scholarly journals Overestimation of grey matter atrophy in glioblastoma patients following radio(chemo)therapy

Author(s):  
A. Gommlich ◽  
F. Raschke ◽  
J. Petr ◽  
A. Seidlitz ◽  
C. Jentsch ◽  
...  

Abstract Objective Brain atrophy has the potential to become a biomarker for severity of radiation-induced side-effects. Particularly brain tumour patients can show great MRI signal changes over time caused by e.g. oedema, tumour progress or necrosis. The goal of this study was to investigate if such changes affect the segmentation accuracy of normal appearing brain and thus influence longitudinal volumetric measurements. Materials and methods T1-weighted MR images of 52 glioblastoma patients with unilateral tumours acquired before and three months after the end of radio(chemo)therapy were analysed. GM and WM volumes in the contralateral hemisphere were compared between segmenting the whole brain (full) and the contralateral hemisphere only (cl) with SPM and FSL. Relative GM and WM volumes were compared using paired t tests and correlated with the corresponding mean dose in GM and WM, respectively. Results Mean GM atrophy was significantly higher for full segmentation compared to cl segmentation when using SPM (mean ± std: ΔVGM,full = − 3.1% ± 3.7%, ΔVGM,cl = − 1.6% ± 2.7%; p < 0.001, d = 0.62). GM atrophy was significantly correlated with the mean GM dose with the SPM cl segmentation (r = − 0.4, p = 0.004), FSL full segmentation (r = − 0.4, p = 0.004) and FSL cl segmentation (r = -0.35, p = 0.012) but not with the SPM full segmentation (r = − 0.23, p = 0.1). Conclusions For accurate normal tissue volume measurements in brain tumour patients using SPM, abnormal tissue needs to be masked prior to segmentation, however, this is not necessary when using FSL.

Author(s):  
Mark Robert Keezer ◽  
Rolando Del Maestro

The case of a 51-year-old man diagnosed with two acquired cavernous hemangiomas 17 years after cranial irradiation for a cerebellar astrocytoma is reported. A review of 84 cases of radiation-induced cavernous hemangiomas found in the literature is presented. In this series the mean age at the time of irradiation (±SD) was 10.4 ± 2.0 years (median = 8 years), while the mean time to cavernous hemangioma diagnosis (±SD) was 10.3 ± 1.9 years (median = 8 years). Time to cavernous hemangioma diagnosis was found to be inversely related to radiation dose. Hemorrhage from radiation-induced cavernous hemangiomas was found in 40.0% of patients, with an incidence of 3.9% per patient year. An inverse trend was identified between radiation dose and symptomatic presentation, cavernous hemangioma hemorrhage or surgical resection. This review of radiation-induced cavernous hemangiomas confirms that both younger patients and those who received a larger dose of radiation are at increased risk of radiation-induced cavernous hemangiomas. Our results suggest that, based on an assessment of CT or MR images, there may be an increased risk of hemorrhage when comparing radiation-induced to congenital cavernous hemangiomas. Increasing radiation doses appear to stabilize these lesions, decreasing the risk of a symptomatic presentation, cavernous hemangioma hemorrhage and surgical intervention.


2013 ◽  
Vol 12 (1) ◽  
pp. 71-76 ◽  
Author(s):  
David S. Hersh ◽  
Jonathan Chun ◽  
Howard L. Weiner ◽  
Steven Pulitzer ◽  
Henry Rusinek ◽  
...  

Object In patients with tuberous sclerosis complex (TSC), the tuber-to-brain proportion (TBP) is a marker of seizure severity and cognitive function. However, few studies have quantified the TBP. Furthermore, authors of these studies have measured the TBP at only a single time point, despite the fact that tuber cells were found to express proliferation markers, suggesting that they may be dynamic lesions. Authors of the present study used a semi-automated tuber segmentation program to determine whether the TBP changes over time. Methods Axial FLAIR MR images were retrospectively identified for patients with TSC who had undergone imaging at the authors' institution between February 1998 and June 2009. Using FireVoxel software, the TBP was measured for each patient at a minimum interval of 2 years. Results Twelve patients meeting the study inclusion criteria were identified. The mean TBP was 1.88% (range 0.38%–3.70%). Eight patients demonstrated minimal changes and 3 patients demonstrated small increases in TBP. The remaining patient exhibited a decrease of 1.00%, which correlated with a visible decrease in the size of 2 cerebellar lesions. Conclusions Semi-automated brain segmentation is a valuable tool in the longitudinal study of tubers. A subset of patients with TSC, particularly those with cerebellar lesions, may exhibit changes in the TBP over time.


Author(s):  
Gildas Patet ◽  
Andrea Bartoli ◽  
Torstein R. Meling

AbstractRadiation-induced cavernous malformations (RICMs) are delayed complications of brain irradiation during childhood. Its natural history is largely unknown and its incidence may be underestimated as RCIMS tend to develop several years following radiation. No clear consensus exists regarding the long-term follow-up or treatment. A systematic review of Embase, Cochrane Library, PubMed, Google Scholar, and Web of Science databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed. Based on our inclusion/exclusion criteria, 12 articles were included, totaling 113 children with RICMs, 86 were treated conservatively, and 27 with microsurgery. We were unable to precisely define the incidence and natural history from this data. The mean age at radiation treatment was 7.3 years, with a slight male predominance (54%) and an average dose of 50.0 Gy. The mean time to detection of RICM was 9.2 years after radiation. RICM often developed at distance from the primary lesion, more specifically frontal (35%) and temporal lobe (34%). On average, 2.6 RICMs were discovered per child. Sixty-seven percent were asymptomatic. Twenty-one percent presented signs of hemorrhage. Clinical outcome was favorable in all children except in 2. Follow-up data were lacking in most of the studies. RICM is most often asymptomatic but probably an underestimated complication of cerebral irradiation in the pediatric population. Based on the radiological development of RICMs, many authors suggest a follow-up of at least 15 years. Studies suggest observation for asymptomatic lesions, while surgery is reserved for symptomatic growth, hemorrhage, or focal neurological deficits.


2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Elin Wallstén ◽  
Jan Axelsson ◽  
Joakim Jonsson ◽  
Camilla Thellenberg Karlsson ◽  
Tufve Nyholm ◽  
...  

Abstract Background Attenuation correction of PET/MRI is a remaining problem for whole-body PET/MRI. The statistical decomposition algorithm (SDA) is a probabilistic atlas-based method that calculates synthetic CTs from T2-weighted MRI scans. In this study, we evaluated the application of SDA for attenuation correction of PET images in the pelvic region. Materials and method Twelve patients were retrospectively selected from an ongoing prostate cancer research study. The patients had same-day scans of [11C]acetate PET/MRI and CT. The CT images were non-rigidly registered to the PET/MRI geometry, and PET images were reconstructed with attenuation correction employing CT, SDA-generated CT, and the built-in Dixon sequence-based method of the scanner. The PET images reconstructed using CT-based attenuation correction were used as ground truth. Results The mean whole-image PET uptake error was reduced from − 5.4% for Dixon-PET to − 0.9% for SDA-PET. The prostate standardized uptake value (SUV) quantification error was significantly reduced from − 5.6% for Dixon-PET to − 2.3% for SDA-PET. Conclusion Attenuation correction with SDA improves quantification of PET/MR images in the pelvic region compared to the Dixon-based method.


Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1161
Author(s):  
Lidia Delrieu ◽  
Liacine Bouaoun ◽  
Douae El Fatouhi ◽  
Elise Dumas ◽  
Anne-Deborah Bouhnik ◽  
...  

Breast cancer (BC) remains complex for women both physically and psychologically. The objectives of this study were to (1) assess the evolution of the main sequelae and treatment two and five years after diagnosis in women with early-stage breast cancer, (2) explore patterns of sequelae associated with given sociodemographic, clinical, and lifestyle factors. The current analysis was based on 654 localized BC patients enrolled in the French nationwide longitudinal survey “vie après cancer” VICAN (January–June 2010). Information about study participants was collected at enrollment, two and five years after diagnosis. Changes over time of the main sequelae were analyzed and latent class analysis was performed to identify patterns of sequelae related to BC five years after diagnosis. The mean age (±SD) of study participants at inclusion was 49.7 (±10.5) years old. Six main classes of sequelae were identified two years and five years post-diagnosis (functional, pain, esthetic, fatigue, psychological, and gynecological). A significant decrease was observed for fatigue (p = 0.03) and an increase in cognitive sequelae was reported (p = 0.03). Two latent classes were identified—functional and esthetic patterns. Substantial sequelae remain up to five years after BC diagnosis. Changes in patient care pathways are needed to identify BC patients at a high risk.


1998 ◽  
Vol 39 (1) ◽  
pp. 64-69 ◽  
Author(s):  
H. Dinç ◽  
F. Esen ◽  
A. Demirci ◽  
A. Sari ◽  
H. Resit Gümele

Purpose: Our purpose was to clarify and further characterize the changes in height, length, width, volume, and shape in the normal pituitary gland and in width in the infundibulum during pregnancy and the first 6 months post partum. Material and Methods: Cranial MR imaging was performed in 78 women who were pregnant in the second or third trimester or who were post partum, and in 18 age-matched control subjects who were not pregnant. Volume measurements were performed in 2 ways; volume 1=1/2xheightxlengthxwidth; and volume 2=area (measured by trackball)xslice thickness Results: Gland volume, height, width, length, and convexity, and infundibular width increased during pregnancy. the highest values were seen during the 3 days immediately post partum. When compared with volunteers, volumes 1 and 2 showed the largest increase (120%) among the parameters. Gland height showed the best correlation (r=0.94, p>0.00001) with gestational age. the mean height of the gland was 8.76 mm in the third trimester. None of the pregnant women had a gland height of above 10 mm during pregnancy. Only 2 subjects had gland heights of 10.04 and 10.2 mm during the 0–3 days post partum. After this first post-partum period of 3 days, the gland size, shape, and volume and the infundibular width returned to normal within 6 months Conclusion: the pituitary gland enlarges in three dimensions throughout pregnancy. During pregnancy, the volume of the gland shows the highest percentage of increase compared to its length, height, and width. the maximum height of the gland does not exceed 10 mm during pregnancy but it may exceed 10 mm during the 3 days immediately post partum.


2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii83-ii83
Author(s):  
Nilan Vaghjiani ◽  
Andrew Schwieder ◽  
Sravya Uppalapati ◽  
Zachary Kons ◽  
Elizabeth Kazarian ◽  
...  

Abstract PURPOSE Radiation-induced meningiomas (RIMs) are associated with previous exposure to therapeutic irradiation. RIMs are rare and have not been well characterized relative to spontaneous meningiomas (SMs). METHODS 1003 patients with proven or presumed meningiomas were identified from the VCU brain tumor database. Chart review classified RIM patients and their characteristics. RESULTS Of the 1003 total patients, 76.47% were female with a mean ± SD age of 67.55 ± 15.50 years. 15 RIM patients were identified (66.67% female), with a mean ± SD age of 52.67 ± 15.46 years, 5 were African American and 10 were Caucasian. The incidence of RIMs was 1.49% in our data set. The mean age at diagnosis was 43.27 ± 15.06 years. The mean latency was 356.27 ± 116.96 months. The mean initiating dose was 44.28 ± 14.68 Gy. There was a significant difference between mean latency period and ethnicity, 258.3 months for African American population, and 405.2 months for Caucasian population (p = 0.003). There was a significant difference between the mean number of lesions in females (2.8) versus males (1.2; p = 0.046). Of the RIMs with characterized histology, 6 (55%) were WHO grade II and 5 (45%) were WHO grade I, demonstrating a prevalence of grade II tumors approximately double that found with SMs. RIMs were treated with combinations of observation, surgery, radiation, and medical therapy. Of the 8 patients treated with radiation, 4 demonstrated response. 8 of the 15 patients (53%) demonstrated recurrence/progression despite treatment. CONCLUSION RIMs are important because of the associated higher grade histology, gender, and ethnic incidences, and increased recurrence/progression compared to SMs. Despite the presumed contributory role of prior radiation, RIMs demonstrate a significant rate of responsiveness to radiation treatment.


2021 ◽  
Vol 87 (4) ◽  
pp. 283-293
Author(s):  
Wei Wang ◽  
Yuan Xu ◽  
Yingchao Ren ◽  
Gang Wang

Recently, performance improvement in facade parsing from 3D point clouds has been brought about by designing more complex network structures, which cost huge computing resources and do not take full advantage of prior knowledge of facade structure. Instead, from the perspective of data distribution, we construct a new hierarchical mesh multi-view data domain based on the characteristics of facade objects to achieve fusion of deep-learning models and prior knowledge, thereby significantly improving segmentation accuracy. We comprehensively evaluate the current mainstream method on the RueMonge 2014 data set and demonstrate the superiority of our method. The mean intersection-over-union index on the facade-parsing task reached 76.41%, which is 2.75% higher than the current best result. In addition, through comparative experiments, the reasons for the performance improvement of the proposed method are further analyzed.


2014 ◽  
Vol 18 (1) ◽  
Author(s):  
Junko Nakamura ◽  
Takeharu Yoshikawa ◽  
Eriko Maeda ◽  
Hiroyuki Akai ◽  
Hiroshi Ohtsu ◽  
...  

Background: The accepted threshold for normal endometrial thickness is 5 mm; lesions with endometrial thickness < 5 mm are considered benign, whilst those > 5 mm areconsidered malignant. However, endometrium ≥ 5 mm on transvaginal ultrasonography inpostmenopausal woman is considered as asymptomatic endometrial thickening. However, recent studies suggest that asymptomatic endometrial thickness of even 8 mm – 11 mm in postmenopausal women may be normal.Objectives: The present study investigated the normal endometrial thickness range in 297 asymptomatic postmenopausal women using 3.0-T magnetic resonance imaging (MRI) T2-weighted sagittal images measured retrospectively by a single radiologist.Method: The data were classified according to patient age and postmenopausal duration, and the medical records and follow-up MR images were reviewed to assess the clinical outcome.Results: The mean endometrial thickness was 2.4 ± 0.1 mm (range: 0.1–11.6). The endometriumin 21 of 297 subjects was ≥ 5 mm thick. Follow-up MR images were obtained in 17 of these 21 women, and their endometrial thickness was found to have decreased in all of them. To date,none of the subjects has been diagnosed with endometrial cancer.Conclusion: Although 5 mm is considered the conservative threshold of normal endometrial thickness on MRI of postmenopausal women, this figure should not, to avoid excessive false-positive diagnoses, be assumed as an indication of malignancy.


2017 ◽  
Vol 4 (S) ◽  
pp. 100
Author(s):  
M.I. Muradov ◽  
K.B. Mukhamedkerim ◽  
A. ABaiguzeva ◽  
K.E. Kazantaev ◽  
D.Zh. Koshkarbaev

Background: To provide quantitative objective data demonstrating the longevity and amount of volume augmentation in the fatty dystrophy of the facial tissue obtained with autologous lipofilling.   Methods: In our clinic had been operated 8 patients for last 2 years with fatty dystrophy of the facial tissue. A prospective analysis of all patients who underwent at our private practice and were followed up for at least 1,5 year. Surgery was performed under general anesthesia it is necessary for clear results tissue correction. We based on the literature has seen numerous clinical reports highlighting the benefits of autologous fat transfer for face from that areas, fat was collected from the abdomen (most frequently used donor site), hips, outer thighs (saddle-bags), internal knee or thigh, with quantitative volume measurements evaluating the amount of postoperative volume change.   Results: Twenty eight patients were included in the study. The mean follow-up time was 18 months. The mean amount of autologous fat injected into each face region was 10-70 mL. Hypercorrection was performed after 3 months and it was 20-50% of the initial injected fat volume. Overall, the mean absolute volume augmentation measured at their last (after 6 month) post operative visit was 10-25%. There was variability between patients in the volume amount and percentage that remained. The resorption process was observed in two patients after 6 month. We made correction with hyaluronic acid and silicone implants.   Conclusion: To our knowledge, this study is the first clinical quantification in our practise of autologous fat transfer and/or grafting in the literature that provides definitive evidence on the amount as well as the resultant longevity in the face. Autologous fat transfer to the face has definite long-term volume augmentation results. On average, approximately 25-35% of the injected volume remains at 18 months. However, some variability exists in the percentage of  volume that remains that may require a touch-up procedure.


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