What does "enhancement" mean on MRI?

My daughter Katie is 2 and has a growing optic glioma impacting the chiasm. Her latest MRI indicates some "enhancement" in the chiasm. I know this is not good - but am a little unsure as to what this means. Does it mean the tumor is gaining mass or getting thicker? Is it changing / growing? If anyone has experience with enhancement in the chiasm - what did this mean for you?...I am assuming this means we will likely start chemo soon, but is this always the case?

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I know with other body parts from MRIs I've had done that "enhancement" just means that there's something there (the signal the MRI received in doing the picture is stronger, thus enhanced). After the word enhanced it should say how large the area of enhancement is. Comparing the size/area of the enhancement from one MRI to the next will let you know if it's growing larger.
Since I don't remember with 100% certainty I don't want to say or guess as to the terminology used for it growing thicker.

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As our daughters docs explained it to us, "enhancement" refers to the tumor's ability to absorb the contrast die that they use during the test (I believe this has to do with the density of the tumor). Our daughter has optic glioma (really thick in left eye) in both eyes and the chiasm. When they were originally found, we were on a 3 month monitoring schedule. Each 3rd month MRI showed growth and increased enhancement . During this time her visual acuity test always revealed normal vision. Her August MRI showed very slight change and her November MRI showed NO changes!!!!


The gliomas have stabilized for now, and her visual acuity tests have shown NO VISION LOSS at this time. We have been really lucky that her vision is not affected.

Considering tumor growth alone, her neuro-oncologist wanted to start chemo last spring. After a lot of prayer and discussions with her oncologist and neuro-opthalmologist, we decided to hold off on chemo. We monitored her every 3 months with MRIs and vision tests. Her tumors STOPPED growing on their own and her vision like I said is stable. Her opthalmologist told us that on chemo the glioma either grow, stabilize or shrink. Without chemo they can grow stabilize or shrink....they are just unpredictable. If we had started chemo in the spring, we would have thought that the chemo was responsible for the stabilization....for now, we watch and wait, hope and pray.

Our daughter's opthalmologist told us that the only reason to start chemo is to stop vision loss, not to shrink the glioma. I am not sure if our experience can be of help to you, but make sure that a neuro-opthalmologist is included in the treatment plan.

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Your post is very helpful. Our oncologist is basically telling us that starting chemo at this point is our decision...It's just a tough choice. I fear visual damage may be permanent - so we'd basically be doing chemo at this point to save her site.

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