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"Astrositoma merupakan salah satu tumor otak primer terbanyak dengan mortalitas yang tinggi. Pemeriksaan MRI dan ADC dapat membantu menentukan derajat astrositoma sebelum dilakukan biopsi histopatologi sehingga edukasi mengenai tatalaksana dan prognosis pasien dapat dilakukan lebih dini. Metode: Penelitian potong lintang ini menggunakan data sekunder MRI kepala pasien dengan histopatologi astrositoma. Penilaian astrositoma dilakukan berdasarkan gambaran MRI menggunakan kriteria Dean dkk dan pengukuran ADC untuk seluruh bagian tumor (Ab) dan bagian tumor padat yang menyangat kontras (Ap) serta beberapa sampel (Ar) pada satu potongan terbesar di ADC map. Analisis data dilakukan untuk mendapatkan nilai diagnostik gambaran MRI dan ADC untuk menentukan derajat astrositoma berdasarkan sensitivitas, spesifisitas, dan kurva receiver operating characteristic (ROC). Hasil: Parameter gambaran astrositoma pada MRI yang bermakna untuk menentukan astrositoma derajat rendah dan tinggi adalah batas, perdarahan, dan heterogenitas. Penggunaan jumlah skoring kriteria Dean dkk pada gambaran astrositoma dengan nilai batas 7 serta penilaian gambaran astrositoma pada MRI untuk menentukan astrositoma derajat rendah dan tinggi memiliki sensitivitas 90,9% dan spesifisitas 87,5%. ADC dengan menggunakan nilai rerata, minimum, dan maksimum pada Ap serta nilai rerata dan minimum pada Ar berbeda bermakna untuk menentukan astrositoma derajat rendah dan tinggi dengan nilai sensitivitas dan spesifisitas masing-masing mencapai 90,9% dan 87,5%. Kesimpulan: MRI dan ADC memiliki sensitivitas dan spesifisitas tinggi untuk menentukan astrositoma derajat rendah dan tinggi.

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Astrocytoma is the most frequent primary brain tumor with high mortality. MRI and ADC could determine astrocytoma grading before histopathological biopsy performed, hence patient education for treatment and prognosis could be established more early.

Method: A cross-sectional research is performed using brain MRI of patients with astrocytoma as histopathological diagnosis. Astrocytoma evaluation using MRI image with Dean et al criteria and ADC measurement for all part of tumor (Ab), single (Ap) and multiple (Ar) solid part of tumor that enhance with contrast administration in one axial section of the largest part of the tumor. Data analysis is performed to obtain diagnostic value of MRI image and ADC to determine astrocytoma grade based on sensitivity, specificity, and receiver operating characteristic (ROC) curve.

Result: MRI image parameters that is significant to determine low and high grade astrocytoma are border, hemorrhage, and heterogeneity. The sum of astrocytoma image scoring of Dean et al criteria with cut-off value of 7 and the evaluation of astrocytoma image in MRI to determine low and high grade astrocytoma has 90,9% sensitivity and 87,5% specificity. ADC, for Ap and Ar, is significant to determine low and high grade astrocytoma with sensitivity up to 90,9% and specificity up to 87,5%.

Conclusion: MRI and ADC has high sensitivity and specificity to determine low and high grade astrocytoma."

"The most recent developments in diagnostic and therapeutic aspects of gliomas (glioblastoma) in the brain are presented. The importance of personalized medicine and clinical validation for targeted therapy are discussed. The identification of various types of biomarkers (determined by molecular genetics) is included, along with their advantages and limitations as markers in tumor detection and diagnosis. The identification and validation of brain cancer (glioblastoma) genes are discussed. The role of cancer stem cells in the initiation and persistence of malignant gliomas is explained, response of glioblastoma cancer stem cells to various growth factors, such as epidermal growth factor receptor kinase inhibitor, is explained. The use of surgical resection, chemotherapy (e.g., temozolomide), immunotherapy, and radiation therapy for glioblastoma patients is included. Biological impediments for chemotherapy and radiotherapy for malignant glioblastoma are pointed out. Standard (established) as well as newer imaging modalities (proton magnetic resonance spectroscopy) are discussed. Also included are proton magnetic resonance spectroscopy in intracranial gliomas, and the use of proton magnetic spectroscopic imaging in determining the infiltration zone in gliomas. The role of molecular signaling in the CNS cancer development is explained, including cell death signaling in glioblastoma multiforme."