Germinoma MRI: Difference between revisions

	Germinoma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Epidemiology and Demographics
Risk Factors
Screening
Differentiating Germinoma from other Diseases
Natural History, Complications and Prognosis
Diagnosis
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Germinoma MRI On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Germinoma MRI All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA onGerminoma MRI
CDC on Germinoma MRI
Germinoma MRI in the news
on Germinoma MRI
Directions to Hospitals Treating Germinoma
Risk calculators and risk factors for Germinoma MRI

VisualWikitext

Latest revision as of 23:34, 26 November 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [4]

Overview

MRI of the brain and spine with and without gadolinium is the imaging modality of choice for germinoma. On MRI, intracranial GCTs appear isointense or hypointense on T1 sequences and hyperintense on T2 sequences.^[1]

MRI

On head and neck MRI, intracranial GCTs appear isointense or hypointense on T1 sequences and hyperintense on T2 sequences. Germ cell tumors typically show homogeneous enhancement with gadolinium or heterogeneous enhancement if cysts are present. Since imaging characteristics of the histologic subtypes are similar, and MRIs cannot reliably distinguish germinomas from non germinomatous germ cell tumors NGGCTs. Since leptomeningeal metastasis is present at diagnosis in 10-15% of patients, MRI of the entire spine is indispensable for adequate staging of intracranial GCTs.^[2]^[3]^[4]^[5]^[6]


Type of the tumor	Features on MRI

Germinoma	Germinomas are homogeneous and show isointensity or slightly low signal intensity on T1-weighted images, and isointensity or high intensity on T2-weighted images
Nongerminomatous germ cell tumor	NGGCTs are more heterogeneous and may have hemorrhage
Malignant teratoma	Malignant teratomas are heterogeneous, with small cysts and irregular tumor margins, and may demonstrate peri-tumor edema

MRI demonstrates a soft tissue mass, typically ovoid or lobulated in contour, engulfing the calcified pineal gland with the following signal characteristic:


MRI component	Features

T1	isointense or slightly hyperintense to adjacent brain
T2	isointense or slightly hyperintense to adjacent brain may have areas of cyst formation may have areas of haemorrhage have a predilection to invade adjacent brain central calcification appears low signal
T1 contrast + gadolinium	vivid and homogenous

MRI showing Axial T1 image of germinoma of CNS^[7]
MRI showing Axial T2 image of pineal germinoma^[7]
Coronal T1 C+ MRI of germinoma of third ventricle^[7]
Coronal T2 MRI of suprasellar germinoma^[7]
Sagittal T1 C+ of suprasellar germinoma^[7]

References

↑ Germinoma. Radiopedia(2015) http://radiopaedia.org/articles/central-nervous-system-germinoma Accessed on January 25, 2016
↑ Liang L, Korogi Y, Sugahara T, Ikushima I, Shigematsu Y, Okuda T; et al. (2002). "MRI of intracranial germ-cell tumours". Neuroradiology. 44 (5): 382–8. doi:10.1007/s00234-001-0752-0. PMID 12012121.
↑ Douglas-Akinwande AC, Ying J, Momin Z, Mourad A, Hattab EM (2009). "Diffusion-weighted imaging characteristics of primary central nervous system germinoma with histopathologic correlation: a retrospective study". Acad Radiol. 16 (11): 1356–65. doi:10.1016/j.acra.2009.05.004. PMID 19643635.
↑ Ogiwara H, Tsutsumi Y, Matsuoka K, Kiyotani C, Terashima K, Morota N (2015). "Apparent diffusion coefficient of intracranial germ cell tumors". J Neurooncol. 121 (3): 565–71. doi:10.1007/s11060-014-1668-y. PMID 25413617.
↑ Jennings MT, Gelman R, Hochberg F (1985). "Intracranial germ-cell tumors: natural history and pathogenesis". J Neurosurg. 63 (2): 155–67. doi:10.3171/jns.1985.63.2.0155. PMID 2991485.
↑ Packer RJ, Cohen BH, Cooney K, Coney K (2000). "Intracranial germ cell tumors". Oncologist. 5 (4): 312–20. PMID 10964999.
↑ ^7.0 ^7.1 ^7.2 ^7.3 ^7.4 Image courtesy of Dr. Ahmed Abd Rabou [1] (original file [2]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC

Template:WikiDoc Sources

[radio-1] Germinoma. Radiopedia(2015) http://radiopaedia.org/articles/central-nervous-system-germinoma Accessed on January 25, 2016

[pmid12012121-2] Liang L, Korogi Y, Sugahara T, Ikushima I, Shigematsu Y, Okuda T; et al. (2002). "MRI of intracranial germ-cell tumours". Neuroradiology. 44 (5): 382–8. doi:10.1007/s00234-001-0752-0. PMID 12012121.

[pmid19643635-3] Douglas-Akinwande AC, Ying J, Momin Z, Mourad A, Hattab EM (2009). "Diffusion-weighted imaging characteristics of primary central nervous system germinoma with histopathologic correlation: a retrospective study". Acad Radiol. 16 (11): 1356–65. doi:10.1016/j.acra.2009.05.004. PMID 19643635.

[pmid25413617-4] Ogiwara H, Tsutsumi Y, Matsuoka K, Kiyotani C, Terashima K, Morota N (2015). "Apparent diffusion coefficient of intracranial germ cell tumors". J Neurooncol. 121 (3): 565–71. doi:10.1007/s11060-014-1668-y. PMID 25413617.

[pmid2991485-5] Jennings MT, Gelman R, Hochberg F (1985). "Intracranial germ-cell tumors: natural history and pathogenesis". J Neurosurg. 63 (2): 155–67. doi:10.3171/jns.1985.63.2.0155. PMID 2991485.

[pmid10964999-6] Packer RJ, Cohen BH, Cooney K, Coney K (2000). "Intracranial germ cell tumors". Oncologist. 5 (4): 312–20. PMID 10964999.

[radio1-7] 7.0 ^7.1 ^7.2 ^7.3 ^7.4 Image courtesy of Dr. Ahmed Abd Rabou [1] (original file [2]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC

[1]

[2]

[3]

[4]

[5]

[6]

[7]

@@ Line 3: / Line 3: @@
 {{CMG}}{{AE}}{{Simrat}}
 ==Overview==
+MRI of the brain and spine with and without gadolinium is the imaging modality of choice for germinoma. On MRI, intracranial GCTs appear isointense or hypointense on T1 sequences and hyperintense on T2 sequences.<ref name="radio"> Germinoma. Radiopedia(2015) http://radiopaedia.org/articles/central-nervous-system-germinoma Accessed on January 25, 2016</ref>
 ==MRI==
-MRI demonstrates a soft tissue mass, typically ovoid or lobulated in contour, engulfing the calcified pineal gland with the following signal characteristics 12:
+On head and neck MRI, intracranial GCTs appear isointense or hypointense on T1 sequences and hyperintense on T2 sequences. Germ cell tumors typically show homogeneous enhancement with gadolinium or heterogeneous enhancement if cysts are present. Since imaging characteristics of the histologic subtypes are similar, and MRIs cannot reliably distinguish germinomas from non germinomatous germ cell tumors NGGCTs. Since [[leptomeningeal]] [[metastasis]] is present at diagnosis in 10-15% of patients, MRI of the entire spine is indispensable for adequate staging of intracranial GCTs.<ref name="pmid12012121">{{cite journal| author=Liang L, Korogi Y, Sugahara T, Ikushima I, Shigematsu Y, Okuda T et al.| title=MRI of intracranial germ-cell tumours. | journal=Neuroradiology | year= 2002 | volume= 44 | issue= 5 | pages= 382-8 | pmid=12012121 | doi=10.1007/s00234-001-0752-0 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12012121  }} </ref><ref name="pmid19643635">{{cite journal| author=Douglas-Akinwande AC, Ying J, Momin Z, Mourad A, Hattab EM| title=Diffusion-weighted imaging characteristics of primary central nervous system germinoma with histopathologic correlation: a retrospective study. | journal=Acad Radiol | year= 2009 | volume= 16 | issue= 11 | pages= 1356-65 | pmid=19643635 | doi=10.1016/j.acra.2009.05.004 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19643635  }} </ref><ref name="pmid25413617">{{cite journal| author=Ogiwara H, Tsutsumi Y, Matsuoka K, Kiyotani C, Terashima K, Morota N| title=Apparent diffusion coefficient of intracranial germ cell tumors. | journal=J Neurooncol | year= 2015 | volume= 121 | issue= 3 | pages= 565-71 | pmid=25413617 | doi=10.1007/s11060-014-1668-y | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25413617  }} </ref><ref name="pmid2991485">{{cite journal| author=Jennings MT, Gelman R, Hochberg F| title=Intracranial germ-cell tumors: natural history and pathogenesis. | journal=J Neurosurg | year= 1985 | volume= 63 | issue= 2 | pages= 155-67 | pmid=2991485 | doi=10.3171/jns.1985.63.2.0155 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2991485  }} </ref><ref name="pmid10964999">{{cite journal| author=Packer RJ, Cohen BH, Cooney K, Coney K| title=Intracranial germ cell tumors. | journal=Oncologist | year= 2000 | volume= 5 | issue= 4 | pages= 312-20 | pmid=10964999 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10964999  }} </ref>
+{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
+|valign=top|
+|+
+! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Type of the tumor}}
+! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Features on MRI}}
+|-
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
+:Germinoma
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Germinomas are homogeneous and show isointensity or slightly low signal intensity on T1-weighted images, and isointensity or high intensity on T2-weighted images
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
+:Nongerminomatous germ cell tumor
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*NGGCTs are more heterogeneous and may have hemorrhage
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
+:Malignant teratoma
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Malignant teratomas are heterogeneous, with small cysts and irregular tumor margins, and may demonstrate peri-tumor edema
+|-
+|}
+MRI demonstrates a soft tissue mass, typically ovoid or lobulated in contour, engulfing the calcified pineal gland with the following signal characteristic:
+{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
+|valign=top|
+|+
+! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|MRI component}}
+! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Features}}
+|-
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
+:T1
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*isointense or slightly hyperintense to adjacent brain
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
+:T2
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*isointense or slightly hyperintense to adjacent brain
+*may have areas of cyst formation
+*may have areas of haemorrhage
+*have a predilection to invade adjacent brain
+*central calcification appears low signal
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
+:T1 contrast + gadolinium
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*vivid and homogenous
+|-
+|}
+<gallery>
+Axial T2 germinoma.jpg|MRI showing Axial T1 image of germinoma of CNS<ref name="radio1">Image courtesy of Dr. Ahmed Abd Rabou [http://radiopaedia.org/images/344845] (original file [http://radiopaedia.org/cases/germinoma-of-the-central-nervous-system]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref>
+Axial T2 pineal.jpg|MRI showing Axial T2 image of pineal germinoma<ref name="radio1">Image courtesy of Dr. Ahmed Abd Rabou [http://radiopaedia.org/images/344845] (original file [http://radiopaedia.org/cases/germinoma-suprasellar]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref>
+Coronal T1 C1.jpg|Coronal T1 C+ MRI of germinoma of third ventricle<ref name="radio1">Image courtesy of Dr.  A.Prof Frank Gaillard [http://radiopaedia.org/images/344845] (original file [http://radiopaedia.org/cases/germinoma01]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref>
+Coronal T2.jpg|Coronal T2 MRI of suprasellar germinoma<ref name="radio1">Image courtesy of Dr. A.Prof Frank Gaillard [http://radiopaedia.org/images/344845] (original file [http://radiopaedia.org/cases/germinoma-suprasellar]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref>
+Sagittal C1.jpg|Sagittal T1 C+ of suprasellar germinoma<ref name="radio1">Image courtesy of Dr. A.Prof Frank Gaillard [http://radiopaedia.org/images/344845] (original file [http://radiopaedia.org/cases/germinoma-suprasellar]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref>
+</gallery>
-T1: isointense or slightly hyperintense to adjacent brain
-T2
-isointense or slightly hyperintense to adjacent brain
-may have areas of cyst formation
-may have areas of haemorrhage (low signal)
-have a predilection to invade adjacent brain (oedema)
-central calcification appears low signal (engulfed pineal gland)
-T1 C+ (Gd): vivid and
 ==References==
 {{Reflist|2}}
-[[Category:Needs content]]
 [[Category:Disease]]
 [[Category:Types of cancer]]
@@ Line 27: / Line 77: @@
 {{WikiDoc Help Menu}}
 {{WikiDoc Sources}}
+ [[Category:Up-To-Date]]
+[[Category:Oncology]]
+[[Category:Medicine]]
+[[Category:Neurology]]
+[[Category:Neurosurgery]]

Germinoma MRI: Difference between revisions

Latest revision as of 23:34, 26 November 2017

Overview

MRI

References

Navigation menu