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Because of tumor heterogeneity, a biopsy may not adequately sample the most aggressive area of the tumor or sufficiently gauge the extent of genomic deviations within it, making therapeutic decision-making more challenging.
Despite the current standard practice of multicore biopsy sampling, the most aggressive area of the tumour is frequently under-represented or over-represented (Corcoran et al, 2012; Bjurlin and Taneja, 2014).
Thus there exists a need for improved, imaging-guided, biopsy procedures to limit the trauma and to focus the biopsies to the most aggressive area of possible PCa, to limit the number of biopsies, and to take whatever steps that are possible to inhibit or eliminate dissemination of ECM.
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One potential role for heterogeneity images in particular, we believe, is to serve as the guide for dose-boosting techniques for targeting the radiation dose at the most aggressive areas.
This score is determined in the most aggressive tumour area and represents one of the key determinants of RCCC-specific survival (Fuhrman et al, 1982).
HGGs are amongst the most infiltrative and heterogeneous tumors, and it was hypothesized that the most highly aggressive areas were missed; thus, better visualization of these high-risk regions for radiation boost could decrease the recurrence rate.
Grading of gliomas was based on histologic examination of the most aggressive neoplastic tissue area present in specimens obtained by surgical resection or biopsy [ 23].
The most aggressive period in logging in the area was 1884 to 1903, when narrow-gauge railroads were built into the higher-elevation forests, she added.
That's when area wolves are most aggressive "toward strange wolves and dogs," according to a fact sheet at the Department of Natural Resources Web site titled "Dog depredations by wolves in Wisconsin".
On the basis of centralised Gleason grading by expert urologic pathologists, a core was taken for each patient from the area with the least aggressive tumour (low GS) to generate a low-grade TMA (L TMA); in parallel, a core was taken from the area with the most aggressive tumour based on Gleason grading (high GS) to generate a high-grade TMA (H TMA).
At histologic review, representative areas with (the most aggressive) tumor tissue and without necrosis, hemorrhage, or inflammation were selected for analysis.
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