Intraoperative Comparison Between Strain Elastography and Preoperative Magnetic Resonance Imaging Features in High-Grade Gliomas Using Fusion Imaging: A Pilot Study.

Autor: Gennari AG; Department of Neuropediatrics, University Children's Hospital, Zurich, Switzerland; Center for MR Research, University Children's Hospital, Zurich, Switzerland., Doniselli FM; Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico 'C. Besta', Milan, Italy., Coley J; Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA., Grisoli M; Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico 'C. Besta', Milan, Italy., Quaia E; Department of Radiology, University of Padova, Padova, Italy., Souchon R; Inserm U1032, LabTau, Lyon, France., Prada F; Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA; Acoustic Neuroimaging and Therapy Lab, Fondazione IRCCS Istituto Neurologico 'C. Besta', Milan, Italy; Focused Ultrasound Foundation, Charlottesville, Virginia, USA; Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico 'C. Besta', Milan, Italy. Electronic address: francesco.prada@istituto-besta.it., DiMeco F; Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico 'C. Besta', Milan, Italy; Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, Maryland, USA; Department of Oncology and Hemato-oncology, Università degli studi di Milano, Milano, Italy.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Sep 10. Date of Electronic Publication: 2024 Sep 10.
DOI: 10.1016/j.wneu.2024.09.024
Abstrakt: Objective: To compare the elastographic patterns of high-grade gliomas (HGGs) solid portions and those of adjacent healthy brain parenchyma, on intraoperative ultrasound, with magnetic resonance image (MRI) characteristics.
Methods: Clinical records and images of HGGs patients, operated between June and December 2018, were retrospectively reviewed. Fusion images were used to compare preoperative gadolinium-enhanced T1-weighted MRI/fluid-attenuated inversion recovery images (Gd-T1 MRI/FLAIR) to intraoperative strain elastography (SE). FLAIR/Gd-T1 MRI images were used to define enhancement patterns (absent/whole lesion/peripheral) and lesions' characteristics (primary and secondary pattern, further subdivided in solid/necrotic/cystic/infiltrating). HGGs SE patterns were categorized as homogeneous/inhomogeneous, while lesions' primary and secondary patterns as stiff/intermediate/elastic. The SE motive of neighboring healthy brain parenchyma was defined similarly.
Results: Eighteen patients (M:F, 11:7; mean age: 53 years) harboring 14 glioblastomas (77.8%) and 4 anaplastic astrocytomas (22.2%) were compared. Glioblastomas typically enhanced peripherally and had a primary necrotic pattern (78.6% and 64.3%, respectively), while anaplastic astrocytomas did not enhance and were solid (75% both) at T1-Gd MRI and FLAIR images. At SE anaplastic astrocytomas had a homogeneous stiff primary pattern, whereas the majority of glioblastomas primary patterns were heterogeneous (85.7%) and intermediate (78.6%).
Conclusions: Three major SE patterns defined HGGs and adjacent healthy brain parenchyma. SE patterns varied according to HGG histotypes and Gd-T1 MRI/FLAIR characteristics.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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