brain tumors.
- Neurosurgeons must understand and apply these advanced sequences for optimal patient care.
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