Histological heterogeneity of neuroradiologically suspected adult low grade gliomas detected by Xenon enhanced computerized tomography (CT)

Acta Neurochir (Wien). 1996;138(11):1341-7. doi: 10.1007/BF01411065.

Abstract

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 enhance 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.

MeSH terms

  • Adolescent
  • Adult
  • Brain Neoplasms / blood supply
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / pathology
  • Cerebrovascular Circulation
  • Female
  • Glioma / blood supply
  • Glioma / diagnostic imaging*
  • Glioma / pathology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Preoperative Care
  • Radiographic Image Enhancement / methods*
  • Tomography, X-Ray Computed*
  • Xenon*

Substances

  • Xenon