Imaging brain tumors - 2 - Astrocytomas
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- čas přidán 7. 06. 2024
- Brain tumors are one of the most common diagnoses addressed in neuroradiology. This covers a wide spectrum of disease, from primary brain tumors like gliomas and glioblastomas to secondary disease like metastases. This lecture covers the spectrum of the most common brain tumors, with an emphasis on primary brain tumors.
This video discusses imaging and genetic features of astrocytomas, including low grade astrocytomas (WHO grade 2), anaplastic astrocytoma (grade 3), and glioblastoma (grade 4). By definition, these tumors have intact 1p19q. They can have either IDH mutation or IDH wild type, and IDH mutation is associated with increased survival. Higher grade tumors are more likely to have more mass effect, more enhancement, and less well-defined margins.
Additional videos in the playlist will address the imaging findings of other types of brain tumors.
The level of this lecture is appropriate for radiology residents, radiology fellows, and trainees in other specialties who have an interest in neuroradiology or may see patients with brain tumors.
Check out this video and additional content on www.learnneuroradiology.com
6:23 my brother's CT looked EXACTLY like that. I remember the doctor pointing with his pen and making markings on the films (this was 2001 so digital radiography wasn't common back then) and showing the splinters that went out from the tumor invading other parts of the brain and he was like "we could remove this tumor and all the spikes but there will always be something growing back because they could never get 100% of them. He had Grade 4 astrocytoma and passed away 3 years after diagnosis. In that time he was able to tour the country with his band, he got to go on trips and meet many famous and important people... He always walked with God and always told me he wasn't afraid of dying. Prayers for ALL affected by cancer.
I'm sorry to hear that. Sadly, these tumors are very tricky to deal with because they blend into the normal brain around them. I'm glad your brother was able to have good experiences after his diagnosis, and we keep working to make treatments work better! Thanks for watching the video.
@@LearnNeuroradiology He went through so many crazy surgeries and every single time the doctors would sit my mom down and go over the risks and the benefits and they always would get the tumors out and they would not cause any damage in the surgery or the followup care. I mean he had a part of his skull removed and then they put a metal plate in there and then the plate got infected so they took the plate out and for a year and a half he had a literal hole in his head. I remember one time the worker at Walmart wouldn't let him use the mobility cart (he probably saw 2 teenagers and through we were messing with it) and he didn't want any trouble and he just stood there while the guard was telling him to move and I took the beanie off my brother's head and watched his jaw hit the floor, needless to say that guy learned a valuable lesson. But I digress. Shout out to Dr. Abdoula Farrukh who carried a picture of my brother with him and he performed so many crazy feats one might say he was a miracle worker but his skill as a surgeon gave me and my family a lot of quality time that we otherwise wouldn't have and for that I think of my case as a blessing rather than a tragedy because I know of some people who get diagnosed and are not so fortunate and have terrible quality of life in the few short weeks/months they do survive.
My thoughts go out to you and your family! I'm glad you have those fond memories
@@LearnNeuroradiology thanks for the wonderful comments I appreciate it so much by the way good job in informing people you make very informative and interesting content
Excellent!!! Clear, Sharp information, and now I love Neuroradiology
Great to hear!
thanks you for the explanations of the classifications 👍
My pleasure!
Very nice tnx!
tks for share!
Our pleasure!
Hi. I just got diagnosed with an astrocytoma in my right temporal lobe, main symptom being seizures. I dont really know any other details other than it is 8 by 11 centimeters and I am getting follow ups from duke, UVA, and Johns hopkins. If you had to guess, would you think malignant or benign?
Hi Delaney,
I'm sorry to hear that you got diagnosed with a tumor. I can't tell without more information how benign or malignant it may be. Astrocytomas range all the way from grade 1 (the best outcomes) to grade 4 (the worst outcomes), and yours could be anywhere in between. The good news it it sounds like you have a team of doctors from great places that is helping you out. You can ask them any questions you have, including what grade the tumor is and what the outcomes are like.
I wish you the best of luck in dealing with the tumor though. It's a tough diagnosis but hang in there!
LNR
Hi one of my family members age 30 MRI has reavled that there is a lession occupying 29 X 22 ×27 mm (AP x TR x CC ) in the pineal region of brain , the MRI study reavals that the lesion occupying space is pineocytoma or high grade astrocytoma . Is this curable with surgery ? And what can we expect about life expectancy
I'm sorry to hear that your family member has a brain tumor. There is a pretty big difference between a pineal tumor and an astrocytoma in terms of what the prognosis is. They may not know the diagnosis without taking a biopsy first, then they should be able to tell you more about the proper treatments and prognosis. I'd encourage you to have this discussion with his/her doctor as you all decide upon a treatment course.
Hi, regarding the CT taking in case 2; how do you differentiate it from the ischemia of brain CT (with loss of grey-white differentiation, may cause midline shift (due to edema?)
Thank you for a good and helpful video
That's a great question. You cannot always tell. Hemorrhage and infarcts can be tremendous mimics of tumors because they can also get mass effect. Your best bet is to try to differentiate if they have vasogenic edema (like a tumor) or cytotoxic edema (stroke). Vasogenic edema (tumor) often spares the adjacent cortex, whereas a stroke will have a wedge shape all the way to the cortex.
In this case, if you look closely at the CT (around 2:55), it looks like the insula is spared along the lateral side of the mass. This is confirmed on the MRI (3:08 and 3:36), where you can see a thin rim of normal, but compressed cortex along the right side of the mass. There is also a little bit more mass effect than you usually see with an infarct, but that is not perfect.
Either way, it can be hard sometimes, and you can be fooled. In most situations, the patients are going to get an MRI anyway and you can see the difference. If a patient can't get an MRI, or you don't have one, you could get a short-term follow up. An infarct or hemorrhage will change pretty quickly, but a tumor will not.
@@LearnNeuroradiology Wow! Thank you so much for a great explanation to a medical student struggling with radiology!
No problem. Keep up the hard work and you gradually will understand more!
So my mother in law has a anaplastic astrocytoma, honoustly on avg what is the life expectency of this I'm aware she will pass cause of this, but if it weeks or months or years
Hi Henry. First, I'm sorry to hear that your family member has an anaplastic astrocytoma. It can definitely be hard to hear about this, and hopefully you have a supportive medical team and family members who can help you through this.
Anaplastic astrocytomas have a life expectancy of years, not months or weeks. It depends a lot on the location, genetics of the tumor, and treatment (whether it is resected, treated with radiation). You can talk to your doctor more about what the expected course is and they should be able to tell you more.
Hi.My father has been diagnosed high grade astrocytoma in 3rd vertical and left lateral vertical underwent surgery in nov 2021 nd removed only 10% and currently he is undergoing with chemotherapy and he also underwent to radiation after the surgery
I'm sorry to hear that. Good luck with the treatment and I hope your family can support him well.
Can chemotherapy shrink the tumor? Is there any chance to undergo for grade4
I had a grade 2 Astroytoma, I had surgery and 100% was removed, if it were to return would it most likely to be grade 3?
Not always. Sometimes grade 2 tumors come back as grade 2 tumors again. You can sometimes tell on imaging because they look the same as they did before they were removed.
Sometimes they come back as a higher grade, such as grade 3 or grade 4. Imaging might look worse, like more enhancement or faster growth.
Glad you had a good recovery after surgery and best of luck in the future.
@@LearnNeuroradiology thank you so much for your reply, honestly really appreciate it, it’s been eating me up as google just scares me with answers such as it will grow back more aggressive, you’ve made me feel at ease that god forbid if it were to come back it could come back as the grade 2, thank you 😊❤️ best wishes for 2021
@@JessM5775 hi hi are you
Diffusse astrosytma kya hota hai
Seizure from workplace, CT came fine, but MRI got a leson, low grade astrocytoma, now on keppra. Location, Canada.
My sister has been diagnosed with Astrocytoma grade 3. She has lost feeling in her legs and can’t get around. The medical team can’t remove the tumor because it’s on both sides of her brain. On the second scan it looked like it shrunk but there seems to be another section growing? I don’t know what to think, but is it possible she can get use of her leg? I’m so worried.
I'm sorry to hear that. It sounds like it has been a bit of a struggle. Many of these tumors are not resectable and require a combination of treatments, including surgery, radiation, and chemotherapy. Unfortunately, most of them are not completely curable although they can sometimes be kept under control for months to years. Sometimes parts of the tumor get better while other parts may bet worse.
I think the best thing to do is discuss your concerns with her doctors to see what can be done and to see if a new therapy or a change in therapy is warranted. Hopefully they can help you with these concerns. Good luck!
sir, I had a non enhansing lesion in left lobe,and removed it by surgery on 14/06/2019_(astrocytoma grade 2 ).Checking by MRI scanning ,between every 6months.Now miled increase in lesion,Ie-28cm*30cm*32cm.now in 50years old
Sorry to hear you had a brain tumor. We are doing our best to find new treatments for patients such as yourself! Good luck.
@@LearnNeuroradiology Sir, now I, using levipil - 500 (1_o _ 1) .And B/P, Blood sugar Pills .ടir, what I Can to do ? Please reply
Nice helpful video thank you so much
But the voice pitch! please is not so clear!
Awww man... that's my voice!
Haha, thanks for the feedback and I'm glad you like the video. I'll be sure to try to make sure the audio is as clear as possible in future videos.
@@LearnNeuroradiology awww sorry I didn't mean that🙏
This is good effort with really nice info continue on🌹👏🏻waiting for more
@@LearnNeuroradiology Just speak louder.
low grade astrocytoma is a benign or bad-tempered?
When most people say low-grade astrocytoma, they mean grade 2 diffuse astrocytoma. They are malignant tumors (bad-tempered) that usually return even after surgery.
Some other tumors are well circumscribed and surgery is generally curative (or at least a high probability of cure), like pilocytic astroctyoma (WHO grade 1)
@@LearnNeuroradiology please! grade 2 diffuse astrocytoma who shows loss of expression of ATRX and positivity of IDH1 is a begnin ?
I've a tumor with the characteristics mentioned above on the occipital lobe, and I'll receive aggressive surgery
what do you think about the chances of high grade development or returning after surgery
thank you in advance
@@absoluuut I'm sorry to hear that you have a tumor. Unfortunately, grade 2 tumors are not entirely benign in that they will often come back. However, there are some very effective treatments including surgery and radiation. You should talk to your doctor about the chances of your own tumor coming back and how to best follow up.
Had craniotomy may 1 2024 to find out my tumor on left temporal lobe. No pathology yet
Sorry to hear you have a tumor. I hope you get optimistic results! Thanks for watching the video.
Is anaplastic astorcytoma curable by only neo adjuvant chemotherapy and radiotherapy if tumour recieving the treatment??
Most of the time, these tumors are not completely cured, even by surgery. That means that at some time in the future they may come back. However, treatments like chemotherapy and radiotherapy can stop the tumor from growing for many years.
@@LearnNeuroradiology Her doctor is saying that she will recover faster and she doesn't need surgery as she has a very small tumor...so what is your opinion Sir...? Please suggest me. Sir she is only 18. Please suggest a cure for her Sir.
Sir after she get her treatment completed is there any life risk for her??
Yes, there is always a risk that these tumors return, but it depends on a lot of factors including the size, location, type of tumor, and treatment. You should discuss these things with your doctors to get the most accurate opinion.
@@LearnNeuroradiology ok sir thanks you sir 😊
Please make it audible.. your video looks very useful and informative but your voice can’t be completely heard.
Sorry for that. I've been trying to make the audio better on more recent videos and I'll come back and edit these at some point.
I m suffering from brain astrostoma hydrocephalus glioma. Please what can I contact u for treatment
Can normal CT scan shows the tumour on our brain.
CT can show large tumors that have mass effect or edema. It will not identify smaller tumors.
@@LearnNeuroradiology I did the non contrasted CT. So non contrasted CT scan also shows the tumour on our brain.
I can't hear a thing :'D sounds like me when I'm hungover. It's really not your fault though, my hearing can be poor.
You're not the first to complain, so probably I can try to speak a little more clearly!
@@LearnNeuroradiology I saw you explain in one of the replies below that it's your voice, I can't expect you to change that. My hearing is also not top notch so it's really alright. Thanks.
No it's not just you, his voice is rather deep, and with as close as he was to the mic during recording it made it sound kinda like lots of clicks and grunts/grumbles.
Had he backed away from the mic, and spoken louder it most likely would have been easier to understand and make out what he is saying.
Also everyone is different, some people have a hard time hearing low frequency, or deep sounds, but are then able to hear high pitched, or high frequency sounds extremely well. Then there are those who can't hardly hear high pitched/frequency sounds, but can very easily hear low frequency or deep sounds extremely well.
My mother is the type who falls into the latter category of not hearing high pitched/frequency sounds, but can hear low frequency or deep sounds extremely well. So I always have to turn the base down in my vehicle when she rides with me, or it bothers her. I am the exact opposite and hear high pitched/frequency sounds well, but not the low or deep, which is why I like to turn up my base, and turn down my treble.
my family member have a anaplastic astrocytoma grade 3 tumor. doctor operate first time and doctor told us it's completely removed. and after surgery and radiotherapy my family member had patient recovering very fast .but suddenly after 7 monts tumor come back then doctor operate 2nd time and after surgery doctor say it's completely removed.but after 2nd radiotherapy patient after sometime patient became weak day by day .every after 3 months doctor did MRI scan now after one year MRi scan tumor come back .so what the solution of this tumor? patient age 34 years old. plz sir tell me
I'm sorry to hear about your family member. These tumors are very challenging to deal with because they infiltrate into the brain next to them. You can't remove them without taking out too much normal brain. That's why most of the time they need radiation and chemotherapy as well. Even then, they often come back. Right now, the best solution we have is to get repeat MRIs to see if the tumor has come back and then make a new plan to do new more surgery or radiation.
Best of luck to you and your family though.
@@LearnNeuroradiology thanku so much for your advice sir.
Hi sir My age is 24 Astrocytoma, IDH mutant, WHO grade is Butu p53 (Clone BP5312, PathnSitu): Occasional cells are positive.
Doctor says p53 is active in non cancer tumor
Cancer may develop in future
Help me for some treatment
I'm sorry you have a tumor but luckily it sounds like a lower grade. You'll have to talk to your doctor about what the best treatment options are.
How are you right now brother?
Dataset of astrocytoma available?
Not sure what you mean. There are some public datasets of astrocytomas available
The voice no good, isn't clear.
Not clearly audible
There are other ways to learn this topic other than these videos if they are not for you, I guess.
His voice makes it hard to understand. Can people jus use normal voice rather then an alter one?
This is obviously not an altered voice. Over time I've tried to improve my voice and the recording quality. Why don't you check out some of the newer videos.
Hi
Could you speak with a normal voice? Looks like you were sleepy
Lol bro that's the most original comment you got? Another guy said "Nice video, Vader". That was original.
Try again