Imaging of adult central nervous system primary malignant gliomas: staging and follow-up

Article Abstract:

Although brain tumors account for less than 1.5 percent of all malignancies, they pose special problems which make them both unique and difficult to treat. About 14,700 patients develop central nervous system tumors each year, and for the vast majority their disease is fatal. Malignant gliomas account for almost half of primary brain tumors, and being enclosed within the brain they can not be treated in a manner comparable to other cancers. Often, they can not be completely resected (removed). Even if the glioma could be resected in principle, however, it may not be resected in practice, since the neurosurgeon can not ''look around'' various parts of the brain to determine the location and extent of the cancer in the same way a surgeon can look at, say, the colon. Traditionally, the neurosurgeon has only been able to remove the area that appeared abnormal on an X-ray. Furthermore, unlike other tissues in which metastatic spread and tumor growth may be observed, the neurosurgeon has no way of staging a glioma. It has been suggested that a great many gliomas were not removed completely simply as a result of geometrical ambiguity in interpreting the X-ray. However, this situation has changed with the advent of computed tomography and magnetic resonance imaging. It is now easier to determine the precise coordinates of the tumor, and obtain a better impression of the true extent of the tumor. However, it is still difficult to determine the stage of a glioma. The author discusses a proposal for a new staging method for gliomas in adults. A system for the classification and staging of gliomas would permit the accumulation of more reliable data on the prognosis of the disease, and more precise evaluation of different treatments. Perhaps, the most effective treatment for each stage could be determined. The adoption of a staging system for gliomas would also permit more reliable comparison of data obtained at different medical centers. The criteria for the proposed staging system are presented, as are magnetic resonance images that illustrate some gliomas and their proposed staging. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Tumor staging, Cancer staging, Brain tumors, Nervous system tumors

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Primary tumors of the foot: MR imaging

Article Abstract:

It is important to know the precise location of a tumor prior to initiating treatment, especially in cases where surgery is planned. Research was conducted to evaluate the value of magnetic resonance (MR) imaging in patients with tumors (neoplasm) of the foot in both cancerous (malignant) and noncancerous (benign) cases. MR imaging is superior to standard X-ray imaging for assessing soft-tissue tumors of the musculoskeletal system. MR imaging of tumors of the foot resulted in images of excellent quality, regardless of the location of the tumor within the foot. Prior to this study, most diagnostic imaging studies of foot tumors were conducted with computed tomography (CT). MR proved superior to CT and standard X-ray imaging for depicting tumors of the foot, although CT and X-ray are considered better at imaging bone involvement in foot disorders. The limited experience of this study (eight patients were evaluated) suggests that MR imaging will prove useful in providing preoperative information for patients with tumors of the foot.

Research, Evaluation, Comparative analysis, Magnetic resonance imaging, X-rays, Tumors, Diagnosis, Radioscopic, Radioscopic diagnosis

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