CT Scan |
Glioma
Subependymal nodules (periventricular region)
Subependymal astrocytoma
Oligodendroglioma |
Increased tissue cellularity, heterogeneous
Less than 6 in number; Calcified nodules
Isodense nodules obstructing the foramen of Monro, resulting ventricular dilatation
Well defined tumor calcification |
Non-contrast CT Scan |
Subependymal astrocytoma |
Calcification and small cysts |
MRI |
Glioma
Ependymoma |
Ill defined margins, surrounding edema, hemorrhage, necrosis
Rise in choline levels, reduced N-acetyl aspartate
Heterogeneous, cysts, calcification, occasional hemorrhage |
• T1-weighted image |
Glioma
Subependymal astrocytoma |
Hypointense to isointense, pattern with heterogeneous enhancement on contrast infusion, ring enhancement is sometimes seen but less common
Isointense with cerebral cortex
Isointense with the white matter |
• T2-weighted image |
Glioma
Subependymal astrocytoma |
Hyperintense
Isointense with cerebral cortex
Isointense with the white matter
Homogeneous or heterogeneous enhancement |
1H MRS |
Parenchymal lesions
Glioma |
Multiple parenchymal lesions showing increased signal intensity
Increasing choline/creatine/lactate and decreasing N-acetylaspartate correlate with tumor progression, helpful in cases of recurring tumor |
Echo Planar MRI |
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Mapping of tumor blood flow and extends better resolution of tumor versus surrounding edema at tumor border |
SPECT Thallium 201 |
Glioma |
Distinguishes benign from malignant lesions
Amount of thalium uptake correlates with grade of tumor |
1MT SPET |
Glioma |
Employs Iodine-123α methyl L-tyrosine for detecting tumors recurrence |
18F-FDG PET |
Glioma |
Differentiate between recurrent or residual tumor and radiation necrosis |
18F-Fluoromisonidazole PET |
|
Physiologic marker for tumor progression and radioresistance |
Amino acid and amino acid analog PET tracers |
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Amino acid uptake is mediated by type L amino acid carriers, upregulated in tumor vasculature |
18F-FLT |
Glioma |
Biomarker for differentiating between radiation necrosis and tumor recurrence. Marker for tumor proliferation |