Radiological evaluation of ex novo high grade glioma: velocity of diametric expansion and acceleration time study
Article Category: Research Article
Publicado en línea: 03 dic 2020
Páginas: 26 - 34
Recibido: 15 jul 2020
Aceptado: 16 oct 2020
DOI: https://doi.org/10.2478/raon-2020-0071
© 2021 Roberto Altieri, Francesco Certo, Giuseppe La Rocca, Antonio Melcarne, Diego Garbossa, Alberto Bianchi, Salvatore Crimi, Alessandro Pluchino, Simone Peschillo, Giuseppe M.V. Barbagallo, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
One of the greatest neuro-oncological concern remains the lack of knowledge about the etiopathogenesis and physiopathology of gliomas. Several studies reported a strict correlation between radiological features and biological behaviour of gliomas; in this way the velocity of diametric expansion (VDE) correlate with lower grade glioma aggressiveness. However, there are no the same strong evidences for high grade gliomas (HGG) because of the lack of several preoperative MRI.
Patients and methods
We describe a series of 4 patients affected by HGG followed from 2014 to January 2019. Two patients are male and two female; two had a pathological diagnosis of glioblastoma (GBM), one of anaplastic astrocytoma (AA) and one had a neuroradiological diagnosis of GBM. The VDE and the acceleration time (AT) was calculated for fluid attenuated inversion recovery (FLAIR) volume and for the enhancing nodule (EN). Every patients underwent sequential MRI study along a mean period of 413 days.
Results
Mean VDE evaluated on FLAIR volume was 39.91 mm/year. Mean percentage ratio between peak values and mean value of acceleration was 282.7%. Median appearance time of EN after first MRI scan was 432 days. Mean VDE was 45.02 mm/year. Mean percentage ratio between peak values and mean value of acceleration was 257.52%.
Conclusions
To our knowledge, this is the first report on VDE and acceleration growth in HGG confirming their strong aggressiveness. In a case in which we need to repeat an MRI, time between consecutive scans should be reduced to a maximum of 15–20 days and surgery should be executed as soon as possible.