Usefulness of advanced magnetic resonance for the preoperative diagnostic approach in gliomas

Abstract

INTRODUCTION: Brain tumors are lesions of great histological and genetic diversity, of which gliomas
are the most frequent group. Imaging advances focused on advanced and functional magnetic resonance
imaging, as well as genetic categorization, have made it possible to improve the therapeutic approach for these patients, but without significant changes in prognosis.
OBJECTIVE: To recognize the capacity of Spectroscopy, Perfusion and Diffusion for the preoperative
diagnosis of the histopathological and immunohistochemical characteristics of space-occupying lesions of
glial origin
MATERIAL AND METHODS: Advanced magnetic resonance techniques (Spectroscopy - Perfusion -
Diffusion) were applied to patients with space-occupying lesions in the CNS with a histopathological
diagnosis of gliomas. These results were correlated with the histopathological and immunohistochemical
analysis of the surgical specimens. The association of these imaging pág. 2 indices (Cho/Cr-Cho/NAANAA/Cr-DWI-rCVB Index) with histology and immunohistochemistry in relation to the cell replication
index of these lesions (KI 67 antibody) was reviewed.
RESULTS: A relationship was found between increased spectroscopy indices (Cho/Cr and Cho/NAA) and
diffusion indices (DWI) and their relationship with KI67/MIB1 and high-grade tumors.
DISCUSSION: Although the results cannot be statistically proven due to the size of the sample, an
association between preoperative imaging findings with preoperative tumor genetic characteristics can be
evidenced.
CONCLUSION: Imaging techniques have advanced significantly in recent decades, but little has been
achieved in influencing the prognosis of patients with glial lesions of the CNS. The possibility of knowing
in a preoperative stage the histological and immunohistochemical characteristics of primary CNS tumors
could be of great help in the approach.