Imaging-based stereotaxic serial biopsies in untreated intracranial glial neoplasms

Abstract

✓ Forty patients with previously untreated intracranial glial neoplasms underwent stereotaxic serial biopsies assisted by computerized tomography (CT) and magnetic resonance imaging (MRI). Tumor volumes defined by computer reconstruction of contrast enhancement and low-attenuation boundaries on CT and T 1 and T 2 prolongation on MRI revealed that tumor volumes defined by T 2-weighted MRI scans were larger than those defined by low-attenuation or contrast enhancement on CT scans. Histological analysis of 195 biopsy specimens obtained from various locations within the volumes defined by CT and MRI revealed that: 1) contrast enhancement most often corresponded to tumor tissue without intervening parenchyma; 2) hypodensity corresponded to parenchyma infiltrated by isolated tumor cells or in some instances to tumor tissue in low-grade gliomas or to simple edema; and 3) isolated tumor cell infiltration extended at least as far as T 2 prolongation on magnetic resonance images. This information may be useful in planning surgical procedures and radiation therapy in patients with intracranial glial neoplasms.