Multimodal Imaging to Delineate Tumor Heterogeneity in Cerebral Gliomas
Astrid Ellen Grams, Jens Gempt, Florian Ringel, Eric Soehngen, Sabrina Astner, Jürgen Schlegel, Bernhard Meyer, Claus Zimmer, Annette Förschler
Department of Neuropathology, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.
Department of Neuroradiology, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.
Department of Neuroradiology, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany;Department of Neuropathology, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.
Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria.
Department of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.
Department of Radiation Oncology, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.
DOI: 10.4236/ojrad.2014.42024   PDF   HTML     5,719 Downloads   6,898 Views   Citations


Purpose: Magnetic resonance imaging (MRI) is the gold standard in visualizing brain tumors and their effects on adjacent structures. However, no reliable information concerning different tumor components and borders between perifocal edema and infiltration areas can be received. The aim of the study was to establish and evaluate a multimodal imaging concept, in order to differentiate different biological tumor components and to determine tumor borders. Materials and Methods: 12 patients with cerebral gliomas (four low and eight high grade) received a “morphological” MRI, a 3D MR spectroscopy and a T2* MR perfusion examination prior to surgery. Data was evaluated by defining different tumor components, which were entitled based upon their multimodal characteristics and histological data. Results: In high grade gliomas different components can be differentiated, which were described as: “true edema”, “cellular proliferation”, “vascular proliferation”, “cellular infiltration”, “tumor” and “necrosis”. In low grade gliomas, four different tumor components were found: “true edema”, “cellular infiltration”, “cellular proliferation” and “tumor”. Conclusion: With the applied multimodal imaging and a novel evaluation concept, it was possible to detect different tumor components, which could be helpful in detecting the optimal sites for tumor biopsy. Especially in morphological “edema appearing” sites, this knowledge could be important for the adaption of tumor resection borders and the planning of radiation therapy. Further studies with more patients and histological correlation are needed.

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Grams, A. , Gempt, J. , Ringel, F. , Soehngen, E. , Astner, S. , Schlegel, J. , Meyer, B. , Zimmer, C. and Förschler, A. (2014) Multimodal Imaging to Delineate Tumor Heterogeneity in Cerebral Gliomas. Open Journal of Radiology, 4, 182-189. doi: 10.4236/ojrad.2014.42024.

Conflicts of Interest

The authors declare no conflicts of interest.


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