Non-invasive preoperative imaging differential diagnosis of pineal region tumor: A novel developed and validated multiparametric MRI-based clinicoradiomic model

2022 ◽  
Author(s):  
Yanghua Fan ◽  
Xulei Huo ◽  
Xiaojie Li ◽  
Liang Wang ◽  
Zhen Wu
Keyword(s):  
Differential Diagnosis ◽  
Pineal Region ◽  
Multiparametric Mri ◽  
Preoperative Imaging ◽  
Pineal Region Tumor ◽  
Non Invasive

scholarly journals Non-Invasive Preoperative Imaging Differential Diagnosis of Intracranial Hemangiopericytoma and Angiomatous Meningioma: A Novel Developed and Validated Multiparametric MRI-Based Clini-Radiomic Model

2022 ◽  
Vol 11 ◽  
Author(s):  
Yanghua Fan ◽  
Panpan Liu ◽  
Yiping Li ◽  
Feng Liu ◽  
Yu He ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Features ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Recursive Feature Elimination ◽  
Preoperative Imaging ◽  
Multivariable Logistic Regression Analysis ◽  
Clinical Model ◽  
Non Invasive ◽  
Model Combining

BackgroundAccurate preoperative differentiation of intracranial hemangiopericytoma and angiomatous meningioma can greatly assist operation plan making and prognosis prediction. In this study, a clini-radiomic model combining radiomic and clinical features was used to distinguish intracranial hemangiopericytoma and hemangioma meningioma preoperatively.MethodsA total of 147 patients with intracranial hemangiopericytoma and 73 patients with angiomatous meningioma from the Tiantan Hospital were retrospectively reviewed and randomly assigned to training and validation sets. Radiomic features were extracted from MR images, the elastic net and recursive feature elimination algorithms were applied to select radiomic features for constructing a fusion radiomic model. Subsequently, multivariable logistic regression analysis was used to construct a clinical model, then a clini-radiomic model incorporating the fusion radiomic model and clinical features was constructed for individual predictions. The calibration, discriminating capacity, and clinical usefulness were also evaluated.ResultsSix significant radiomic features were selected to construct a fusion radiomic model that achieved an area under the curve (AUC) value of 0.900 and 0.900 in the training and validation sets, respectively. A clini-radiomic model that incorporated the radiomic model and clinical features was constructed and showed good discrimination and calibration, with an AUC of 0.920 in the training set and 0.910 in the validation set. The analysis of the decision curve showed that the fusion radiomic model and clini-radiomic model were clinically useful.ConclusionsOur clini-radiomic model showed great performance and high sensitivity in the differential diagnosis of intracranial hemangiopericytoma and angiomatous meningioma, and could contribute to non-invasive development of individualized diagnosis and treatment for these patients.

Meningiomas of the velum interpositum: surgical considerations

2003 ◽  
Vol 15 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Alan P. Lozier ◽  
Jeffrey N. Bruce
Keyword(s):  
Third Ventricle ◽  
Pineal Region ◽  
Preoperative Imaging ◽  
Cerebral Veins ◽  
Pia Mater ◽  
Posterior Portion ◽  
Pineal Region Tumor ◽  
The Third ◽  
Supracerebellar Infratentorial Approach ◽  
Velum Interpositum

Meningiomas of the third ventricle are a rare subtype of pineal region tumor that arise from the posterior portion of the velum interpositum, the double layer of pia mater that forms the roof of the third ventricle. The authors review the literature concerning these meningiomas and present a case in which the lesion was resected via the supracerebellar–infratentorial approach. The relationship of the tumor to the deep venous system and the splenium of the corpus callosum guides the selection of the most advantageous surgical approach. Posterior displacement of the internal cerebral veins demonstrated on preoperative imaging provides a strong rationale for use of the supracerebellar–infratentorial approach.

scholarly journals Gastric Schwannoma: A Rare but Important Differential Diagnosis of a Gastric Submucosal Mass

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
William Yoon ◽  
Kari Paulson ◽  
Paul Mazzara ◽  
Sweety Nagori ◽  
Mohammed Barawi ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Surgical Resection ◽  
Treatment Options ◽  
Partial Gastrectomy ◽  
Preoperative Imaging ◽  
Mesenchymal Tumors ◽  
Gastric Schwannoma ◽  
Gastric Mass ◽  
Submucosal Mass ◽  
Slow Growing

Schwannomas are generally slow growing asymptomatic neoplasms that rarely occur in the GI tract. However, if found, the most common site is the stomach. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and 60–70% of them occur in the stomach. Owing to their typical presentation as submucosal neoplasms, gastric schwannomas and GISTs appear grossly similar. Accordingly, the differential diagnosis for a gastric submucosal mass should include gastric schwannomas. Furthermore, GI schwannomas are benign neoplasms with excellent prognosis after surgical resection, whereas 10–30% of GISTs have malignant behavior. Hence, it is important to distinguish gastric schwannomas from GISTs to make an accurate diagnosis to optimally guide treatment options. Nevertheless, owing to the paucity of gastric schwannomas, the index of suspicion for this diagnosis is low. We report a rare case of gastric schwannoma in 53-year-old woman who underwent laparoscopic partial gastrectomy under the suspicion of a GIST preoperatively but confirmed to have a gastric schwannoma postoperatively. This case underscores the importance of including gastric schwannomas in the differential diagnosis when preoperative imaging studies reveal a submucosal, exophytic gastric mass. For a gastric schwannoma, complete margin negative surgical resection is the curative treatment of choice.

scholarly journals Interhemispheric transcallosal intervenous approach to a pineal region tumor

2021 ◽  
Vol 5 (1) ◽  
pp. V11
Author(s):  
Daniel A. Donoho ◽  
Guillermo Aldave
Keyword(s):  
Extent Of Resection ◽  
Pineal Region ◽  
Cerebral Veins ◽  
Surgical Morbidity ◽  
Pineal Tumors ◽  
Pineal Region Tumor ◽  
Pineal Region Tumors ◽  
Transcallosal Approach ◽  
Formidable Challenge ◽  
The Right

Pineal region tumors represent a formidable challenge to the neurosurgeon. Choosing the right approach is key to optimizing the extent of resection and minimizing surgical morbidity. In this video, the authors show an interhemispheric transcallosal approach to a pineal region tumor in a 15-year-old boy. The advantage of this corridor over posterior approaches is that it provides a nice view of the tumor plane with the venous complex, especially while dissecting tumor from the anterior aspect of the internal cerebral veins on their vertical path. Thus, this approach represents a safe and effective alternative for selected pineal tumors. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2120.

scholarly journals Possibilities of multiparametric MRI in the differential diagnosis of histological types of cervical cancer in the preoperative period

2016 ◽  
Vol 12 (2) ◽  
pp. 60-69
Author(s):  
E. V. Tarachkova ◽  
M. A. Shorikov ◽  
V. O. Panov ◽  
V. V. Kuznetsov ◽  
L. Sh. Usmanova ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Differential Diagnosis ◽  
Multiparametric Mri ◽  
Preoperative Period ◽  
Histological Types

Diurnally fluctuating frontal dysequilibrium secondary to a pineal pilocytic astrocytoma: is this symptom associated with a check-valve mechanism in a pineal region tumor?

2008 ◽  
Vol 25 (3) ◽  
pp. 367-371 ◽  
Author(s):  
Tae-Won Kim ◽  
Tae-Kyu Lee ◽  
Bum-Soo Kim ◽  
Kwang-Soo Lee ◽  
In-Uk Song ◽  
...  
Keyword(s):  
Pilocytic Astrocytoma ◽  
Check Valve ◽  
Pineal Region ◽  
Valve Mechanism ◽  
Pineal Region Tumor

DIFFUSION MRI-BASED FIBER TRACKING IN HEALTHY AND BRAIN INJURY PATIENTS: A COMPARISON OF DIFFERENT SOFTWARE TOOLS

2015 ◽  
Vol 15 (02) ◽  
pp. 1540020
Author(s):  
GIULIA LUCCONI ◽  
CHIARA ROMEO ◽  
ROBERTO BONETTI ◽  
PATRIZIA CENNI ◽  
NICOLETTA SCRITTORI
Keyword(s):  
Brain Injury ◽  
Corpus Callosum ◽  
Corticospinal Tract ◽  
Preoperative Imaging ◽  
Brain Images ◽  
Non Invasive ◽  
Imaging Tool ◽  
Termination Criteria ◽  
Fibers Orientation ◽  
Deterministic And Probabilistic Approaches

In this work, we compared different DTI-based fibertracking software using deterministic and probabilistic approaches. DTI brain images of 35 healthy and five brain-injury patients were acquired with Philips Achieva 1.5 T scanner using an EPI-SE DTI sequence with 16 diffusion directions. Images were analyzed with Philips FiberTrack module, DTI-Studio and FSL. We studied corticospinal tract and corpus callosum, considering different termination criteria for the fibertracking algorithm. Group studies were performed to create a database of healthy patients. Results of FSL fibertracking with 1 or 2 fibers per voxel were no statistically different. T-tests between Philips and DTI-Studio led to p-values > 0.01 for corticospinal tract and < 0.01 for corpus callosum. FSL analysis led to higher ADC and lower FA values, with significative differences with the other software. In brain injury patients we measured different fibers orientation, reduced FA and increased ADC around the lesion. In conclusion, although DTI fibertracking is a promising non-invasive preoperative imaging tool, the outcome is strongly influenced by the algorithm used and the parameters chosen for the seed generation and fiber propagation.

Radiologic Reporting of Simple Hepatic Cyst Versus Biliary Cystadenoma May Lead to Unnecessary Surgery

2021 ◽  
pp. 000313482110540
Author(s):  
Aman Kumar ◽  
Alex Zendel ◽  
Michael Batres ◽  
David A. Gerber ◽  
Chirag S. Desai
Keyword(s):  
Differential Diagnosis ◽  
Cyst Wall ◽  
Cystic Lesion ◽  
Liver Cyst ◽  
Hepatic Cyst ◽  
Preoperative Imaging ◽  
Imaging Studies ◽  
Biliary Cystadenoma ◽  
Benign Condition ◽  
Simple Hepatic Cyst

Background and Aims Simple liver cyst (SHC) is a benign condition with no malignant potential. They are typically discovered incidentally due to the increased use of abdominal imaging, but some patients may present with abdominal pain. A radiologist’s differential diagnosis in cases of SHC will often include “rule out biliary cystadenoma.” Under these circumstances, patients and surgeons are more likely to pursue surgical options even in asymptomatic cases. The aim of this study is to conduct a retrospective analysis of presentation, radiologic reporting, management plan, and histopathology of patients referred to a tertiary hospital in order to determine the correlation between radiology and histology. Methods We retrospectively analyzed the clinical, radiological, and histopathological data of 20 patients operated for a diagnosis of a cystic lesion in the liver. Result The CT/MRI of 6 (30%) patients was reported as a biliary cystadenoma, 13 (65%) were reported as a simple hepatic cyst and 1 patient (5%) had hepatocellular carcinoma (HCC) with the additional diagnosis of multiple hepatic cysts. The lesion reported as HCC on the scan was separate from the cystic lesions. The modality of imaging for these cysts was evenly split, 50% of patients had a CT scan, and 50% had an MRI performed. All imaging studies were interpreted by an attending radiologist and most of them were discussed in multidisciplinary meetings. Nineteen patients (95%) had an intraoperative diagnosis of a simple liver cyst based on its visual appearance and clear fluid within the cyst. These patients underwent cyst wall fenestration and de-roofing with the cyst wall sent for histopathology. One patient (5%) with HCC underwent a non-anatomical liver resection. Histopathology was conclusive for a benign hepatic cystic lesion from the cyst wall biopsy. All 20 patients in this study underwent surgery, either due to symptoms or due to radiologic diagnosis of BCA. Four of the 20 cases (20%) were asymptomatic and out of these four cases, 3 (75%) were diagnosed as cystadenoma on the preoperative imaging studies. All 19 cases were diagnosed as a simple liver cyst on pathology. Conclusion In summary, there is a growing trend of “ruling-out the diagnosis of biliary cystadenoma” in patients who present with liver cysts. Patients are appropriately more anxious after this preoperative diagnosis and the treating surgeons have medico-legal concerns regarding conservative management in asymptomatic patients diagnosed as BCA. This single center experience draws attention to the radiology criteria utilized for diagnosing a biliary cystadenoma and suggests that it is time to revisit the imaging interpretation and differential diagnosis.

Medical Epitome

2020 ◽  
pp. 105-138
Author(s):  
Petros Bouras-Vallianatos
Keyword(s):  
Differential Diagnosis ◽  
Case Studies ◽  
Close Reading ◽  
Non Invasive ◽  
Diagnosis And Therapy ◽  
Invasive Techniques

This chapter examines John’s Medical Epitome. The focus here is on the first four of its six books. In contrast to the established view that this work was intended for physicians, it is argued that it was primarily written for philiatroi, intellectuals who were deeply interested in medicine, but not practising physicians themselves. The Medical Epitome, unlike John’s other two works, mainly consisted of material from earlier sources. The analysis of the text starts with a close reading of John’s proem and a discussion of the background of his dedicatee, the Byzantine statesman Alexios Apokaukos. It then shifts to an examination of the work’s structure with the aim of emphasizing John’s intentions in putting together his material. The analysis proceeds by way of a number of case studies focusing on diagnosis and therapy, and goes on to show that John intentionally condensed his material, removing specialized advice, so as to make it appeal to non-expert readers. Thus it is shown, for example, that the absence of details on invasive operations is consistent with the character of his intended readers, who were only able to use non-invasive techniques, such as phlebotomy and arteriotomy. Finally, the particular attention John paid to differential diagnosis, especially as regards eye affections, which is often supplemented with his own advice, is highlighted.

Dermoscopy in differentiating palmar syphiloderm from palmar papular psoriasis

2017 ◽  
Vol 28 (14) ◽  
pp. 1461-1463 ◽  
Author(s):  
Enzo Errichetti ◽  
Giuseppe Stinco
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Errors ◽  
Secondary Syphilis ◽  
Non Invasive

Palmar syphiloderm is one of the most common presentations of secondary syphilis and its recognition is of utmost importance in order to promptly identify such a disease and initiate appropriate workup/management. However, the differential diagnosis with palmar papular psoriasis often poses some difficulties, with consequent possible diagnostic errors/delays and prescription of improper therapies. In this report, we underline the role of dermoscopy as a supportive tool to facilitate the non-invasive recognition of palmar syphiloderm and its distinction from palmar papular psoriasis.

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