Abstract
Advanced magnetic resonance imaging and the contribution of 99mTc-tetrofosminbrain SPECT in the differential diagnosis of cerebral tumors
Highlights
Neuroimaging has evolved from a purely anatomy-based specialty to a multi-parameter discipline that combines morphologic abnormalities with hemodynamic information, intra-cellular microstructure and cellular metabolism.Advanced MR neuroimaging includes 1HMR spectroscopy which is a powerful noninvasive imaging technique that provides important in vivo metabolic information, complementing morphological findings from conventional MRI in the clinical setting
In addition to 1H-MRS, perfusion imaging has already found increasing use in the evaluation of brain tumors as it allows some insight into angiogenesis, a process that is present in a number of hypoxic and ischemic conditions in the central nervous system and an important factor in malignant primary tumors
Neoplasms have increased permeability parameters on perfusion MR images and the increase of the relative cerebral blood volume (rCBV) is found to correlate with aggressive tumor growth, it facilitates the prediction of brain lesion progression in conjunction with histopathology [1,3]
Summary
Advanced MR neuroimaging includes 1HMR spectroscopy which is a powerful noninvasive imaging technique that provides important in vivo metabolic information, complementing morphological findings from conventional MRI in the clinical setting. Neoplasms have increased permeability parameters on perfusion MR images and the increase of the rCBV is found to correlate with aggressive tumor growth, it facilitates the prediction of brain lesion progression in conjunction with histopathology [1,3]. Diffusion imaging has been shown to be an imaging biomarker for assessing tumor aggressiveness and early response to therapy in neoplasms as it probes local tissue microstructure and provides a sensitive means to detect alterations in the integrity of white matter structures [4,5]. DTI, the evolution of DWI, has the potential to give a complete picture of the neuronal architecture as water molecules diffuse differently along the tissues depending on its type, integrity and presence of barriers, giving information about its orientation and quantitative anisotropy [6]
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