Radiological evaluation of ex novo High Grade Glioma: Velocity of Diametric Expansion and Acceleration Time Study

Roberto Altieri; Francesco Certo; Giuseppe La Rocca; Antonio Melcarne; Diego Garbossa; Alberto Bianchi; Salvatore Crimi; Alessandro Pluchino; Simone Peschillo; Giuseppe Barbagalllo

Roberto Altieri Department of Neurosurgery, University of Catania
Francesco Certo 1. Division of Neurosurgery, Department of Neurosciences, Policlinico "G. Rodolico", University Hospital, Catania, Italy
Giuseppe La Rocca 4. Division of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
Antonio Melcarne Department of Neuroscience, University of Turin, Turin, Italy
Diego Garbossa Department of Neuroscience, University of Turin, Turin, Italy
Alberto Bianchi 5. Department of General Surgery and Medical Surgery Specialties, University of Catania, Catania, Italy
Salvatore Crimi Department of General Surgery and Medical Surgery Specialties, University of Catania, Catania, Italy
Alessandro Pluchino 6. Department of Physics and Astronomy “E.Maiorana”, University of Catania, Catania, Italy
Simone Peschillo Division of Neurosurgery, Department of Neurosciences, Policlinico "G. Rodolico", University Hospital, Catania, Italy.
Giuseppe Barbagalllo Division of Neurosurgery, Department of Neurosciences, Policlinico "G. Rodolico", University Hospital, Catania, Italy.

Abstract

Purpose

One of the greatest neuro-oncological concern remains the lack of knowledge about the etiopathogenesis and physiopathology of gliomas. Several studies reported a strict correlation between radiological features and biological behavior of gliomas; in this way the Velocity of Diametric Expansion (VDE) correlate with lower grade glioma aggressiveness. However, there are no the same strong evidences for High Grade Gliomas (HGG) because of the lack of several preoperative MRI.

Methods

We describe a series of 4 patients affected by HGG followed from 2014 to January 2019. 2 patients are male and 2 female; 2 had a pathological diagnosis of Glioblastoma (GBM), 1 of Anaplastic Astrocytoma (AA) and 1 had a neuroradiological diagnosis of GBM. The VDE and the acceleration time (AT) was calculated for FLAIR volume and for the enhancing nodule (EN). Every patients underwent sequential MRI study along a mean period of 413 days.

Results

Mean VDE evaluated on FLAIR volume was 39.91 mm/year. Mean percentage ratio between peak values and mean value of acceleration was 282.7%. Median appearance time of EN after first MRI scan was 432 days. Mean VDE was 45.02 mm/year. Mean percentage ratio between peak values and mean value of acceleration was 257.52%.

Conclusion

To our knowledge, this is the first report on VDE and acceleration growth in HGG confirming their strong aggressiveness. In a case in which we need to repeat an MRI, time between consecutive scans should be reduced to a maximum of 15 days and surgery should be execute as soon as possible.