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Help in asseSsing MRI of grade II MIXED OLIGIASTROCYTOMA.

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My mom has a grade 2 mixed oligoastrocytoma that was diagnosed in October 2013. We have had 4 MRIs since then and would like help in explaining the MRIs to us. In May we had an MRI and the neurosurgeon gave us an overview explanation that part of the tumor had decreased in size while another part had increased. However when asked to explain the MRI in full he was unable to do so. We have tried researching the terminology within the report to fully understand what it says but need someone experienced with reading MRI reports to explain them to us in layman's terms and help us understand what the reports mean for her overall cancer and its progression or regression.

Examples include:

enhancement - what does this mean in regards to the tumor? some reports mention minimally enhancing, decreased enhancement, etc., but we do not understand what this really means.

nodular area of enhancement - there was a nodular enhancement that was measurable in October and in the next 2 MRis but in our latest scan it had disappeared. Is this good, insignificant, or bad?

what is a peritumoral cyst and how does this relate to her tumor?

what is methemoglobin and hemosiderin and how does this relate to her tumor?

One report mentions the formation of cysts but the following MRI does not. Would this mean they were not seen in the following MRI?

overall, looking at the MRI reports from October to July does it seem that the tumor is progressing, remaining stable or possibly regressing?

Category: Neurologist, Medical

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Category: Pediatric Neurologist
Dr. Sudhir Kumar is online now

Expert:  Dr. Sudhir Kumar replied 4 Days.


Thank you for posting your query on DoctorSpring.com.

I have noted the details of your mother's case, as well as the reports of the multiple brain scans.

The tumor has overall increased in size, but only to a small extent. This shows that it is cancerous but not highly malignant (cancerous). It seems to be a grade 2 tumor. (Grade 4 is the fastest growing).

Enhancement and nodular enhancement patterns on MRI indicate that the tumor is active, and there are chances in that it would continue to grow. In contrast, a scar or inactive tissue would show no enhancement.

Absence of nodular enhancement is not a significant issue. This is because we know there is an active tumor and it has been confirmed by a biopsy too. Important point here is the size of tumor.

Presence of cyst reflect collection of brain CSF (cerebrospinal fluid), and it is benign (not cancer). This is also a point in support of the fact that this tumor is not very cancerous.

Meth-hemoglobin and hemosiderin are blood products and reflect old areas of haemorrhage of bleeding. These are not related to the tumor.

Yes, if cysts are not there, they would not be reported.

I hope this helps. Feel free to ask queries.

Best wishes,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology) Senior Consultant Neurologist.

Dr. Sudhir Kumar
Category: Pediatric Neurologist
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
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