Abstract
This chapter gives an overview of important radiological aspects in brain tumor imaging. It was not our aim to deal with the wide differential diagnosis of brain tumors, and this chapter should not replace a neuroradiological textbook. Instead, it addresses important radiological and neurological aspects which should be known by the radiologist reporting brain tumors. In general, age is one of the most important criterion to distinguish different brain neoplasms, since the differential diagnosis differ considerably between ages. Therefore, the chapter is divided into childhood and adulthood brain tumors. Further, important pitfalls in brain tumor diagnosis are treated especially concerning non-neoplastic brain lesions and post-treatment changes. The localization of brain tumors in relation to functional brain areas is another important issue which has to be reported by the neuroradiologist, since preservation of important brain function is the ultimate goal and determines the treatment modality. Therefore, this chapter gives some help to localize a tumor with respect to the functional primary motor and language areas.
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Abbreviations
- MRI:
-
Magnetic resonance imaging
- CT:
-
Computed tomography
- CNS:
-
Central nervous system
- SE:
-
Spin echo
- FLAIR:
-
Fluid-Attenuated Inversion Recovery
- PD:
-
Proton density
- i.v.:
-
intravenous
- fMRI:
-
Functional MRI
- DWI:
-
Diffusion-weighted imaging
- ADC:
-
Apparent diffusion coefficient
- DTI:
-
Diffusion tensor imaging
- SWI:
-
Susceptibility-weighted imaging
- PNET:
-
Primitive neuroepithelial tumor
- DNET:
-
Dysembryoplastic neuroepithelial tumor
- MPR:
-
Multiplanar reformatting
- PPL:
-
Posterior pituitary lobe
- WI:
-
Weighted imaging
References
Aghi M, Gaviani P, Henson JW, Batchelor TT, Louis DN, Barker FG 2nd (2005) Magnetic resonance imaging characteristics predict epidermal growth factor receptor amplification status in glioblastoma. Clin Cancer Res 11(24 Pt1):8600–8605
Bähr O, Hattingen E, Rieger J, Steinbach JP (2011) Bevacizumab induced tumor calcifications as a surrogate marker of outcome in patients with glioblastoma. Neuro Oncol 13(9):1020–1029
Baleriaux DL (1999) Spinal cord tumors. European Radiol 9(7):1252–1258
Beni-Adani L, Gomori M, Spektor S, Constantini S (2000) Cyst wall enhancement in pilocytic astrocytoma: neoplastic or reactive phenomena. Pediatr Neurosurg 32(5):234–239
Bishop FS, Liu JK, Chin SS, Fults DW (2008) Recurrent cerebellar hemangioblastoma with enhancing tumor in the cyst wall: case report. Neurosurgery 62(6):E1378–E1379
Brandsma D, Stalpers L, Taal W, Sminia P, van den Bent MJ (2008) Clinical features, mechanisms, and management of pseudoprogression in malignant gliomas. Lancet Oncol 9(5):453–461
Bühring U, Herrlinger U, Krings T, Thiex R, Weller M, Küker W (2001) MRI features of primary central nervous system lymphomas at presentation. Neurology 57(3):393–396 (Review)
Chaichana KL, McGirt MJ, Niranjan A, Olivi A, Burger PC, Quinones-Hinojosa A (2009) Prognostic significance of contrast enhancing low-grade gliomas in adults and a review of the literature. Neurol Res 31(9):931–939
Di Iorgi N, Napoli F, Allegri AE, Olivieri I, Bertelli E, Gallizia A, Rossi A, Maghnie M (2012) Diabetes insipidus–diagnosis and management. Horm Res Paediatr 77(2):69–84
Diehn M, Nardini C, Wang DS, McGovern S, Jayaraman M, Liang Y, Aldape K, Cha S, Kuo MD (2008) Identification of noninvasive imaging surrogates for brain tumor gene-expression modules. Proc Natl Acad Sci U S A 105(13):5213–5218
Eoli M, Menghi F, Bruzzone MG, De Simone T, Valletta L, Pollo B, Bissola L, Silvani A, Bianchessi D, D’Incerti L, Filippini G, Broggi G, Boiardi A, Finocchiaro G (2007) Methylation of O6-methylguanine DNA methyltransferase and loss of heterozygosity on 19q and/or 17p are overlapping features of secondary glioblastomas with prolonged survival. Clin Cancer Res 13(9):2606–2613
Fischbein NJ, Prados MD, Wara W, Russo C, Edwards MS, Barkovich AJ (1996) Radiologic classification of brain stem tumors: correlation of magnetic resonance imaging appearance with clinical outcome. Pediatr Neurosurg 24(1):9–23
Forsting M, Albert FK, Kunze S, Adams HP, Zenner D, Sartor K (1993) Extirpation of glioblastomas: MR and CT follow-up of residual tumor and regrowth patterns. AJNR Am J Neuroradiol 14(1):77–87
Gaudino S, Quaglio F, Schiarelli C, Martucci M, Tartaglione T, Gualano MR, Di Lella GM, Colosimo C (2012) Spontaneous modifications of contrast enhancement in childhood non-cerebellar pilocytic astrocytomas. Neuroradiology 54(9):989–995
Gnekow AK, Falkenstein F, von Hornstein S, Zwiener I, Berkefeld S, Bison B, Warmuth-Metz M, Driever PH, Soerensen N, Kortmann RD, Pietsch T, Faldum A (2012) Long-term follow-up of the multicenter, multidisciplinary treatment study HIT-LGG-1996 for low-grade glioma in children and adolescents of the German Speaking Society of pediatric oncology and hematology. Neuro Oncol 14(10):1265–1284
Huisman TA (2009) Pediatric tumors of the spine. Cancer Imaging 9 Spec No A:45–48
Jallo GI, Freed D, Epstein F (2003) Intramedullary spinal cord tumors in children. Child’s Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery 19(9):641–649
Jellison BJ, Field AS, Medow J, Lazar M, Salamat MS, Alexander AL (2004) Diffusion tensor imaging of cerebral white matter: a pictorial review of physics, fiber tract anatomy, and tumor imaging patterns. AJNR Am J Neuroradiol 25(3):356–369 (Review)
Kan P, Liu JK, Hedlund G, Brockmeyer DL, Walker ML, Kestle JR (2006) The role of diffusion-weighted magnetic resonance imaging in pediatric brain tumors. Child’s Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery 22(11):1435–1439
Kandt RS (2003) Tuberous sclerosis complex and neurofibromatosis type 1: the two most common neurocutaneous diseases. Neurol Clin 21(4):983–1004 (Review)
Kato Y, Higano S, Tamura H, Mugikura S, Umetsu A, Murata T, Takahashi S (2009) Usefulness of contrast-enhanced T1-weighted sampling perfection with application-optimized contrasts by using different flip angle evolutions in detection of small brain metastasis at 3T MR imaging: comparison with magnetization-prepared rapid acquisition of gradient echo imaging. AJNR Am J Neuroradiol 30(5):923–929
Kim SS, McCutcheon IE, Suki D, Weinberg JS, Sawaya R, Lang FF, Ferson D, Heimberger AB, DeMonte F, Prabhu SS (2009) Awake craniotomy for brain tumors near eloquent cortex: correlation of intraoperative cortical mapping with neurological outcomes in 309 consecutive patients. Neurosurgery 64(5):836–845
Knauth M, Aras N, Wirtz CR, Dorfler A, Engelhorn T, Sartor K (1999) Surgically induced intracranial contrast enhancement: potential source of diagnostic error in intraoperative MR imaging. AJNR Am J Neuroradiol 20(8):1547–1553
Kumar N, Miller GM, Piepgras DG, Mokri B (2010) A unifying hypothesis for a patient with superficial siderosis, low-pressure headache, intraspinal cyst, back pain, and prominent vascularity. Journal of Neurosurg 113(1):97–101
Lesniak MS, Klem JM, Weingart J, Carson BS Sr (2003) Surgical outcome following resection of contrast-enhanced pediatric brainstem gliomas. Pediatr Neurosurg 39(6):314–322
Liang L, Korogi Y, Sugahara T, Ikushima I, Shigematsu Y, Okuda T, Takahashi M, Kochi M, Ushio Y (2002) MRI of intracranial germcell tumours. Neuroradiology 44(5):382–388
Makras P, Samara C, Antoniou M, Zetos A, Papadogias D, Nikolakopoulou Z, Andreakos E, Toloumis G, Kontogeorgos G, Piaditis G, Kaltsas GA (2006) Evolving radiological features of hypothalamo-pituitary lesions in adult patients with Langerhans cell histiocytosis (LCH). Neuroradiology 48(1):37–44
Medina JH, Abrams K, Falcone S, Bhatia RG (2010) Spinal imaging findings in spontaneous intracranial hypotension. AJR Am J Radiol 195(2):459–464
Muragaki Y, Chernov M, Maruyama T, Ochiai T, Taira T, Kubo O, Nakamura R, Iseki H, Hori T, Takakura K (2008) Low-grade glioma on stereotactic biopsy: how often is the diagnosis accurate? Minim Invasive Neurosurg 51(5):275–279
Pinker K, Noebauer-Huhmann IM, Stavrou I, Hoeftberger R, Szomolanyi P, Karanikas G, Weber M, Stadlbauer A, Knosp E, Friedrich K, Trattnig S (2007) High-resolution contrast-enhanced, susceptibility-weighted MR imaging at 3T in patients with brain tumors: correlation with positron-emission tomography and histopathologic findings. AJNR Am J Neuroradiol 28(7):1280–1286
Poretti A, Meoded A, Huisman TA (2012) Neuroimaging of pediatric posterior fossa tumors including review of the literature. J Magn Reson Imaging 35(1):32–47
Poussaint TY, Kocak M, Vajapeyam S, Packer RI, Robertson RL, Geyer R, Haas-Kogan D, Pollack IF, Vezina G, Zimmerman R, Cha S, Patay Z, Boyett JM, Kun LE (2011) MRI as a central component of clinical trials analysis in brainstem glioma: a report from the pediatric brain tumor consortium (PBTC). Neuro Oncol 13(4):417–427
Rieger J, Bähr O, Müller K, Franz K, Steinbach J, Hattingen E (2010) Bevacizumab-induced diffusion-restricted lesions in malignant glioma patients. J Neurooncol 99(1):49–56
Roux FE, Boulanouar K, Lotterie JA, Mejdoubi M, LeSage JP, Berry I (2003) Language functional magnetic resonance imaging in preoperative assessment of language areas: correlation with direct cortical stimulation. Neurosurgery 52(6):1335–1345
Ruff IM, Petrovich Brennan NM, Peck KK, Hou BL, Tabar V, Brennan CW, Holodny AI (2008) Assessment of the language laterality index in patients with brain tumor using functional MR imaging: effects of thresholding, task selection, and prior surgery. AJNR Am J Neuroradiol 29(3):528–535
Scott JN, Brasher PM, Sevick RJ (2002) How often are nonenhancing supratentorial gliomas malignant? A population study. Neurology 59:947–949
Spiller M, Tenner MS, Couldwell WT (2001) Effect of absorbable topical hemostatic agents on the relaxation time of blood: an in vitro study with implications for postoperative magnetic resonance imaging. J Neurosurg 95(4):687–693
Spreer J, Arnold S, Quiske A, Wohlfarth R, Ziyeh S, Altenmüller D, Herpers M, Kassubek J, Klisch J, Steinhoff BJ, Honegger J, Schulze-Bonhage A, Schumacher M (2002) Determination of hemisphere dominance for language: comparison of frontal and temporal fMRI activation with intracarotid amytal testing. Neuroradiology 44(6):467–474
Stephenson JA, Wiley AL Jr (1995) Current techniques in threedimensional CT simulation and radiation treatment planning. Oncology 9(11):1225–1232
Sumida M, Uozumi T, Kiya K, Mukada K, Arita K, Kurisu K, Sugiyama K, Onda J, Satoh H, Ikawa F et al (1995) MRI of intracranial germ cell tumours. Neuroradiology 37(1):32–37
Tong KA, Ashwal S, Obenaus A, Nickerson JP, Kido D, Haacke EM (2008) Susceptibility-weighted MR imaging: a review of clinical applications in children. AJNR Am J Neuroradiol 29(1):9–17
Tsuda M, Takahashi S, Higano S, Kurihara N, Ikeda H, Sakamoto K (1997) CT and MR imaging of craniopharyngioma. Eur Radiol 7(4):464–469
Vos MJ, Uitdehaag BM, Barkhof F, Heimans JJ, Baayen HC, Boogerd W, Castelijns JA, Elkhuizen PH, Postma TJ (2003) Interobserver variability in the radiological assessment of response to chemotherapy in glioma. Neurology 60(5):826–830
Warmuth-Metz M, Gnekow AK, Muller H, Solymosi L (2004a) Differential diagnosis of suprasellar tumors in children. Klin Padiatr 216(6):323–330
Warmuth-Metz M, Kuhl J, Krauss J, Solymosi L (2004b) Subdural enhancement on postoperative spinal MRI after resection of posterior cranial fossa tumours. Neuroradiology 46(3):219–223
Wen PY, Macdonald DR, Reardon DA, Cloughesy TF, Sorensen AG, Galanis E, Degroot J, Wick W, Gilbert MR, Lassman AB, Tsien C, Mikkelsen T, Wong ET, Chamberlain MC, Stupp R, Lamborn KR, Vogelbaum MA, van den Bent MJ, Chang SM (2010) Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 28(11):1963–1972
Wetzel SG, Johnson G, Tan AG, Cha S, Knopp EA, Lee VS, Thomasson D, Rofsky NM (2002) Three-dimensional, T1-weighted gradient-echo imaging of the brain with a volumetric interpolated examination. AJNR Am J Neuroradiol 23(6):995–1002
White ML, Zhang Y, Kirby P, Ryken TC (2005) Can tumor contrast enhancement be used as a criterion for differentiating tumor grades of oligodendrogliomas? AJNR Am J Neuroradiol 26(4):784–790
Zulfiqar M, Dumrongpisutikul N, Intrapiromkul J, Yousem DM (2012) Detection of intratumoral calcification in oligodendrogliomas by susceptibility-weighted MR imaging. AJNR Am J Neuroradiol 33(5):858–864
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Hattingen, E., Warmuth-Metz, M. (2013). MR Imaging of Brain Tumors. In: Hattingen, E., Pilatus, U. (eds) Brain Tumor Imaging. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2013_936
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DOI: https://doi.org/10.1007/174_2013_936
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