Document Detail


Conventional MRI evaluation of gliomas.
MedLine Citation:
PMID:  22433821     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
MRI using T(1) weighted, T(2) weighted and gadolinium-enhanced sequences plays a central clinical role in diagnosis, characterisation, surveillance and therapeutic monitoring of gliomas. Such conventional MRI protocols provide high resolution multiplanar structural information, and substantially improved tissue characterisation compared with CT. However, the MRI signal lacks biological specificity, e.g. T(2) weighted dependent signal abnormality is dominated by tissue water content, and contrast enhancement reflects a non-specific increase in blood-brain barrier permeability. This limits non-invasive glioma diagnosis, characterisation and therapeutic planning and assessment of active tumour load may be confounded by treatment-related effects. The complex features of glioma morphology and often subtle changes between MRI examinations are also frequently difficult to detect reliably by visual inspection of the images, even by an experienced radiologist. Moreover, the most widely used response criteria in clinical practice and therapeutic trials rely on linear measurements of enhancing tumour and are further challenged by the irregular shape and heterogeneous composition of gliomas. This contributes to the poor correlation of these criteria with hard clinical endpoints. While conventional MRI is widely available and provides essential anatomical information, the lack of pathology-specific biomarkers available from standard MRI sequences and methods of image analysis used limit overall diagnostic and prognostic efficacy of the examination.
Authors:
N Upadhyay; A D Waldman
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The British journal of radiology     Volume:  84 Spec No 2     ISSN:  1748-880X     ISO Abbreviation:  Br J Radiol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-03-21     Completed Date:  2012-10-10     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0373125     Medline TA:  Br J Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  S107-11     Citation Subset:  AIM; IM    
Affiliation:
Department of Imaging, Charing Cross Hospital, Imperial College Healthcare NHS Trust and Institute of Clinical Sciences, Imperial College London, London, UK. neil.upadhyay@imperial.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Brain / pathology
Brain Neoplasms / diagnosis*,  pathology
Contrast Media / diagnostic use
Gadolinium / diagnostic use
Glioma / diagnosis*,  pathology
Humans
Image Enhancement / methods
Magnetic Resonance Imaging / methods*
Neoplasm Grading
Chemical
Reg. No./Substance:
0/Contrast Media; 7440-54-2/Gadolinium
Comments/Corrections

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