Article
Interpretation of imaging in patients with suspected brain tumours in daily practise
Wertigkeit der Interpretation von Schnittbildverfahren bei intrakraniellen Raumforderungen im Alltag
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Published: | April 23, 2004 |
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Outline
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Objective
Despite significant advances made in the field of neuroradiology, an inherent rate of diagnostic error still exists. The aim of this study was to investigate the rate of change in clinical diagnosis due to neuroimaging compared to histological findings.
Methods
We retrospectively investigated the charts of 165 patients (49.7% males, 59.3 years, mean), who had a stereotatic biopsy of a suspected brain tumour. We registered the diagnosis of the referring radiologist (RD), the diagnosis of our outpatient department (OD) and the histological diagnosis (HD) after biopsy. In addition we registered surgical complications and the clinical course during hospital stay.
Results
The basal ganglia (16.4%), temporal (15.8%) and frontal region (15%) were the most common locations. 1.2% showed a space occupying bleeding, 8% surgical related complications. Glioblastoma WHO IV (32.7%), astrocytoma WHO II (15.1%), astrocytoma WHO III (13.3%) and B cell lymphoma (7.8%) were the most common histological results. We saw in only 15.7% no change in the diagnosis at the three stages, 77% of these suffered from glioblastoma. There was a significant change in diagnosis comparing the three stages (RD-OD p<0.0001; OD-HD p<0.001; RD-HD p<0.005). Additional imaging data like CCT and MRI did not give additional security in diagnosis (46.1% with changing diagnosis from OD to HD had CCT and MRI, p< 0.025).
Conclusions
There seems to be a high change in diagnosis based only on neuroimaging findings in daily practise. A biopsy to histologically verify the diagnosis is warranted.