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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleAdult Brain
Open Access

MR Imaging Features of Anaplastic Pleomorphic Xanthoastrocytoma Mimicking High-Grade Astrocytoma

D. She, J. Liu, Z. Xing, Y. Zhang, D. Cao and Z. Zhang
American Journal of Neuroradiology August 2018, 39 (8) 1446-1452; DOI: https://doi.org/10.3174/ajnr.A5701
D. She
aFrom the Departments of Radiology (D.S., J.L., Z.X., D.C.)
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J. Liu
aFrom the Departments of Radiology (D.S., J.L., Z.X., D.C.)
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Z. Xing
aFrom the Departments of Radiology (D.S., J.L., Z.X., D.C.)
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Y. Zhang
bPathology (Y.Z.), First Affiliated Hospital of Fujian Medical University, Fuzhou, P.R. China
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D. Cao
aFrom the Departments of Radiology (D.S., J.L., Z.X., D.C.)
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Z. Zhang
cSiemens Healthcare Ltd (Z.Z.), Shanghai, P.R. China
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Abstract

BACKGROUND AND PURPOSE: Anaplastic pleomorphic xanthoastrocytoma, which has been recently defined as a distinct entity in the 2016 World Health Organization classification, may exhibit aggressive clinical behavior and relatively worse prognosis than pleomorphic xanthoastrocytoma. This study aimed to investigate whether there were any differences in MR imaging characteristics between these 2 tumors.

MATERIALS AND METHODS: This retrospective study included 9 patients with anaplastic pleomorphic xanthoastrocytoma and 10 patients with pleomorphic xanthoastrocytoma who underwent MR imaging before an operation. DWI was performed in 17 patients (8 with anaplastic pleomorphic xanthoastrocytoma, 9 with pleomorphic xanthoastrocytoma); and DSC-PWI, in 9 patients (5 with anaplastic pleomorphic xanthoastrocytoma, 4 with pleomorphic xanthoastrocytoma). Demographics, conventional imaging characteristics (location, size, cystic degeneration, enhancement, peritumoral edema, and leptomeningeal contact), minimum relative ADC ratio, and maximum relative CBV ratio were evaluated between the anaplastic pleomorphic xanthoastrocytoma and pleomorphic xanthoastrocytoma groups.

RESULTS: Anaplastic pleomorphic xanthoastrocytoma was more likely to demonstrate high-grade features than pleomorphic xanthoastrocytoma, including greater maximum tumor diameter (4.7 ± 0.6 cm versus 3.1 ± 1.1 cm, P = .001), more frequent heterogeneous contrast enhancement of solid portions (88.9% versus 20.0%, P = .01), more obvious peritumoral edema (2.3 ± 0.9 cm versus 1.0 ± 0.9 cm, P = .008), lower minimum relative ADC on DWI (1.0 ± 0.2 versus 1.5 ± 0.4, P = .008), and higher maximum relative CBV on DSC-PWI (2.6 ± 0.8 versus 1.6 ± 0.2, P = .036).

CONCLUSIONS: Anaplastic pleomorphic xanthoastrocytomas often have more aggressive MR imaging features mimicking high-grade astrocytomas than pleomorphic xanthoastrocytomas. DWI and DSC-PWI might be useful in the characterization and differentiation of anaplastic pleomorphic xanthoastrocytoma and pleomorphic xanthoastrocytoma.

ABBREVIATIONS:

APXA
anaplastic pleomorphic xanthoastrocytoma
PXA
pleomorphic xanthoastrocytoma
rADCmin
minimum relative ADC
rCBVmax
maximum relative CBV
WHO
World Health Organization
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American Journal of Neuroradiology: 39 (8)
American Journal of Neuroradiology
Vol. 39, Issue 8
1 Aug 2018
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Cite this article
D. She, J. Liu, Z. Xing, Y. Zhang, D. Cao, Z. Zhang
MR Imaging Features of Anaplastic Pleomorphic Xanthoastrocytoma Mimicking High-Grade Astrocytoma
American Journal of Neuroradiology Aug 2018, 39 (8) 1446-1452; DOI: 10.3174/ajnr.A5701

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MR Imaging Features of Anaplastic Pleomorphic Xanthoastrocytoma Mimicking High-Grade Astrocytoma
D. She, J. Liu, Z. Xing, Y. Zhang, D. Cao, Z. Zhang
American Journal of Neuroradiology Aug 2018, 39 (8) 1446-1452; DOI: 10.3174/ajnr.A5701
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