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Early-Stage Glioblastomas: MR Imaging-Based Classification and Imaging Evidence of Progressive Growth.

C H Toh1, M Castillo2

  • 1From the Department of Medical Imaging and Intervention (C.H.T.), Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Tao-Yuan, Taiwan eldomtoh@hotmail.com.

AJNR. American Journal of Neuroradiology
|November 19, 2016
PubMed
Summary
This summary is machine-generated.

Early glioblastomas may first appear as cortical lesions on MRI, progressing to involve white matter (WM). This study classified these early imaging patterns, revealing a progression from Type I (gray matter) to Type III (gray-white junction) lesions.

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Area of Science:

  • Neuroimaging
  • Oncology
  • Radiology

Background:

  • Serial imaging changes in glioblastoma growth are rarely documented.
  • Understanding early glioblastoma imaging patterns is crucial for timely diagnosis and treatment.

Purpose of the Study:

  • To classify the magnetic resonance (MR) imaging patterns of early-stage glioblastomas.
  • To define the sequence of imaging pattern appearance during the growth of small glioblastomas.

Main Methods:

  • Retrospective review of preoperative MR imaging studies for glioblastoma patients (2006-2013).
  • Inclusion criteria: early-stage glioblastomas with abnormal signal intensity but lacking classic findings.
  • Independent review by two neuroradiologists for lesion characteristics and classification into three types.

Main Results:

  • Thirty-one MR imaging studies from 26 patients met criteria; all early glioblastomas were hyperintense on FLAIR/T2-weighted images.
  • Type I lesions involved gray matter (GM); Types II and III involved both GM and white matter (WM).
  • Focal contrast enhancement was observed only in Type III lesions at the gray-white junction; lesion progression (I to II, II to III) was noted on follow-up.

Conclusions:

  • Cortical lesions can represent the earliest MR imaging-detectable abnormality in some glioblastomas.
  • These early cortical tumors demonstrate a potential to progress and involve white matter.