Cerebral astrocytomas: histopathologic correlation of MR and CT contrast enhancement with stereotactic biopsy

Gadolinium-labeled diethylenetriaminepentaacetic acid was used as a contrast agent for stereotactic magnetic resonance (MR) imaging in six selected patients with brain tumors who underwent stereotactic biopsy. Regions of contrast enhancement demonstrated by computed tomography (CT) and MR imaging in four of the six patients correlated with areas of malignant neovascularity and endothelial proliferation within solid tumor. Radiation necrosis produced contrast enhancement indistinguishable from that of recurrent neoplasm. Isolated tumor cells within intact white matter were identified in biopsy specimens obtained outside of regions that were depicted as abnormal by contrast material-enhanced CT, as well as by precontrast and postcontrast T1- and T2-weighted MR images.