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Query: UMLS:C0017636 (glioblastoma)
 18,345 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The relationship between MR configuration and pathological grade was studied in 41 histologically verified supratentorial astrocytic gliomas with a 0.5T superconductive MR system. The gliomas included 13 low-grade astrocytomas (LGAs), 14 anaplastic astrocytomas (AAs) and 14 glioblastoma multiformes (GBMs). MRI configurations were classified into nine criteria which were scored and statistically analyzed. The mean values of LGAs, AAs and GBMs were 0.45 +/- 0.31, 1.18 +/- 0.20 and 1.47 +/- 0.22. In each grade, MRI score increased as pathological grades increased (p < 0.01-0.001). LGAs had significantly lower values than AAs in five of the nine criteria (55.6%); heterogeneity, cyst or necrosis, edema or mass effect, border definition, and the degree of contrast enhancement, and lower values than GBMs in eight criteria (88.9%) except for hemorrhage. Three criteria (33.3%), heterogeneity, cyst or necrosis, and flow void sign were significantly higher in GBMs than AAs. The four variables, heterogeneity, cyst or necrosis, edema or mass effect and border definition, proved to be important factors related to the pathological grade in a multiple regression analysis.
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PMID:Astrocytic gliomas: MRI and pathological grade. 812 12

More than 80% of malignant gliomas have been reported to recur locally after conventional chemoradiation therapy. This regional pattern of recurrence has encouraged the introduction of new treatments for local tumors. Since 1987 interstitial brachytherapy using Iridium-192 seeds has been carried out in our department for malignant brain tumors. The present study was designed to evaluate the patterns of recurrence following interstitial brachytherapy and to assess how this recurrence differs from that observed in patients treated by conventional means. Ten patients who satisfied the following criteria were selected among 41 patients treated with brachytherapy. The criteria were; 1) histologically diagnosed to be malignant glioma (astrocytoma grade III or glioblastoma), 2) followed up with MRI every month after the brachytherapy, 3) follow-up period was more than 6 months, and 4) the time of recurrence was confirmed. The patients were classified into 3 groups according to the patterns of tumor recurrence as follows; 1. Local recurrence group: The tumor recurred near the pretreatment tumor site. 2. Necrotomy group: Reoperation was performed because of neurological deterioration and radiographic evidence of increasing mass effect with surrounding edema. Neurological symptoms were unchanged or improving during the 6 months after the reoperation. 3. CSF seeding group: Primary tumor was well controlled, but seeding via cerebrospinal fluid was recognized on MRI. Local recurrence occurred in three patients, necrotomy was carried out in three patients, and CSF metastases were defined by both MRI and clinical symptoms in four patients. Median radiation does was 33 Gy in the local recurrence group, 57.6 Gy in the necrotomy group, and 43.2Gy in the CSF seeding group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Patterns of recurrence in malignant gliomas after brachytherapy]. 816 95

A 50-year-old male developed gait disturbance and bilateral sensory disturbance in territories below Th 11 level in February, 1990. On February 26, 1990, an intradural tumor was partially removed at Th 11-12 levels, which was histologically diagnosed as glioblastoma multiforme; followed by post-operative radiotherapy (40Gy to the tumor area). CT scan of the brain was unremarkable and he was discharged home as ambulatory in July, 1990. Gait disturbance, occasional headache and vomiting developed in June, 1991. MRI revealed multiple spinal cord tumors at Th 11-12 and L 2-3 levels, as well as multiple intracranial tumors in the cerebellum, cingulate gyrus, and sylvian fissure, all of which were thought to be located in the cerebrospinal fluid (CSF) space. VP shunt was performed for hydrocephalus. MRI taken 2 months after operation demonstrated diffuse subarachnoid dissemination and new spinal cord tumors at C 3-4 and Th 3-10 levels. Although pathology of the intracranial tumors was not confirmed, dissemination from the spinal tumor was strongly suggested by the evidence including the long interval after the spinal cord operation, the location of the multiple tumors in the CSF space, and the simultaneous intraspinal dissemination. Only 31 cases with intracranial dissemination from malignant spinal astrocytoma or glioblastoma have been reported, and, of these, most were located around the brainstem, cerebellum, and other regions bordering the CSF space. In malignant spinal cord tumor, every effort should be made to prevent CSF dissemination at operation or to detect it as early as possible thereafter. MRI was found to be the most effective method for evaluating CSF dissemination.
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PMID:[A case of spinal glioblastoma with intracranial dissemination]. 825 21

A patient presented with myelopathy due to intramedullary thoracic spinal cord glioblastoma 10 months after treatment for a supratentorial glioblastoma. There was no supratentorial recurrence, and no evidence of gross leptomeningeal dissemination documented by CSF cytology, complete myelography, and MRI imaging. Gross examination of the spinal cord and arachnoid at the time of exploratory thoracic spinal surgery was normal. However, histological review of thoracic arachnoid demonstrated microscopic deposits of glial fibrillary acidic protein (GFAP) positive tumour consistent with malignant astrocytoma. Intramedullary spinal cord metastasis of cerebral glioblastoma rarely occurs, but may develop in association with leptomeningeal tumour dissemination. As local control of primary tumours improves, distant metastasis is likely to become a more common clinical problem. Leptomeningeal gliomatosis may be very difficult to document, even when clinically suspected and GFAP staining of a biopsy of arachnoid tissue can play an important role in confirming the diagnosis. This information can be critical to establish prognosis and develop an appropriate treatment strategy.
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PMID:Supratentorial glioblastoma with spinal cord intramedullary metastasis. 838 62

The authors statistically analyzed the MR configurations of 14 glioblastoma multiformes (GBMs) and 15 metastatic adenocarcinomas (MACs) of the brain in order to distinguish these two histological types on MR images. MR configurations were classified and scored upon the 9 criteria of heterogeneity, cyst or necrosis, haemorrhage, crossing of the midline by the tumour, oedema or mass effect, border definition, flow void sign, degree and heterogeneity after contrast enhancement. The mean value of GBMs was 1.47 +/- 0.22, and that of MACs was 0.91 +/- 0.37 (P < 0.001). GBMs had significantly higher values in five out of the nine criteria: border definition, heterogeneity, crossing of the midline of the tumour, flow void sign, and degree of the contrast enhancement (P < 0.001-0.05). Border definition was the best criterion for distinguishing two histological types. Six cases of MACs displayed hypo-intense lesions on T2 weighted images in contrast to GBMs which showed hyperintense lesions in all cases. In 4 out of the 6 MACs which were shown as hyperintensities on T2 weighted images, a hypo-intense peritumoural rim was noticed between the tumour parenchyma and the surrounding oedema. These data strongly suggest that GBMs and MACs can be distinguished on MR image by using MRI score.
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PMID:Evaluation of MRI score in the differentiation between glioblastoma multiforme and metastatic adenocarcinoma of the brain. 839 78

Human glioblastomas of the brain are characterized by a wide range of proton relaxation rates in vitro (1/T1 and 1/T2) and heterogeneous appearance in magnetic resonance imaging. It was previously found that their 1/T1 values vary widely at magnetic field strengths much below imaging fields, even at the same water content. In the present study, we measure 1/T1 at different magnetic field strengths (NMRD profile) for a specific transplantable, human glioblastoma (SF295), grown subcutaneously in athymic nude mice, to search for histologic characteristics that might correlate with the variability of 1/T1 at low fields (1/T1L). Using a field-cycling relaxometer, NMRD profiles were obtained for 32 fresh, histologically characterized, tumor specimens, 7 to 24 days post implantation of cryopreserved SF295 fragments. Tumor volume, dry weight, and pH of specimens were determined, the extent of hemorrhage and necrosis rated, and specimen location within the tumor recorded. A statistically significant increase in the average 1/T1 was found with increasing level of necrosis at 0.0024 T and below, possibly reflecting progressive protein aggregation in samples with up to 40% necrosis. This correlation was not significant at imaging fields. Although pH was increased in central necrosis, neither pH, dry weight, sample location, nor fresh hemorrhage could explain the changes in 1/T1L. The variability of 1/T1L among SF295 samples is much reduced compared to that of fresh surgical specimens of human glioblastomas of the brain. The heterogeneous appearance of glioblastomas in MRI may have a histologic correlate which reflects molecular changes involved with induction of cell death and necrosis. Further investigations may identify the factors responsible for affecting 1/T1L (hypoxia, radiation, chemotherapy).
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PMID:Correlation of relaxometry and histopathology: the transplantable human glioblastoma SF295 grown in athymic nude mice. 854 67

Metastasis of intracranial glioblastomas have been described for the first time more than fifty years ago. They are exceptional and seem to develop clinically in less than 2% of cases. In fact, microscopic metastasis (necropsic series) of such glioblastomas are much more frequent: from 6% for supratentorial glioblastomas to 60% in infratentorial ones; but patients usually die before clinical symptoms appear. The authors report on an intraspinal metastasis which appeared clinically four years after the removal of a frontal glioblastoma. The metastasis was subdural, T3. Preoperative radiological data (CT-scan, MRI) evoked a meningioma, while surgical findings favoured the diagnosis of neurinoma. The diagnosis of glioblastoma metastasis was suggested by intra-operative pathological findings, and confirmed a few days later on smears and stains studies.
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PMID:[Secondary intraspinal localizations of glioblastoma. Apropos of a case]. 857 58

Primary malignant brain tumors are among the most difficult human malignancies to manage. Other common tumors such as in the lung or breast generally can be cured if caught at an early stage. A 2 cm adenocarcinoma in the peripheral lung field without mediastinal or systemic metastasis can be cured. A small breast carcinoma which has not invaded into the regional lymph nodes can generally be removed with the expectation of permanent control. However, a 1 cm glioblastoma in the anterior right frontal lobe, even with gross total resection and maximum adjunctive radiation, will recur and cause death within a year or two. There is no realistic possibility of cure or even long-term survival. These patients pose unusual management problems. They require different medications such as anticonvulsants and steroids. There are neurocognitive problems and the quality of life is usually worse than for the other common malignancies. They require a multidisciplinary approach with health care providers skilled in a variety of disciplines. Malignant gliomas have two components. There is the main bulk of the tumor (the ring enhancing portion seen on the MRI) and the infiltrating portion than cannot be seen by any imaging method. Local control has improved over the past ten years, but control of the infiltrating portion is still lacking. It is likely that some form of biologic approach will be needed to seek out and kill these infiltrating cells that travel with such ease within the white matter tracts of the brain. Perhaps selective delivery of self-destruct genes to these cells will be possible. Perhaps the search and destroy potential of the immune system can be harnessed. If so, this incurable cancer may some day be brought under control. The effort involved will be extensive both in the laboratory and in the clinic.
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PMID:Multidisciplinary approach to malignant gliomas. 879 16

Few studies have attempted to correlate neuroimaging with outcome in patients with glioblastoma. Our aim was to evaluate the relationship between neuroradiological findings and survival in these patients. We studied 18 consecutive patients with glioblastoma who had undergone surgery and radiotherapy. We assessed the following features, using preoperative CT and/or MRI: tumour size, extent of necrotic area within the mass, extent of perifocal oedema and contrast enhancement. The mean survival was 14.2 +/- 5 months (range 6-22). The extent of radiological evidence of necrosis within the mass correlated significantly with survival time, whereas tumour size, perifocal oedema and contrast enhancement did not.
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PMID:Supratentorial glioblastoma: neuroradiological findings and survival after surgery and radiotherapy. 881 75

The aim of this study was to obtain an MRI severity-related classification of diffuse astrocytic tumours able to integrate the histological data in the grading of such tumours. We studied presurgical MR images of 91 patients with a histological diagnosis of astrocytoma, anaplastic astrocytoma and glioblastoma. A score ranging from 1 to 3 was assigned by two independent readers to each of the following MR features: oedema, mass effect, contrast enhancement, borders, signal homogeneity, necrosis, haemorrhage and flow void. Statistical analysis showed significant differences in the mean MRI scores between the three histological grades. Contrast enhancement was found to be the best predictor of the histological grade followed by necrosis, signal homogeneity and border scores. This classification represents a simple and reproducible means of carefully evaluating some macroscopic characteristics of these tumours. It could be used to integrate histological data especially in cases in which tissue sampling defects may affect the validity of this examination.
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PMID:Supratentorial diffuse astrocytic tumours: proposal of an MRI classification. 908 64


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