Radiological Imaging after Treatment in High-Grade Glial Tumor

Year 2015, , 642 - 653, 02.10.2015

Özlem Alkan

https://doi.org/10.17826/cutf.93167

Abstract

High-grade glial tumors are the most common primary brain tumor in adults. The current standard of care for high-grade glial tumors includes surgical resection followed by combination of radiation with temazolomide treatment and adjuvant temozolomide. The Macdonald Criteria are currently the most widely used guideline for assessing response to therapy in patients with high-grade glial tumors. These are based on the size of the contrast-enhancing lesion in MR imaging. Recently, nontumoral changes in enhancement have been found. It is now clear that evaluation of gadolinium enhancement alone is not adequate to characterize tumor regression or progression. MR diffusion, MR perfusion, MR spectroscopy, and PET imaging will be important adjuncts to traditional imaging for tumor assessment. We review MR imaging findings following high-grade tumor treatment.

Keywords

High-grade glial tumour, MR, Diffusion MR, Perfusion MR, MR spectroscopy

Yüksek Dereceli Glial Tümörlerde Tedavi Sonrası Radyolojik Görüntüleme

Abstract

Yüksek dereceli glial tümörler erişkinlerde en sık görülen beyin tümörleridir. Yüksek dereceli glial tümörlerde güncel tedavi yaklaşımı cerrahi rezeksiyonu takiben, temazolomide ve radyoterapinin kombinasyonu ve takiben adjuvan temazolomide şeklindedir. Macdonald kriterleri yüksek dereceli glial tümörlerde tedaviye yanıt değerlendirmesinde yaygın olarak kullanılmaktaydı. Bu kriterler MR görüntülerde kontrast tutan lezyonun boyutuna dayanıyordu. Bu günlerde tümoral olmayan kontrastlanmalar saptandı. Tumor progresyonu ya da regresyonunu değerlendirmede kontrastlı görüntüler yetersiz kalmaktadır. MR difüzyon, MR perfüzyon, MR spektroskopi ve PET görüntüleme tümör değerlendirmesinde konvansiyonel MR görüntülere yardımcı olmaktadır. Biz bu makalede yüksek dereceli glial tümörlerde tedavi sonrası MR görüntüleme bulgularını gözden geçirdik.

Keywords

Yüksek dereceli glial tümör, Difüzyon MR, Perfüzyon MR, MR spektroskopi

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