Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Feb 2015
Brain imaging and genetic risk in the pediatric population, part 2: congenital malformations of the central nervous system.
In this article, an update is presented of the correlation of imaging and genetic findings in congenital malformations of the central nervous system (CMCNS). A nonsystematic search of the PubMed/Medline database was performed. ⋯ The highlights of genotype-imaging phenotype correlation of some congenital malformations are provided. It is hoped that developments in genotype-MR phenotype in CMCNS will foster further prognostic and pathogenic breakthroughs for the frequently associated neurologic dysfunction in children affected by these common diseases.
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Despite the recognized limitations of (18)Fluorodeoxyglucose positron emission tomography (FDG-PET) in brain tumor imaging due to the high background of normal gray matter, this imaging modality provides critical information for the management of patients with cerebral neoplasms with regard to the following aspects: (1) providing a global picture of the tumor and thus guiding the appropriate site for stereotactic biopsy, and thereby enhancing its accuracy and reducing the number of biopsy samples; and (2) prediction of biologic behavior and aggressiveness of the tumor, thereby aiding in prognosis. Another area, which has been investigated extensively, includes differentiating recurrent tumor from treatment-related changes (eg, radiation necrosis and postsurgical changes). Furthermore, FDG-PET has demonstrated its usefulness in differentiating lymphoma from toxoplasmosis in patients with acquired immune deficiency syndrome with great accuracy, and is used as the investigation of choice in this setting. ⋯ The value of hypoxia imaging tracers (such as fluoromisonidazole or more recently EF5) is substantial in radiotherapy planning and predicting treatment response. In addition, they may play an important role in the future in directing and monitoring targeted hypoxic therapy for tumors with hypoxia. Development of optimal image segmentation strategy with novel PET tracers and multimodality imaging is an approach that deserves mention in the era of intensity modulated radiotherapy, and which is likely to have important clinical and research applications in radiotherapy planning in patients with brain tumor.