Summary
Xenon-enhanced computerized tomography (XeCT) was performed on 14 consecutive adult patients presenting with seizures showing supratentorial non-enhancing radiologically uniform appearing low grade gliomas on CT/MR images. Pre-operative XeCT patterns were compared with postoperative histological diagnosis, grading and Ki67 proliferation indices (PI).
After gross-total, subtotal resection or biopsy, 11 astrocytomas, 2 oligodendrogliomas and 1 oligo-astrocytoma were diagnosed and graded: Grade I: 2 patients (Ki67-PI=0.5–0.8), Grade I–II: 4 patients (Ki67-PI=0.3–1.5), Grade II: 3 patients (Ki67-PI=0.5–3.5), Grade II–III: 4 patients (Ki67-PI=3.8–6.8) and Grade III: 1 patient (Ki67-PI=5.2), (Kernohan Classification). Xenon CT studies revealed different flow patterns, correlating with the postoperative histological diagnosis, grading and proliferation indices: A tumour group with well defined, delayed, only minimally enhancing tumour area (5 patients, Grade I, I–II or II), a second group with less well defined low-flow-area borders and inhomogenous, strong enhancement within the tumour (4 patients, Grade II–III, III) and a third group with fast enhancing tumours was identified. The third pattern was exclusively shown in the 2 oligodendrogliomas (Grade I and II–III) and 1 oligo-astrocytoma (Grade II).
The preliminary report identifies the Xenon enhanced CT as a beneficial pre-operative investigation for patients with radiologically uniform appearing suspected adult supratentorial low-grade gliomas, which may give information about the presence of anaplastic foci or oligodendroglial components.
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References
Cairncross JG, Laperriere NJ (1989) Low-grade glioma. To treat or not to treat? Arch Neurol 46: 1238–1239
Chamberlain MC, Murovic JA, Levin VA (1988) Absence of contrast enhancement on CT brain scans of patients with supra-tentorial malignant gliomas. Neurology 38: 1371–1374
Francavilla TL, Miletich RS, Dichiro G (1989) Positron emission tomography in detection of malignant degeneration of low-grade gliomas. Neurosurgery 26: 1–5
Guthrie BL, Laws ER Jr (1990) Supratentorial low-grade gliomas. Neurosurg Clin North Am 1: 37–48
Herholz K, Pietrzyk U, Voges J (1993) Correlation of glucose consumption and tumor cell density in astrocytomas. A stereotactic PET study. J Neurosurg 79: 853–858
Kernohan JW, Mabon RF, Svien HJ (1949) Symposium on new and simplified concepts of gliomas. A simplified classification of the glioma. Proc Staff Meet Mayo Clin 24: 71–75
Kinoshita Y, Kajiwara H, Yokota A (1994) Proton magnetic resonance spectroscopy of brain tumors: an in vitro study. Neurosurgery 35: 606–614
Kondziolka D, Lunsford D, Martinez AJ (1993) Unreliability of contemporary neurodiagnostic imaging in evaluating suspected adult supratentorial (low-grade) astrocytoma. J Neurosurg 79: 533–536
Levivier M, Goldman S, Pirotte B (1995) Diagnostic yield of stereotactic brain biopsy guided by positron emission tomography with F 18 fluorodeoxyglucose. J Neurosurg 82: 445–452
Moranz RA, Walsh JW (1994) Brain tumors. A comprehensive text. The management of patients with a low-grade cerebral astrocytoma. Dekker, New York, pp 387–415
Okazaki H, Scheithauer BW (1988) Atlas of neuropathology. Astrocytoma, histological grading. Lippincott-Gower, New York, pp 62–72
Orrison WW (1989) Introduction to neuroimaging. Little, Brown, Boston, pp 65–234
Roessler K, Neuchrist C, Kitz K (1992) Expression of leucocyte adhesion molecules at the human blood-brain barrier (BBB). J Neurosci Res 31: 365–374
Shaw EG, Daumas-Duport C, Scheithauer BW (1989) Radiation therapy in the management of low-grade supratentorial astrocytomas. J Neurosurg 70: 853–861
Schoenberg BS, Christine BW, Whisnant JP (1976) The descriptive epidemiology of primary intracranial neoplasms. Am J Epidemiol 104: 499–510
Worthington C, Tyler JL, Villemure JG (1987) Stereotactic biopsy and positron emission tomography correlation of cerebral gliomas. Surg Neurol 27: 87–92
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Roessler, K., Nasel, C., Czech, T. et al. Histological heterogeneity of neuroradiologically suspected adult low grade gliomas detected by Xenon enhanced computerized tomography (CT). Acta neurochir 138, 1341–1347 (1996). https://doi.org/10.1007/BF01411065
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DOI: https://doi.org/10.1007/BF01411065