what does enhancement mean in low grade gliomas?
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What does enhancement mean in low grade gliomas?. B. Bison, M. Warmuth-Metz, M. Schneckenburger Reference Center for Neuroradiology for the HIT-Studies of the GPOH Departement of Neuroradiology University Hospital Würzburg, Germany. Rationale. - PowerPoint PPT PresentationTRANSCRIPT
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What does enhancement mean
in low grade gliomas?
B. Bison, M. Warmuth-Metz, M. Schneckenburger
Reference Center for Neuroradiology for the HIT-Studies of the GPOH
Departement of NeuroradiologyUniversity Hospital Würzburg, Germany
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Rationale• In high grade gliomas an
intensification or new contrast enhancement (CE) is considered a sign of malignisation and therefore progression
• CE in low grade gliomas is variable and without prognostic significance
• Pilocytic astrocytomas showing a spontaneous regression (+/-NF1) always show a reduction of CE
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Rationale• New or intensified CE in low grade
gliomas is frequently diagnosed as progression by outside (neuro)radiologists in the German patients of the LGG-study.
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6/09 vs. 9/09
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Patients• 303 pairs of MRIs of consecutive time
points• 73 patients• up to 9 pairs of MRIs per patient• patients with multifocal tumors
(n=79)• 3 categories of CE
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Change of CE• increase: 35
• no change: 234– without CE: 75
• decrease: 34
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Increase of CE• n = 35• 9 x size reduction (-39 bis -
2%)• 3 x same size• 23 x size increase (2-1664%)• median 14.95%• mean 125.32%
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No change of CE• n = 234• 109 x size reduction (-84 to -0.02%)• 21 x no change of size• 104 x size increase (0.4 to
503.6%)• median 0%• mean 5.8%
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Decrease of CE• n = 34• 12 x size increase (0.2 to
81%)• 22 x size reduction (-2 to -72%)• median -10.4%• mean -14.5%
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New enhancement• n = 14 (n=3 no further MRI)
• 1 x progression next follow up• 2 x in progression• 1 x in regression• 1 x regression next follow up• 6 x stabile tumor
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Conclusion• There is a statistical correlation
between CE in low grade gliomas and a change of tumor size.
• But, discrepant behaviour can be found in all groups
• No conclusion must be drawn from a change of CE alone.
• The primary staging criteria is the evolution of tumor size.
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Thank you
The Reference Center for Neuroradiology for the HIT-studies and the HIT LGG-study are supported by: