Vascular Distribution of Glioblastoma Multiforme at Diagnosis

Treatment of high-grade gliomas with selective intra-arterial (IA) administration of chemotherapies has been proposed, and utilized as a therapeutic modality. This approach offers the conceptual benefit of providing maximal delivery of the agent to the tumor bed, while potentially reducing systemic...

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Bibliographic Details
Published in:Interventional neuroradiology 2013-03, Vol.19 (1), p.127-131
Main Authors: Yohay, K., Wolf, D.S., Aronson, L.J., Duus, M., Melhem, E.R., Cohen, K.J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Brain Neoplasms - blood supply
Brain Neoplasms - pathology
Brain Neoplasms - surgery
Cerebral Arteries - pathology
Cerebrovascular Circulation
Child
Contrast Media
Female
Gadolinium DTPA
Glioblastoma - blood supply
Glioblastoma - pathology
Glioblastoma - surgery
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Original
Preoperative Care
Retrospective Studies
Young Adult
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Summary:Treatment of high-grade gliomas with selective intra-arterial (IA) administration of chemotherapies has been proposed, and utilized as a therapeutic modality. This approach offers the conceptual benefit of providing maximal delivery of the agent to the tumor bed, while potentially reducing systemic exposure to the agent. This retrospective study was designed to determine the vascular distribution of glioblastoma multiforme (GBM) at the time of diagnosis in an effort to determine what proportion of patients would likely be candidates for this approach. The preoperative MRI scans of 50 patients with GBM were analyzed and compared to published normative data of intracranial vascular distribution. Vascular distribution was determined by analyzing post-gadolinium axial and coronal T1 images, axial T2 images, and axial T2 images with an additional 1 cm margin (T2 + 1 cm) added in all dimensions. T1 analysis demonstrated 60% of tumors in a single vascular distribution. T2 analysis of these tumors reduced that number to 34%. When the T2 + 1 cm margin was utilized, only 6% of tumors were in a single vascular distribution. 66% of tumors were limited to the anterior circulation on T1 imaging but only 34% on T2 + 1 cm imaging. 30% of tumors were also within the distribution of the anterior choroidal artery. These findings suggest that the use of selective IA administration of agents is necessarily limited to a fraction of presenting patients or will require administration via multiple cerebral arteries.
ISSN:1591-0199
2385-2011
DOI:10.1177/159101991301900119