Pattern of use of intraoperative ultrasound in surgery for brain tumors influences outcomes in glial tumors.

2021 ◽  
pp. 1-10
Author(s):  
Ujwal Yeole ◽  
Prakash Shetty ◽  
Vikas Singh ◽  
Aliasgar Moiyadi
Keyword(s):  
Brain Tumors ◽  
Intraoperative Ultrasound ◽  
Glial Tumors

scholarly journals Is There a Relationship between the Elasticity of Brain Tumors, Changes in Diffusion Tensor Imaging, and Histological Findings? A Pilot Study Using Intraoperative Ultrasound Elastography

2021 ◽  
Vol 11 (2) ◽  
pp. 271
Author(s):  
Santiago Cepeda ◽  
Sergio García-García ◽  
María Velasco-Casares ◽  
Gabriel Fernández-Pérez ◽  
Tomás Zamora ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Diffusion Tensor Imaging ◽  
Linear Regression ◽  
Brain Tumors ◽  
Diffusion Tensor ◽  
Intraoperative Ultrasound ◽  
Ultrasound Elastography ◽  
Proliferation Index ◽  
Strong Positive Correlation ◽  
Non Linear

Intraoperative ultrasound elastography (IOUS-E) is a novel image modality applied in brain tumor assessment. However, the potential links between elastographic findings and other histological and neuroimaging features are unknown. This study aims to find associations between brain tumor elasticity, diffusion tensor imaging (DTI) metrics, and cell proliferation. A retrospective study was conducted to analyze consecutively admitted patients who underwent craniotomy for supratentorial brain tumors between March 2018 and February 2020. Patients evaluated by IOUS-E and preoperative DTI were included. A semi-quantitative analysis was performed to calculate the mean tissue elasticity (MTE). Diffusion coefficients and the tumor proliferation index by Ki-67 were registered. Relationships between the continuous variables were determined using the Spearman ρ test. A predictive model was developed based on non-linear regression using the MTE as the dependent variable. Forty patients were evaluated. The pathologic diagnoses were as follows: 21 high-grade gliomas (HGG); 9 low-grade gliomas (LGG); and 10 meningiomas. Cases with a proliferation index of less than 10% had significantly higher medians of MTE (110.34 vs. 79.99, p < 0.001) and fractional anisotropy (FA) (0.24 vs. 0.19, p = 0.020). We found a strong positive correlation between MTE and FA (rs (38) = 0.91, p < 0.001). A cubic spline non-linear regression model was obtained to predict tumoral MTE from FA (R2 = 0.78, p < 0.001). According to our results, tumor elasticity is associated with histopathological and DTI-derived metrics. These findings support the usefulness of IOUS-E as a complementary tool in brain tumor surgery.

Patient-specific model-based segmentation of brain tumors in 3D intraoperative ultrasound images

2018 ◽  
Vol 13 (3) ◽  
pp. 331-342 ◽  
Author(s):  
Elisee Ilunga-Mbuyamba ◽  
Juan Gabriel Avina-Cervantes ◽  
Dirk Lindner ◽  
Felix Arlt ◽  
Jean Fulbert Ituna-Yudonago ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Intraoperative Ultrasound ◽  
Specific Model ◽  
Patient Specific ◽  
Ultrasound Images ◽  
Model Based

scholarly journals Possibilities of Photodynamic Therapy in the Complex Treatment of Malignant Gliomas

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Artemii Y Rynda
Keyword(s):  
Photodynamic Therapy ◽  
Brain Tumors ◽  
Median Survival ◽  
Median Duration ◽  
Control Group ◽  
Study Group ◽  
Complex Treatment ◽  
Glial Tumors ◽  
Disease Free ◽  
Grade Iii

Abstract INTRODUCTION The median life expectancy of patients with malignant glial tumors is in the range of 18 to 23 mo for Grade III and 12 to 15 mo for Grade IV. The use of the method of PDT in the surgery of glial tumors of various degrees of malignancy, as well as a comparative analysis of the effectiveness of the method in patients, is discussed in this study. METHODS This study includes an analysis of 190 patients with glial brain tumors of supratentorial localization, of various degrees of malignancy, operated on in the Department of Neurooncology, Polenov Russian Research Institute of Neurosurgery, from 2004 to 2016; 95 patients (study group) who underwent removal of a tumor with intraoperative photodynamic therapy with a drug of the chlorin e6 group of the second generation; and 95 patients (control group) who underwent tumor removal without PDT. RESULTS The median survival for patients with Grade III gliomas using PDT was 38.5 ± 5.9 mo; in the control group (without PDT), it was 20.3 ± 2.8 mo (P = .0003). The median survival for patients with Grade IV gliomas using PDT was 19.4 ± 3.1 mo; in the control group (without PDT), it was 14.8 ± 2.6 mo (P = .0002). The median duration of the disease-free period for patients in the Grade III subgroup was as follows: in the study group, 20.4 ± 2.79 mo; and in the control group, 13.1 ± 4.1 mo (P = .0002). The median duration of the disease-free period for patients in the Grade IV subgroup was 10.1 ± 3.3 mo in the study group; in the control group, it was 8.7 ± 1.11 mo (P = .0001). CONCLUSION PDT is a promising and safe technique that allows intraoperative action on the residual volume of tumor cells located in the perifocal zone. The use of PDT in the complex treatment of glial brain tumors allows us to increase the median of survival and the recurrence-free period.

scholarly journals Capabilities of the modernized technique of one-photon emission computer tomography of brain with 99mTc-MIBI in determination of the degree of malignancy of glial tumors

2008 ◽  
Vol 7 (5-1) ◽  
pp. 90-99
Author(s):  
V. S. Dekan ◽  
B. V. Martynov ◽  
G. Ye. Trufanov ◽  
D. V. Svistov
Keyword(s):  
Brain Tumors ◽  
Computer Tomography ◽  
Photon Emission ◽  
Tumor Grade ◽  
Brain Spect ◽  
New Technique ◽  
Glial Tumors ◽  
Degree Of Malignancy

99mTc-MIBI Brain SPECT results of 79 patients with glial brain tumors are presented in the issue. The new technique of brain SPECT with 99mTc-MIBI was discovered and its oppotunities in characterization of tumor grade is shown in his study.

scholarly journals Dynamic Contrast Enhanced MRI in Glioma Diagnosis

2017 ◽  
pp. 88-96
Author(s):  
E. A. Nechipay ◽  
M. B. Dolgushin ◽  
A. I. Pronin ◽  
E. A. Kobyakova ◽  
L. M. Fadeeva
Keyword(s):  
Differential Diagnosis ◽  
Brain Tumors ◽  
Surgical Removal ◽  
Low Grade ◽  
Glial Tumors ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Informative Parameters ◽  
Contrast Enhanced ◽  
Grade Iii

The aim: to examine the possibility of using dynamic contrast  enhanced magnetic resonance imaging (DCE MRI) in clarifying the  diagnosis of glial brain tumors and the differentiation between them  on the basis of the malignancy degree. In this regard, the authors  evaluated the effectiveness of perfusion parameters (Ktrans, Kep, Ve and iAUC).Materials and methods.The study included examination of 54  patients with an established presence of brain glial tumors. Glioma  Grade I–II diagnosed in 13 (24.1%) and glioma Grade III–IV in 41  (75.9%) cases. Morphological verification of the diagnosis obtained  as a result of either surgical removal of the tumor or stereotactic biopsy was achieved in 31 (57.4%) patients: glial tumors Grade I–II  identified in 6 (19.4%), and glioma Grade III–IV – 25 (80.6%) cases. Results. According to DCE increasing of the malignancy degree of  glial tumors is followed by increasing of all perfusion parameters:  thus, the lowest values of Ktrans, Kep, Ve and iAUC were identified  in low grade gliomas (0.026 min−1, 0.845 min−1, 0.024 and 1.757,  respectively), the highest in gliomas Grade III–IV (0.052 min−1  1.083 min−1, 0.06 and 2.694, respectively). The most informative parameters with sensi tivity 90% and specificity 100% in the  differential diagnosis of gliomas Grade I-II and Grade III-IV are  Ktrans (cut-off = 0.16 min−1) and Ve (cut-off = 0.13).Conclusion.DCE MRI can be used in differential diagnosis of glial brain tumors of different malignancy grade.

ITVT-06. Application of artificial intelligence and radiomics for the analysis of intraoperative ultrasound images of brain tumors

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi229-vi229
Author(s):  
Santiago Cepeda
Keyword(s):  
Artificial Intelligence ◽  
Survival Analysis ◽  
Deep Learning ◽  
Brain Tumors ◽  
Cox Regression ◽  
Intraoperative Ultrasound ◽  
Area Under The Curve ◽  
Ultrasound Images ◽  
Strain Elastography ◽  
Tumor Region

Abstract BACKGROUND Intraoperative ultrasound (ioUS) images of brain tumors contain information that has not yet been exploited. The present work aims to analyze images in both B-mode and strain-elastography using techniques based on artificial intelligence and radiomics. We pretend to assess the capacity for differentiating glioblastomas (GBM) from solitary brain metastases (SBM) and also to assess the ability to predict the overall survival (OS) in GBM. METHODS We performed a retrospective analysis of patients who underwent craniotomy between March 2018 to June 2020 with GBM and SBM diagnoses. Cases with an ioUS study were included. In the first group of patients, an analysis based on deep learning was performed. An existing neural network (Inception V3) was used to classify tumors into GBM and SBM. The models were evaluated using the area under the curve (AUC), classification accuracy, and precision. In the second group, radiomic features from the tumor region were extracted. Radiomic features associated with OS were selected employing univariate correlations. Then, a survival analysis was conducted using Cox regression. RESULTS For the classification task, a total of 36 patients were included. 26 GBM and 10 SBM. Models were built using a total of 812 ultrasound images. For B-mode, AUC and accuracy values ranged from 0.790 to 0.943 and from 72 to 89 % respectively. For elastography, AUC and accuracy values ranged from 0.847 to 0.985 and from 79 to 95 % respectively. Sixteen patients were available for the survival analysis. A total of 52 radiomic features were extracted. Two texture features from B-mode (Conventional mean and GLZLM_SZLGE) and one texture feature from strain-elastography (GLZLM_LZHGE) were significantly associated with OS. CONCLUSIONS Automated processing of ioUS images through deep learning can generate high-precision classification algorithms. Radiomic tumor region features in B-mode and elastography appear to be significantly associated with OS in GBM.

Imaging of brain tumors using peripheral benzodiazepine receptor ligandss

1989 ◽  
Vol 71 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Keith L. Black ◽  
Kiyonobu Ikezaki ◽  
Arthur W. Toga
Keyword(s):  
Brain Tumors ◽  
Benzodiazepine Receptor ◽  
Brain Structures ◽  
Normal Brain ◽  
Peripheral Benzodiazepine Receptor ◽  
Metastatic Tumors ◽  
Glial Tumors ◽  
Content Type ◽  
Positron Emission ◽  
Benzodiazepine Binding

✓ Peripheral benzodiazepine receptor ligands were utilized to selectively image intracerebrally implanted C6 gliomas, RG-2 gliomas, and Walker 256 metastatic tumors by means of quantitative autoradiography. Intravenous injections of 3H-PK11195 (1-(2-chlorophenyl)-N-methyl-N-(1-methylpropyl)-3-isoquinoline carboxamide) or 3H-flunitrazepam in combination with clonazepam revealed high densities of peripheral benzodiazepine binding in glial tumors, with less binding in metastatic tumors. Peripheral binding was displaced by preadministration of excess PK11195. Topographical correlation was excellent between areas of histologically verified tumor and high densities of peripheral benzodiazepine binding. The choroid plexus, ependyma, and pineal gland also showed a moderate level of binding, but there was little binding in other normal brain structures or necrotic tissue. Binding densities were three- to fivefold higher in C6 glial tumors compared to normal cortex. Injection of 3H-flunitrazepam alone, which binds to both central and peripheral receptors, had the advantage of showing normal anatomic structures in addition to a clear definition of tumor topography. The potential value of peripheral benzodiazepine ligands in selectively imaging brain tumors in man with positron emission tomography is discussed.

scholarly journals New Hope in Brain Glioma Surgery: The Role of Intraoperative Ultrasound. A Review

2018 ◽  
Vol 8 (11) ◽  
pp. 202 ◽  
Author(s):  
Maria Pino ◽  
Alessia Imperato ◽  
Irene Musca ◽  
Rosario Maugeri ◽  
Giuseppe Giammalva ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Low Cost ◽  
Tumor Resection ◽  
Intraoperative Ultrasound ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Glioma Surgery ◽  
Pubmed Database

Maximal safe resection represents the gold standard for surgery of malignant brain tumors. As regards gross-total resection, accurate localization and precise delineation of the tumor margins are required. Intraoperative diagnostic imaging (Intra-Operative Magnetic Resonance-IOMR, Intra-Operative Computed Tomography-IOCT, Intra-Operative Ultrasound-IOUS) and dyes (fluorescence) have become relevant in brain tumor surgery, allowing for a more radical and safer tumor resection. IOUS guidance for brain tumor surgery is accurate in distinguishing tumor from normal parenchyma, and it allows a real-time intraoperative visualization. We aim to evaluate the role of IOUS in gliomas surgery and to outline specific strategies to maximize its efficacy. We performed a literature research through the Pubmed database by selecting each article which was focused on the use of IOUS in brain tumor surgery, and in particular in glioma surgery, published in the last 15 years (from 2003 to 2018). We selected 39 papers concerning the use of IOUS in brain tumor surgery, including gliomas. IOUS exerts a notable attraction due to its low cost, minimal interruption of the operational flow, and lack of radiation exposure. Our literature review shows that increasing the use of ultrasound in brain tumors allows more radical resections, thus giving rise to increases in survival.

Role of intraoperative ultrasound in resection of pediatric brain tumors

2010 ◽  
Vol 26 (9) ◽  
pp. 1189-1193 ◽  
Author(s):  
Mohamed Ahmed El Beltagy ◽  
Mohamed Aggag ◽  
Mohamed Kamal
Keyword(s):  
Brain Tumors ◽  
Intraoperative Ultrasound ◽  
Pediatric Brain Tumors ◽  
Pediatric Brain

Photodynamic Therapy of Malignant Brain Tumors: Clinical Results of, Difficulties with, Questions about, and Future Prospects for the Neurosurgical Applications

Neurosurgery ◽  
1988 ◽  
Vol 23 (5) ◽  
pp. 557-563 ◽  
Author(s):  
Carlo Perria ◽  
Martino Carai ◽  
Antonello Falzoi ◽  
Giuseppe Orunesu ◽  
Antonio Rocca ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Brain Tumors ◽  
Residual Tumor ◽  
Clinical Results ◽  
Halogen Lamp ◽  
Glial Tumors ◽  
Malignant Brain Tumors ◽  
Neurosurgical Patients ◽  
Clinical Series ◽  
Causes Of Failure

Abstract Photodynamic therapy (PDT) has been applied in a variety of oncological fields with good results. In neurosurgery, the clinical series are limited and the number of treated patients is not statistically significant. This work examines the results of PDT performed in our clinic and discusses some difficulties and causes of failure of this method in neurosurgical patients. Eight patients with malignant brain tumors underwent PDT. All had been treated previously by operation and radiation therapy and one patient had also received chemotherapy. At 24 hours after the i.v. injection of hematoporphyrin (5 mg/kg body weight), the tumor was removed as radically as possible and the residual tumor bed was exposed to either 630-nm light from an argon-dye laser or 600- to 680-nm light isolated from the emission of a quartz-halogen lamp. The type of sensitizer, the irradiation methods, and the peculiarities of glial tumors are examined as possible causes of failure. The longer survivals of some patients with glial tumors treated by PDT may make this treatment suitable when traditional therapies fail.

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