Handbook of Neuro-Oncology Neuroimaging

Front Cover
HANDBOOK OF NEURO-ONCOLOGY NEUROIMAGING
HANDBOOK OF NEURO-ONCOLOGY NEUROIMAGING
Copyright
Dedication
Contents
Contributors
About the editor
Preface
I - Overview of neuro-oncological disorders
1 - Overview of brain tumour epidemiology
Epidemiology of primary brain tumours
Epidemiology of metastatic brain tumours
References
2 - Overview of pathology and treatment of primary brain tumours
Pathology of selected primary brain tumours
Diffuse astrocytomas
Localised astrocytomas
Oligodendrogliomas
Medulloblastoma and other embryonal tumours
Meningioma and other tumours of the meninges
Primary central nervous system lymphoma
Surgical therapy of primary brain tumours
Radiation therapy of primary brain tumours
Chemotherapy of primary brain tumours
Molecular or ‘targeted’ treatment
Tumour Treating Fields
Diet modifications
References
3 - Overview of pathology and treatment of metastatic brain tumors
Pathology of metastatic brain tumors
Surgical therapy of metastatic brain tumors
Radiation therapy of metastatic brain tumors
Chemotherapy of metastatic brain tumors
References
4 - Overview of spinal cord tumour epidemiology
Epidemiology of primary spinal cord tumours
Epidemiology of intramedullary spinal cord metastases
References
5 - Overview of pathology and treatment of primary spinal cord tumours
Pathology of selected primary spinal cord tumours
Surgical therapy of primary spinal cord tumors
Radiation therapy of primary spinal cord tumors
Chemotherapy of primary spinal cord tumours
Molecular or ‘targeted’ treatment
References
6 - Overview of pathology and treatment of intramedullary spinal cord metastases
Pathology of intramedullary spinal cord metastases
Surgical therapy of intramedullary spinal cord metastases
Radiation therapy of intramedullary spinal cord metastases
Chemotherapy of intramedullary spinal cord metastases
References
7 - Epidural spinal cord compression in adult neoplasms
Introduction
Clinical features
Diagnosis
Steroids
Treatment
Summary
References
8 - Leptomeningeal metastases from solid tumours
Epidemiology
Pathogenesis
Clinical features
Diagnosis
Neuroimaging
CSF analysis
Staging
Prognosis
Evaluation and response to treatment
Treatment
Chemotherapy
Systemic therapy
Intra-CSF therapy
Surgery
Radiotherapy
Supportive care
Conclusions
References
9 - Vascular disorders: epidemiology
Introduction
Coagulopathy
Ischemic cerebrovascular events
Intracranial tumour
Treatment effects
Infection
Other
References
10 - Intracranial haemorrhage in cancer patients
Introduction
Aetiology
Tumour-related haemorrhages
Coagulopathy
Treatment effects
Clinical presentation
Diagnosis
Management
References
11 - Central nervous system infarction
Introduction
Imaging evaluation of CNS infarction
Computed tomography
Non-contrast computed tomography
CT angiography (CTA)
CT perfusion
Magnetic resonance
Conventional MRI
Diffusion-weighted imaging
MR angiography
Time-of-flight MRA
Phase contrast MRA
Contrast-enhanced MRA
Clinical utility of MRA
MR perfusion imaging
Catheter angiography
CNS infarction in neuro-oncology
CNS infarction caused by brain tumours
CNS infarction as a result of treatment of brain tumours
Spinal cord infarction in neuro-oncology
Conclusion
References
12 - Intracranial veno-occlusive disease
Introduction
Aetiology
Non-metastatic cerebral venous thrombosis
Metastatic cerebral venous thrombosis
Post-surgical
Clinical features
Diagnosis
Treatment
References
13 - Paraneoplastic syndromes
Introduction
Epidemiology
Antibodies and paraneoplastic neurological disorders
Clinical features
Paraneoplastic cerebellar degeneration
Autoimmune encephalitis
Brainstem encephalitis
Opsoclonus–myoclonus ataxia syndrome
Paraneoplastic chorea
Paraneoplastic myelopathies
Peripheral nervous system disorders
Myasthenia gravis and Lambert–Eaton syndrome
Diagnostic evaluations
Neuroimaging
Electrophysiological studies
CSF analysis
Antibody testing
Tumour surveillance
Treatment
Conclusions
References
14 - Neoplastic plexopathies
Introduction
Classification
Plexus anatomy
Cervical plexus
Brachial plexus
Lumbosacral plexus
Epidemiology and risk factors
Pathogenesis and pathophysiology
Clinical features
Associated neoplastic disorders
Pancoast syndrome
Differential diagnosis
Post-radiation plexopathy
Evaluation
Management
Prognosis and future perspectives
References
15 - Neurologic complications of oncologic therapy
Complications of radiotherapy
Brain
Acute (0–14Days)
Acute encephalopathy
Fatigue
Early delayed (4Weeks to months)
Somnolence syndrome
Pseudo-progression
Transient cognitive impairment
Subacute rhombencephalitis
Late delayed (Months to years)
Radionecrosis
Leukoencephalopathy
Dementia
Mild to moderate cognitive impairment
Radiotherapy-induced tTumours
Vasculopathy
Large vessel atherosclerosis
Vascular malformations
Small vessel disease
Neuroendocrine dysfunction
Spinal cord
Acute
Early–delayed radiation myelopathy
Late–delayed radiation myelopathy
Delayed radiation myelopathy
Radiogenic lower motor neuron disease
Vascular changes
Plexuses and peripheral nerve
Plexopathies
Peripheral nerve
Peripheral neuropathy
Nerve sheath Tumours
Cranial neuropathies
Complications of chemotherapy, targeted therapy and immunotherapy
Chemotherapy-induced cognitive impairment
Antimetabolites
Methotrexate
5-Fluorouracil
Cytosine arabinoside (cytarabine, Ara-C)
Alkylating agents
Ifosfamide
Busulfan
Platinum-based agents
Cisplatin
Oxaliplatin
Carboplatin
Taxanes (paclitaxel and docetaxel)
Vincristine
l-Asparaginase
Anthracycline antibiotics (daunorubicin, doxorubicin, mitoxantrone)
Monoclonal antibodies
Targeted therapies
Immunotherapies
Immune checkpoint inhibitors
CAR T
Summary
References
II - Physics and basic science of neuro-imaging
16 - Physics of computed tomography scanning
Historical development
Image reconstruction
References
Further reading
17 - Physics of computed tomography: contrast agents
History
General principle of X-ray contrast agents
Current applications of contrast agents in computed tomography
Side effects and toxicity
References
18 - Introductory magnetic resonance imaging physics
Introduction
External magnetic field, protons and equilibrium magnetisation
Larmor precession and MRI signal
Radiofrequency energy and resonance
Relaxation
T1 and T2 relaxation
T2∗ relaxation
Image contrast mechanisms
Basic pulse sequence and imaging parameters: repetition time and echo time
Proton density, T1-weighted and T2-weighted images
Proton density images
T1-weighted images
T2-weighted images
Inversion recovery
Chemical shift fat saturation
Dixon techniques for fat suppression
Making an image
Spatial localisation by magnetic field gradients
k-space
Magnetic field gradients, spatial frequencies and k-space
Frequency encoding
Phase encoding
Slice selection
Expanded pulse sequence diagram and two-dimensional versus three-dimensional imaging techniques
Echoes
Spin echoes
Gradient echoes
Spatial encoding with RF coils: parallel imaging
Additional topics relevant to neuroimaging
Diffusion-weighted imaging and diffusion tensor imaging
Susceptibility-weighted imaging
Motion compensation
Making more with less: rapid, continuous and comprehensive imaging
Artificial intelligence and MR physics
Conclusion
References
19 - Advanced magnetic resonance imaging of brain tumours
Diffusion-weighted imaging
Differential diagnosis, grading, monitoring of progression and response
Diffusion tensor imaging for preoperative assessment, surgical guidance and follow-up
Magnetic resonance spectroscopy
Magnetic resonance spectroscopy in differential diagnosis, grading, surgical planning and follow-up
Magnetic resonance spectroscopy in assessment of treatment response
Microvascular imaging in brain tumours: perfusion-weighted imaging and T1-Weighted permeability imaging
Perfusion-weighted imaging
Perfusion-weighted imaging in diagnosis, grading, operative planning and follow-up
T1-weighted permeability imaging
T1-weighted permeability imaging in diagnosis, grading and follow-up
Conclusion
References
20 - Magnetic resonance contrast agents for neuroradiology
Introduction
Contrast media in neuroimaging
Safety
Adverse reactions
Nephrogenic systemic fibrosis
Gadolinium tissue deposition
Future applications
Artificial intelligence applications
References
21 - Physics of high-field magnetic resonance imaging and applications to brain tumour imaging
Introduction
Magnetic resonance imaging physics
Magnetic resonance imaging of brain tumours – state of the art
Indirect measure of pathology
A direct measure of pathology
How magnetic resonance imaging compares with other imaging techniques
High-field imaging: PROS and CONS
High-resolution imaging
Magnetic susceptibility
Static magnetic field: signal-to-noise ratio and magnetic susceptibility
Radio frequency penetration
Other radio frequency issues
Conclusion
Acknowledgements
References
III - Advances in neuro-imaging of brain tumours
22 - Magnetic resonance image guided neurosurgery
Image-guided therapy systems
Choice of MRI scanner and procedural flow
Safety
Patient positioning
Brain tumor resection under intraoperative MRI guidance
Rationale
Multimodality imaging for guiding brain tumor removal
Intraoperative dynamic contrast and perfusion imaging
Tractography
Intraoperative detection of complications
Instrument tracking and neuronavigation
Magnetic resonance imaging–guided thermal ablations and focused ultrasound surgery
Conclusion
References
23 - Neurosurgical treatment planning
Introduction
General considerations in brain Tumour surgery
Pre-operative imaging and mapping strategies
White matter mapping and diffusion MRI
Functional magnetic resonance imaging
Magnetoencephalography
Navigated transcranial magnetic stimulation
Electrocorticography and direct cortical stimulation
Wada testing
Functional applications
Motor mapping
Language localisation
Intraoperative image-guided surgery
Limitations and future directions
Conclusion
References
24 - Use of neuro-imaging for radiation therapy planning
Introduction
Neuro-imaging
Radiation planning and delivery
Quality assurance of imaging and dose delivery
Stereotactic radiosurgery
Practical application of radiotherapy in high-grade glioma
Treatment toxicities
Delineating pseudo-progression, true disease progression and radiation necrosis
Future directions
Conclusion
References
25 - Tumour treating fields: therapy preclinical and clinical data
Introduction
Basic principles of TTFields and preclinical findings
Introduction to the physics of electric fields
Mechanisms of action of TTFields
Cell biology effects of TTFields, preclinical findings, and pilot trials
Clinical application of TTFields
Efficacy of alternating electric fields therapy for glioblastoma
Electric field distribution within cranium and brain
Experimental evidence
Computational model
Modelling results
Future modelling developments
Imaging in patients treated with optune
Response criteria
Pseudo-progression and other treatment-related changes
Advanced imaging techniques
Imaging in patients treated with optune: early experience
Conclusions
References
26 - Advanced imaging techniques and planning for laser interstitial thermal therapy
Clinical applications of laser interstitial thermal therapy
Background
Intraoperative workflow
Potential indications
Primary brain tumours
Brain metastases
Radiation necrosis
Other lesions
Complications and considerations
Pre-operative imaging for laser interstitial thermal therapy
Size and location
Trajectory planning
Diffusion tensor imaging
Functional MRI
Future directions
Post-LITT imaging
Immediately post-op and early stage (0–3 months post-procedure)
Delayed stage (up to 6months post-procedure)
Conclusion
Disclosures
References
27 - Applications of stereotactic radiosurgery in neuro-oncology
Introduction
Foundations of radiosurgery
Target size
Target location
Target proximity to cranial nerves
Delivery of radiosurgery
Photon and proton radiosurgery
Gamma Knife radiosurgery
LINAC radiosurgery
Proton beam radiosurgery
Cranial immobilisation during radiosurgery
Non-invasive fixation
Neuroimaging and radiosurgery
Computerised tomography
Magnetic resonance imaging
CT–MR image integration
Clinical applications of radiosurgery
Cerebral metastases
Meningiomas
Acoustic neuromas
Pituitary adenomas
Prolactinomas
Growth hormone-secreting adenomas
Adrenocorticotropic hormone–secreting adenomas
Nonfunctioning adenomas
Radiation-associated tumour formation
Radiation necrosis
Conclusion
References
28 - Diffusion magnetic resonance imaging in brain tumours
Introduction
Physical basis
Diffusion-weighted MRI
Diffusion tensor MRI
Clinical applications of diffusion MRI in brain tumours
Assessment of extraaxial tumours
Epidermoid tumour versus arachnoid cyst
Meningiomas characterisation
Characterisation of intraaxial masses
Glioma grading
Differentiating tumour histology
Diffusion MRI role in radiogenomics
Diffusion MRI in pre-operative planning and peritumoural margins
Intraoperative diffusion imaging
Role of diffusion MRI in post-treatment evaluation
Early alterations in post-treatment MRI follow-up
Pseudo-progression
Pseudo-response
Coagulative necrosis
Limitations and potential future perspectives
Summary
References
29 - Imaging and measuring diffusion in brain tumours
Magnetic resonance diffusion imaging
Quantitative characterisation of brain tumours with a single diffusion coefficient derived from conventional diffusion-weig ...
Characterisation of brain tumours with multiple diffusion parameters derived from higher-order model analysis of highly dif ...
Diffusion anisotropy for the assessment of nerve fiber tract integrity
Advanced quantitative methods
Intravoxel Incoherent Motion imaging
Diffusion time imaging
Quantification of microscopic diffusion anisotropy
Measuring diffusion of other molecules than water
Considerations in the comparison of quantitative diffusion values
Conclusion
Acknowledgement
References
30 - Functional magnetic resonance imaging
Introduction
General fMRI considerations
Sensory/motor fMRI
Language fMRI
Lateralisation
Localisation
Special considerations for fMRI measurements using brain Tumour patients
The effects of brain tumours and prior surgery on the BOLD fMRI signal
Interpretation pitfalls
Surgical outcomes and future developments
References
31 - Magnetic resonance spectroscopy
Introduction
Clinical applications
Neoplastic versus non-neoplastic
Grading and differential diagnosis
Lesion size
Prognosis and survival
MRSI guidance for therapy
Surgical planning
Radiation planning
Assessment of treatment efficacy/response
Radiation
Chemotherapy
Serial monitoring
Differential diagnosis
Recurrent disease
Malignant transformation of low-grade tumours
Differentiation of radiation necrosis and recurrent tumour
Future directions
References
32 - Perfusion magnetic resonance imaging for brain tumour characterisation and assessment of treatment response
Introduction
Dynamic contrast agent MRI perfusion techniques
Dynamic contrast-enhanced imaging
Basic principles
Imaging methodology
Use of DCE-MRI to characterise non-CNS Tumours
Use of DCE to characterise gliomas and predict treatment response
Toward standardisation of DCE acquisition and postprocessing methods
Dynamic susceptibility contrast imaging
Basic principles
DSC imaging methodology
Choice of DSC imaging sequence
Post-processing of DSC data
Contrast agent leakage effects
Distinction of glioma tumour grade
Distinction of high-grade gliomas from other neoplasms
Potential role of CBF to characterise brain tumours
Assessment of tumour vascular architecture
MR perfusion imaging assessment of peritumoural regions
MR perfusion imaging for assessment of Tumour therapy
Distinction of Tumour recurrence from radiation necrosis
Arterial spin labelling techniques
Summary
References
33 - Positron emission tomography and single-photon emission computed tomography physics
Introduction
SPECT imaging
Introduction to SPECT physics
SPECT instrumentation
Anger camera
Collimator
SPECT image reconstruction and correction
PET imaging
Introduction to PET physics
PET instrumentation
Detector materials
Detector configurations
PET image reconstruction and correction
References
34 - Positron emission tomography and single photon emission computed tomography imaging
Overview
Incidence and prevalence
Brain Tumour classification
Neuroimaging
SPECT imaging
Perfusion agents: [99mTc]HMPAO and [99mTc]ECD
Labelled cations: thallium-201(201TL) and technetium-99m methoxyisobutylisonitrile ([99mTc]MIBI)
Thallium-201
Technetium-99m MIBI
Labelled amino acids: [123I]Iodo-α-methyltyrosine
Labelled somatostatin analogs: [111In]octreotide
PET imaging
[18F]FDG-PET
Tumour detection
Tumour grading and degree of malignancy
Follow-up assessment and monitoring treatment
Other applications
Novel PET tracers [11C]MET, [18F]FET and [18F]FLT
[11C] methionine
[18F] fluoroethyl-l-tyrosine
3, 4-dihydroxy-6-[18F]-fluoro-l-phenylalanine
3′-Deoxy-3′-[18F]fluorothymidine
Conclusions
References
35 - Methionine PET – overview and application to brain tumour imaging and treatment
Limitations of anatomic imaging
Amino acid PET in neuro-oncology
Guiding stereotactic biopsy
References
36 - Ultra-high field magnetic resonance imaging of brain tumours
Introduction
Spatial resolution
Magnetic susceptibility
Imaging tumour oxygenation
Cellular magnetic resonance imaging
MR spectroscopy
Multinuclear imaging and chemical exchange saturation transfer imaging
Acknowledgement
References
37 - Imaging of brain tumours in animal models of central nervous system cancer
Introduction
Magnetic resonance imaging and spectroscopy
Measuring vascular parameters by magnetic resonance imaging
Probing cellular structure and organisation
Assessment of tissue protein/peptide fragments using amide proton transfer
Probing tumour metabolism by magnetic resonance spectroscopy
In vivo bioluminescence imaging
Micro-positron emission tomography
Micro-single-photon emission computed tomography
Recent advances
Conclusions
References
38 - Response assessment in neuro-oncology criteria: overview and future directions
Introduction and background
A brief history of radiologic grading schema in neuro-oncology
RANO criteria for gliomas
Key aspects of imaging and clinical criteria used for RANO evaluation
T1 contrast-enhancing disease
Imaging standardisation
T2/FLAIR imaging
Modified RANO criteria
Limitations of the 2010 RANO criteria
Corticosteroid use
Assessment of patient well-being and neurological functioning – the neurologic assessment in neurooncology scale
RANO criteria for low-grade gliomas
RANO criteria for brain metastases
Application of RANO criteria in the setting of immunotherapy – immunotherapy response assessment in neurooncology
Future directions for RANO
Phase 0/Window of Opportunity studies
RANO criteria for other neurologic malignancies
Future efforts
Conclusion
References
IV - Neuro-imaging of brain tumours
39 - Imaging of malignant astrocytomas
Introduction
Imaging
Advanced imaging techniques
Emerging imaging techniques
Imaging of a treated tumour
References
40 - Low-grade astrocytomas
Introduction
Physiologic imaging
Diffuse astrocytoma
Non-infiltrative astrocytomas
Pilocytic astrocytoma
Pilomyxoid astrocytoma
Pleomorphic xanthoastrocytoma
Subependymal giant cell astrocytoma
Gliomatosis cerebri
Surveillance imaging in low-grade astrocytomas
References
41 - Imaging of oligodendrogliomas
Introduction
Characteristics of oligodendrogliomas on routine CT and MR images
Diffusion-weighted imaging
MR spectroscopy
MR perfusion and permeability imaging
Dynamic susceptibility-weighted contrast-enhanced perfusion imaging
MR permeability imaging – dynamic contrast-enhanced imaging
Functional MRI and fractional anisotropy
Functional MRI
Diffusion tensor imaging – fractional anisotropy
Positron emission tomography
Imaging differentiation of tumour progression from pseudo-progression
Other treatment-related imaging changes
Conclusion
References
42 - Primary central nervous system lymphoma
Introduction
General imaging features
Anatomical distribution
Computed tomography and magnetic resonance imaging
Angiography
Other imaging modalities
Imaging patterns in immunocompetent versus immunocompromised patients
Differential diagnosis of primary CNS lymphoma
Uncommon manifestations of primary CNS lymphoma
Primary leptomeningeal lymphoma
Intravascular lymphomatosis
Lymphomatosis cerebri
Primary lymphoma of the spinal cord
Primary CNS Hodgkin's lymphoma
Primary intraocular lymphoma
Low-grade PCNSL
Mucosa-associated lymphoid tissue lymphoma of the CNS
Primary T cell CNS lymphoma
References
43 - Imaging of CNS ependymomas
Introduction
Epidemiology
Histologic and molecular classification
Differential diagnosis of ependymomas based on imaging
Management of ependymomas
Imaging characteristics of intracranial ependymomas
CT
Anatomical MRI
Diffusion-weighted MRI
Perfusion-weighted MRI
Magnetic resonance spectroscopy
Machine learning and radiomics
Imaging characteristics of spinal ependymomas
CT
Anatomical MRI
Perfusion MRI and MR spectroscopy
Conclusions
References
44 - Pituitary and sellar region lesions
Introduction
Anatomy
Imaging
Solid lesions
Pituitary adenoma
Meningioma
Chiasmatic and hypothalamic gliomas
Germinoma
Metastasis
Schwannoma
Hypothalamic hamartoma
Pituitary hyperplasia
Mixed solid and cystic lesions
Craniopharyngioma
Epidermoid and dermoid
Rathke's cleft cyst
Arachnoid cyst
Empty sella
Pituitary stalk lesions
Miscellaneous lesions
References
45 - Neoplasms of the cranial nerves
Nerve sheath neoplasms
Schwannomas
Introduction
Pathology
Imaging
Cranial nerve VIII—acoustic neuroma (vestibular schwannoma)
Nonvestibular schwannomas
Cranial nerve V—trigeminal schwannomas (neuromas)
Cranial nerve VII—facial nerve schwannomas
Cranial nerves IX, X and XI—jugular foramen schwannomas
Cranial nerve XII—hypoglossal nerve schwannomas
Cranial nerves III, IV and VI—extraocular nerve schwannomas
Cranial nerve I—olfactory nerve schwannomas
Management of non-vestibular schwannomas
Glial neoplasms
Optic pathway gliomas
Introduction
Pathology
Imaging
Management
Primary central nervous system lymphoma
Introduction
Pathology
Imaging
Management
References
46 - Meningeal tumours
Introduction
Imaging of extra-axial tumours
Meningiomas
Imaging evaluation
Magnetic resonance imaging
Advanced MR imaging
Angiographic evaluation
Imaging meningiomas post-embolisation
Post-treatment surveillance of meningiomas
Mesenchymal, non-meningothelial tumours
Hemangiopericytoma
Melanocytic lesions
Other rare lesions
References
47 - Intracranial schwannomas
Introduction – historical
Schwannoma origin
Pathology
Epidemiology
Neurofibromatosis 2
Imaging
Current therapy for VS
Ongoing clinical trials
Non-vestibular schwannomas
Summary
References
48 - Diencephalic and other deep brain tumours
Primary diencephalic tumours
Basal Ganglia–Thalami
Gliomas
Pilocytic astrocytoma
Diffuse or infiltrating astrocytoma
Bilateral thalamic glioma
Oligodendrogliomas
Neuronal and mixed–neuronal–glial tumour
Germ cell tumours
Embryonal tumours
Lymphomas
Metastases
Hypothalamus–optic chiasm
Hypothalamic and chiasmatic gliomas
Hamartoma
Chordoid glioma
Lymphoma
Miscellaneous masses
Tumours that secondarily invade the deep brain
Peripheral brain tumours
Ventricular tumours
Tumours of the pineal region
References
Further Reading
49 - Neuro-imaging of glioneuronal tumors
Introduction
Central and extraventricular neurocytoma
Clinical
Pathology
Imaging
Prognosis/treatment
Cerebellar liponeurocytoma
Clinical
Pathology
Imaging
Prognosis/treatment
Ganglioglioma and gangliocytoma
Clinical
Pathology
Imaging
Prognosis/treatment
Desmoplastic infantile astrocytoma and ganglioglioma
Clinical
Pathology
Imaging
Prognosis/treatment
Dysembryoplastic neuroepithelial tumour
Clinical
Pathology
Imaging
Prognosis/treatment
Dysplastic cerebellar gangliocytoma (Lhermitte–Duclos disease)
Clinical
Pathology
Imaging
Prognosis/treatment
Papillary glioneuronal tumour
Clinical
Pathology
Imaging
Prognosis/treatment
Rosette-forming glioneuronal tumour
Clinical
Pathology
Imaging
Prognosis/treatment
Diffuse leptomeningeal glioneuronal tumour
Clinical
Pathology
Imaging
Prognosis/treatment
Spinal paraganglioma
Clinical
Pathology
Imaging
Prognosis/treatment
Multinodular and vacuolating neuronal tumor
Clinical
Pathology
Imaging
Prognosis/treatment
Myxoid glioneuronal tumor
Clinical
Pathology
Imaging
Prognosis/treatment
Polymorphous low-grade neuroepithelial tumor of the young
Clinical
Pathology
Imaging
Prognosis/treatment
References
50 - Pineal region tumours
Introduction
Anatomy, function, and normal imaging
Epidemiology and pathology
Clinical
Imaging
Pineal calcification
Pineal cysts
Pineal Region Germ Cell Tumors
Germinoma
Non-germinomatous germ cell Tumours
Pineal parenchymal Tumours
Pineoblastomas
Pineocytomas
Pineal parenchymal Tumours of intermediate differentiation
Papillary tumours of the pineal region
Other lesions
Making a diagnosis
Treatment and prognosis
Summary
References
51 - Chordomas and other skull base tumours
Chordoma
Pathology
Clinical presentation
Imaging
Treatment
Chondrosarcoma
Pathology
Clinical presentation
Imaging
Treatment
Other skull base tumours
References
52 - Paediatric brain tumours
Introduction
2021 WHO classification of brain tumours (focus on paediatric population)
Role of the radiologist in paediatric brain tumour diagnosis
Specific paediatric brain tumours
Tumours of the cerebral hemispheres
Gliomas
Diffuse paediatric gliomas
Paediatric diffuse low-grade glioma group
Paediatric diffuse high-grade glioma group
Circumscribed astrocytic gliomas
Pilocytic astrocytomas
Subependymal giant cell tumour
Glioneuronal and neuronal tumours
Dysembryoplastic neuroepithelial tumour (DNT)
DGONC (diffuse glioneuronal tumour with oligodendroglioma-like features and nuclear clusters)
Multinodular and vacuolating neuronal tumour
Dysplastic cerebellar gangliocytoma
Neurocytoma
Supratentorial ependymoma
Choroid plexus tumours
Choroid plexus papilloma
Choroid plexus carcinoma
Posterior fossa tumours
Medulloblastoma
Cerebellar astrocytomas
Brainstem tumours
Pontine tumours
Cervicomedullary tumours
Midbrain tumours
Posterior fossa ependymomas
Atypical teratoid/rhabdoid tumours (AT/RT)
Sellar and suprasellar tumours
Craniopharyngioma
Chiasmatic/hypothalamic gliomas
Hypothalamic hamartoma
Germ-cell tumours
Pituitary adenomas
Langerhans cell histiocytosis
Parameningeal and metastatic tumours
Conclusion
References
53 - Papillary glioneuronal tumours
Introduction
Pathology
Treatment
General imaging features
Features of PGNT on CT
Features of PGNT on MRI
Uncommon manifestations of PGNT
Differential diagnosis on MRI
References
54 - Intracranial metastases
Introduction
Epidemiology
Anatomy
Clinical presentation
Diagnosis
Computed tomography
Magnetic resonance imaging
Techniques to increase lesion conspicuity
Diffusion-weighted imaging
Perfusion-weighted imaging
Magnetic resonance spectroscopy
Nuclear medicine techniques
Prognosis
Recursive partitioning analysis
GPA and disease-specific GPA
Management
Symptom management
Steroids
Anticonvulsants
Whole-brain radiation therapy
Surgery
Stereotactic radiosurgery
Surgery versus SRS
Combination of SRS and WBRT
Preoperative and postoperative SRS
Radiation necrosis
Systemic therapies
Targeted therapies
Brain metastases from NSCLC
Brain metastases from breast cancer
Brain metastases from melanoma
Immunotherapy
Leptomeningeal metastases
Response assessment
Management of recurrences
Conclusion
References
55 - Non-neoplastic mass lesions of the central nervous system
Developmental anomalies
Arachnoid cysts
Cholesteatoma
Colloid cysts
Dermoid cysts
Epidermoid cysts
Epithelial cysts of the CNS
Hamartomas
Intracranial lipoma
Neuroenteric cysts
Pineal cysts
Rathke cleft cysts
Inflammatory disorders
Autoimmune encephalitis
Demyelinating diseases
Idiopathic pachymeningitis
Inflammatory pseudotumor
Infundibulitis and hypophysitis
Primary CNS vasculitis
Rosai–Dorfman disease
Sarcoidosis
Tolosa–Hunt syndrome
Infections
Brain abscess and bacterial CNS infections
Fungal CNS infections
Parasitic infections
Neurocysticercosis
Toxoplasmosis
Viral CNS infections
Herpes simplex encephalitis
Progressive multifocal leukoencephalopathy
Cerebrovascular lesions
Ischemic infarctions
Intracranial Haemorrhage
Other entities
Amyloidoma
Extramedullary hematopoiesis
Polymorphic posttransplant lymphoproliferative disorder
Radiation-induced treatment effects
References
56 - Neuroimaging issues in assessing glioma response to brain tumour therapy
Introduction
Characteristics and management of gliomas
Low-grade glioma
High-grade glioma
Response assessment following treatment
Macdonald criteria
Response evaluation criteria in solid tumours
Response assessment in neuro-oncology
Response assessment in neuro-oncology for LGG
Immunotherapy response assessment in neuro-oncology
Related practical issues
Neuroimaging in clinical trials
Timing of scans
Pseudo-response and angiogenesis inhibitors (Fig. 56.2)
Role of advanced imaging
Conventional MRI imaging
Computer-aided volumetric analysis
Diffusion-weighted imaging
Magnetic resonance spectroscopy imaging
Amino acid positron emission tomography
Radiomics
Summary
References
57 - Pseudo-progression in neuro-oncology: overview, pathophysiology and interpretation
Overview of pseudo-progression
History
Pathophysiology
Histology
Theories of pathophysiology
Methods of differentiation between progression and pseudo-progression
AVAglio protocol
RANO criteria
Limitations of current systems
Immunotherapy Response Assessment in Neuro-Oncology
Novel imaging techniques
Diffusion-weighted MRI
Perfusion imaging
Delayed contrast extravasation MRI
MR spectroscopy
Arterial spin imaging
PET imaging
Amide proton transfer-weighted imaging
Radiomics
Biologic differentiation
Conclusions
References
58 - Pitfalls in the neuro-imaging of brain tumours
Introduction
Imaging features
Extra-axial and meningeal lesions
Intra-axial lesions
Recurrence versus treatment-related changes
References
V - Neuro-imaging of other neuro-oncological syndromes
59 - Neuroradiology of leptomeningeal metastases
Introduction
Brain and spine MRI
Indication
Technical considerations
Imaging findings
Differential diagnosis
Prognostic role and implication for therapeutic options
Response assessment
Radioisotope CSF flow studies
Indications
Technical considerations
Imaging findings
Prognostic role and implications for therapy
Other neuroradiographic modalities
Conclusion
References
60 - Imaging of epidural spinal cord compression
Introduction
Non-metastatic epidural lesions
Metastatic epidural spinal cord compression
Magnetic resonance imaging
Additional imaging modalities
Myelography
Nuclear medicine techniques
Future directions in spinal epidural mass imaging
References
Further reading
61 - Neuroimaging for surgical treatment planning of neoplastic disease of the spine
Introduction
Metastatic spinal tumours
Primary bone tumours
Extramedullary intradural spinal tumours
Meningiomas
Nerve sheath tumours
Intramedullary tumours
Ependymomas
Astrocytomas
Hemangioblastomas
Surgical intervention for spinal tumours
En bloc resection of single metastasis to the spine
Neuroimaging preoperative planning
Magnetic resonance imaging features in spinal metastasis
Leptomeningeal metastasis
Diffusion-weighted imaging
Computed tomography
Differentiation of lytic versus blastic spinal disease
Differential diagnosis of spinal tumours
Dynamic X-rays
Positron emission tomography scan
Single-photon emission computed tomography/computed tomography
Angiography
Conclusions
References
62 - Imaging of plexopathy in oncologic patients
Introduction
Normal anatomy of plexuses
Cervical and brachial plexus
Lumbosacral plexus
Radiographic methods of imaging
Technique – computed tomography
Technique – magnetic resonance
Visualisation of normal plexus components on computed tomography and MRI
Abnormal nerve
Imaging method of choice
Primary plexus neoplasms
Extrinsic plexus tumours
Radiation injury
Future trends
Summary
References
63 - Imaging of peripheral neurogenic tumours
Introduction
Benign peripheral nerve sheath tumours
Neurilemoma
Neurofibroma
Imaging of benign PNSTs
Neurofibromatosis
Neural fibrolipoma
Traumatic neuroma
Nerve sheath ganglion
Morton's neuroma
Glomus tumour
Malignant PNST
Metastases to nerves
Secondary signs
Summary
References
64 - Neuroimaging of cerebrovascular complications in cancer patients
Introduction
Tumour-related cerebrovascular complications
Coagulopathy
Tumour-related haemorrhagic stroke
Direct tumour-related compromise of arterial vasculature
Tumour emboli and neoplastic aneurysms
Leptomeningeal metastases
Therapy-related cerebrovascular complications
Chemotherapy-related cerebrovascular complications
Immunotherapy-related complications
Radiation-induced cerebrovascular complications
Endovascular therapy-related cerebrovascular complications
Imaging of perioperative cerebrovascular complications
Combined tumour- and therapy-related cerebrovascular complications
Carotid blowout syndrome
Mineralising microangiopathy
Infection-related cerebrovascular complications
Miscellaneous tumour-related cerebrovascular conditions
Primary angiitis of central nervous system
Intravascular lymphomatosis
Summary
References
65 - Neuroimaging in paraneoplastic syndromes
Paraneoplastic cerebellar degeneration
Paraneoplastic limbic encephalitis
NMDAR encephalitis
Paraneoplastic brainstem encephalitis
Paraneoplastic chorea
Paraneoplastic myelopathy
Imaging of Occult malignancy in patients with paraneoplastic disorders
Summary
References
Index
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
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