====== PRESTO ======

Changes in [[brain tissue]] can be detected sensitively using [[PRESTO]] (principles of echo-shifting with a train of observations) [[magnetic resonance imaging]] (MRI). 

The aim of a study of Iida et al. from the Department of Neurosurgery, [[Hyogo]] College of Medicine, Nishinomiya, [[Japan]], was to evaluate the correlation between the proliferative ability of [[astrocytoma]] and intratumoral spotty [[signal void]]s seen as [[hypointense]] dots on PRESTO MRI.

Fifty-seven [[astrocytic tumor]]s, comprising 14 astrocytomas, 12 anaplastic astrocytomas, and 31 glioblastomas, were included in this retrospective study. The tumors were classified independently by blinded radiologists according to the number of spotty signal voids detected on PRESTO-MRI as follows: spot-free (grade 0), less than 3 spots (grade 1), or more than 3 spots or a large spot (grade 2).

Thirteen patients (92.9%) with astrocytoma were classified as PRESTO grade 0 and 1 patient (7.1%) was classified as grade 1. Seven patients (58.3%) with anaplastic astrocytoma were classified as PRESTO grade 0, 1 (8.3%) as grade 1, and 4 as grade 2 (33.3%). Three patients (9.7%) with glioblastoma were classified as grade 0, 6 (19.4%) as grade 1, and 22 (70.9%) as grade 2. There was a strong correlation between PRESTO tumor grade and the mean MIB-1 index.

These results indicate that a grading system based on the number of spotty signal voids detected on PRESTO images would be useful for the diagnosis of astrocytic tumors and predicting their proliferative ability
((Iida T, Tomogane Y, Takagi T, Miyaji Y, Sakamoto D, Yoshida Y, Ishikura R,
Ando K, Nakagomi N, Hirota S, Yoshimura S. Grading of astrocytomas using the
PRESTO (principles of echo-shifting with a train of observations) magnetic
resonance imaging sequence. Clin Neurol Neurosurg. 2018 Jul 23;173:91-95. doi:
10.1016/j.clineuro.2018.07.016. [Epub ahead of print] PubMed PMID: 30096569.
)).