"grade 4 = 745 ± 135 x 10-6 mm2/s"
"grade 3 = 1067 ± 276 x 10-6 mm2/s"
"grade 2 = 1273 ± 293 x 10-6 mm2/s"
"grade 4 = 745 ± 135 x 10-6 mm2/s"
"grade 3 = 1067 ± 276 x 10-6 mm2/s"
"grade 2 = 1273 ± 293 x 10-6 mm2/s"
"The median survival for adult-type astrocytoma IDH-mutant varies by grade18:"
"FDG, 18F-choline and 11C-choline PET is useful for biopsy targeting the most hypermetabolic areas that are most likely the highest grade component"
"FDG, 18F-choline and 11C-choline PET is useful for biopsy targeting the most hypermetabolic areas that are most likely the highest grade component"
"Patients with low-grade gliomas not meeting low-risk criteria are high-risk and generally benefit from immediate post-operative adjuvant therapy if they present with any adverse prognostic factor. For WHO grade 2 gliomas, adjuvant therapy is conditionally recommended if any high-risk features are present: subtotal resection (≥1 cm residual tumour) or biopsy only, age ≥40 years, maximal tumour diameter ≥4-6 cm, tumour crossing the midline, significant pre-surgical neurologic deficits, or refractory seizures. WHO grade 3 gliomas are inherently high-risk 23."
"For radiotherapy planning, the gross tumour volume should be contoured on a new, high-quality, post-operative 3D volumetric MRI (isotropic voxels ≤1 mm) with T2-weighted FLAIR and pre- and post-contrast T1-weighted sequences. This MRI should be acquired specifically for RT planning after the resolution of transient post-surgical changes (reactive enhancement, infarcts, oedema), which can obscure residual tumour on immediate post-operative scans (within 48-72 hours) 23,24."
"For radiotherapy planning, the gross tumour volume should be contoured on a new, high-quality, post-operative 3D volumetric MRI (isotropic voxels ≤1 mm) with T2-weighted FLAIR and pre- and post-contrast T1-weighted sequences. This MRI should be acquired specifically for RT planning after the resolution of transient post-surgical changes (reactive enhancement, infarcts, oedema), which can obscure residual tumour on immediate post-operative scans (within 48-72 hours) 23,24."
"* NB: It is almost certain that grade 2 tumours do somewhat better and grade 3 do somewhat worse, although little data on this exists on strictly molecular-based diagnosis (post-2016) 18."
"There is a substantially higher incidence in men of all ages and of all grades tumour (M: F ~1.5) 1,17."
"* NB: It is almost certain that grade 2 tumours do somewhat better and grade 3 do somewhat worse, although little data on this exists on strictly molecular-based diagnosis (post-2016) 18."
"typically will show elevated choline peak, low NAA peak, elevated choline: creatine ratio"
"For radiotherapy planning, the gross tumour volume should be contoured on a new, high-quality, post-operative 3D volumetric MRI (isotropic voxels ≤1 mm) with T2-weighted FLAIR and pre- and post-contrast T1-weighted sequences. This MRI should be acquired specifically for RT planning after the resolution of transient post-surgical changes (reactive enhancement, infarcts, oedema), which can obscure residual tumour on immediate post-operative scans (within 48-72 hours) 23,24."
"The ESTRO-EANO guideline for WHO grade 3 gliomas requires omitting confidently identified pure vasogenic oedema from the gross tumour volume, a significant diagnostic challenge demanding advanced imaging like amino acid PET and perfusion/diffusion MRI to differentiate oedema from infiltrative tumour. Standard reports based solely on T2/FLAIR are insufficient. Accurate organ at risk delineation (e.g. optic chiasm, hippocampus, brainstem, cochlea) is crucial for minimising long-term toxicity in radiotherapy for this population 23."
"cerebritis/encephalitis: herpes simplex encephalitis, ADEM"
"elevated myo-inositol and myo-inositol/creatine ratio"
Expected headings
"Grading"
"PET-CT"
"Treatment"
"Radiotherapy"
"Target therapy"
"Prognosis"
"Astrocytoma, IDH-mutant tumours are WHO CNS grade 2, 3 or 4 tumours of the brain found in adults. They are diffuse infiltrating astrocytic tumours where there is no identifiable border between the tumour and normal brain tissue, even though the borders may appear relatively well-marginated on imaging."
"These IDH-mutant astrocytomas are now graded 2, 3 or 4 based on histological and molecular features, but importantly, a grade 4 tumour is no longer a glioblastoma, but rather just an astrocytoma, IDH-mutant WHO CNS grade 4 16."
"There is a substantially higher incidence in men of all ages and of all grades tumour (M: F ~1.5) 1,17."
"There is an increasing body of evidence that suggests that concurrent chemoradiotherapy, usually reserved for tumours that progressed to higher grades, may be of benefit in lower grade tumours also."
"the "microcystic changes" along the lines of the spread of the infiltrative astrocytoma is a unique behaviour for the infiltrative astrocytoma; however, it is only appreciated in a small number of cases"
"Patients with low-grade gliomas not meeting low-risk criteria are high-risk and generally benefit from immediate post-operative adjuvant therapy if they present with any adverse prognostic factor. For WHO grade 2 gliomas, adjuvant therapy is conditionally recommended if any high-risk features are present: subtotal resection (≥1 cm residual tumour) or biopsy only, age ≥40 years, maximal tumour diameter ≥4-6 cm, tumour crossing the midline, significant pre-surgical neurologic deficits, or refractory seizures. WHO grade 3 gliomas are inherently high-risk 23."