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