ABSTRACT:
Brain tumors are common, requiring general medical providers to have a basic understanding of their diagnosis and management. The most prevalent brain tumors are intracranial metastases from systemic cancers, meningiomas, and gliomas, specifically, glioblastoma. Central nervous system metastases may occur anywhere along the neuroaxis, and require complex multidisciplinary care with neurosurgery, radiation oncology, and medical oncology. Meningiomas are tumors of the meninges, mostly benign and often managed by surgical resection, with radiation therapy and chemotherapy reserved for high-risk or refractory disease. Glioblastoma is the most common and aggressive malignant primary brain tumor, with a limited response to standard-of-care concurrent chemoradiation. This review addresses the specific contributions of nuclear medicine techniques, and especially positron emission tomography (PET), for diagnosis and management of brain tumors. F-Fluorodeoxyglucose PET has particular strengths in predicting prognosis and differentiating cerebral lymphoma from nonmalignant lesions. Amino acid tracers including C-methionine, F-fluoroethyltyrosine, and F-L-3,4-dihydroxyphenylalanine provide high sensitivity, which is most useful for detecting recurrent or residual gliomas, including most low-grade gliomas. They also play an increasing role for planning and monitoring of therapy. F-fluorothymidine can only be used in tumors with absent or broken blood–brain barrier and has potential for tumor grading and monitoring of therapy. Ligands for somatostatin receptors are of particular interest in pituitary adenomas and meningiomas. Tracers to image neovascularization, hypoxia, and phospholipid synthesis are under investigation for potential clinical use.
Cite this article:
Kanchan R. Pagar, Mukta R. Mahale. A Review on Brain Tumour, Etiology and Treatment. Asian Journal of Pharmaceutical Research. 2023; 13(1):51-4. doi: 10.52711/2231-5691.2023.00010
Cite(Electronic):
Kanchan R. Pagar, Mukta R. Mahale. A Review on Brain Tumour, Etiology and Treatment. Asian Journal of Pharmaceutical Research. 2023; 13(1):51-4. doi: 10.52711/2231-5691.2023.00010 Available on: https://asianjpr.com/AbstractView.aspx?PID=2023-13-1-10
REFERENCES:
1. Kleihues P, Louis DN, Scheithauer BW, et al. The WHO classification of tumors of the nervous system. J Neuropathol Exp Neurol. 2002; 61:215–225. discussion 226-219.
2. Reivich M, Kuhl D, Wolf A, et al. The [18F]fluorodeoxyglucose method for the measurement of local cerebral glucose utilization in man. Circ Res. 1979; 44:127–137.
3. Spence AM, Muzi M, Mankoff DA, et al. 18F-FDG PET of gliomas at delayed intervals: Improved distinction between tumor and normal gray matter. J Nucl Med. 2004; 45:1653–1659.
4. Prieto E, Martí-Climent JM, Domínguez-Prado I, et al. Voxel-based analysis of dual-time-point 18F-FDG PET images for brain tumor identification and delineation. J Nucl Med. 2011; 52:865–872.
5. Horky LL, Hsiao EM, Weiss SE, et al. Dual phase FDG-PET imaging of brain metastases provides superior assessment of recurrence versus post-treatment necrosis. J Neurooncol. 2011; 103:137–146
6. Di Chiro G, Oldfield E, Wright DC, et al. Cerebral necrosis after radiotherapy and/or intraarterial chemotherapy for brain tumors: PET and neuropathologic studies. Am J Roentgenol. 1988; 150:189–197.
7. Omuro AM, Leite CC, Mokhtari K, et al. Pitfalls in the diagnosis of brain tumours. Lancet Neurol. 2006; 5:937–948.
8. Makino K, Hirai T, Nakamura H, et al. Does adding FDG-PET to MRI improve the differentiation between primary cerebral lymphoma and glioblastoma? Observer performance study. Ann Nucl Med. 2011; 25:432–438
9. Kosaka N, Tsuchida T, Uematsu H, et al. 18F-FDG PET of common enhancing malignant brain tumors. Am J Roentgenol. 2008; 190:W365–W369.
10. Goldman S, Levivier M, Pirotte B, et al. Regional methionine and glucose uptake in high-grade gliomas: A comparative study on PET-guided stereotactic biopsy. J Nucl Med. 1997; 38:1459–1462.
11. Mosskin M, Ericson K, Hindmarsh T, et al. Positron emission tomography compared with magnetic resonance imaging and computed tomography in supratentorial gliomas using multiple stereotactic biopsies as reference. Acta Radiol. 1989; 30:225–232.
12. irotte BJ, Levivier M, Goldman S, et al. Positron emission tomography-guided volumetric resection of supratentorial high-grade gliomas: A survival analysis in 66 consecutive patients. Neurosurgery. 2009; 64:471–481. discussion 481
13. Pirotte B, Levivier M, Morelli D, et al. Positron emission tomography for the early postsurgical evaluation of pediatric brain tumors. Childs Nerv Syst. 2005; 21:294–300.
14. Epidemiology of childhood cancer. IARC Scientific Publication no.149. Lyon, France: International Agency for Research on Cancer, 1999.
15. Current epidemiological trends and surveillance issues in brain tumours. Expert Rev Anticancer Ther2001; 1:395–401.
16. Wrensch M, Minn Y, Chew T, et al. Epidemiology of primary brain tumours: current concepts and review of the literature. Neuro-oncology 2002; 4:278–99.