scholarly journals NI-20 IS GLIOMATOSIS CEREBRI DIAGNOSED AS GRADEII IN NEUROIMAGING A POTENTIALLY GRADEII GLIOMA?

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii29-ii29
Author(s):  
Etsuko Owashi ◽  
Hiroaki Takei ◽  
Yuka Ikegame ◽  
Yoshitaka Asano ◽  
Kazuhiro Miwa ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Who Classification ◽  
Gliomatosis Cerebri ◽  
World Health ◽  
Resonance Spectroscopy ◽  
Diffuse Glioma ◽  
Diffuse Astrocytoma ◽  
Positron Emission ◽  
The Mean ◽  
Met Pet

Abstract The 2007 World Health Organization (WHO) classification defined gliomatosis cerebri (GC) as a rare entity and an extensively infiltrating diffuse glioma involving three or more cerebral lobes. Although the revised 2016 WHO classification removed GC as a separate glioma entity due to the common histopathological findings shared with other gliomas, GC exhibits a distinct growth pattern and worse prognosis compared with other grade-matched gliomas. We retrospectively reviewed five patients with GC and five patients with insulo-opercular diffuse astrocytoma (IODA) who underwent both proton magnetic resonance spectroscopy (MRS) and [11C]-methionine positron emission tomography (MET-PET). The patients were diagnosed with GC or IODA by T2-weighted magnetic resonance imaging /fluid-attenuated inversion recovery from April 2014 to August 2019 at our institution. The locations of lesions where single-voxel MRS to measure the N-acetylaspartate (NAA)/choline (Cho) ratio and MET-PET to measure the tumor/normal (T/N) ratio were performed were the same in every patient. The mean age of all patients was 46.3±13.7 years. The mean ages of the GC (three males and two females) and IODA (two males and three females) groups were 54.0±14.0 and 38.6±8.7 years, respectively. The mean NAA/Cho ratios in the GC and IODA groups were 1.010±0.441 and 0.594±0.449, respectively. The mean T/N ratios in the GC and IODA groups were 1.201±0.050 and 1.169±0.009, respectively. The higher NAA/Cho ratio in the GC lesions may reflect the abundance of normal neural tissue in GC compared with IODA. Nonetheless, the T/N ratios of the two groups were comparable. The discrepancy suggests that GC cells have higher tumor metabolic activity than IODA cells. Therefore, when GC is simply classified as grade II glioma based on neuroimaging diagnosis, the possibility of underestimating its malignant potential at the single-cell level should be considered.

Usefulness of positron emission tomography for differentiating gliomas according to the 2016 World Health Organization classification of tumors of the central nervous system

2020 ◽  
Vol 133 (4) ◽  
pp. 1010-1019 ◽  
Author(s):  
Hiroaki Takei ◽  
Jun Shinoda ◽  
Soko Ikuta ◽  
Takashi Maruyama ◽  
Yoshihiro Muragaki ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Pet Imaging ◽  
Who Classification ◽  
Standardized Uptake Value ◽  
Emission Tomography ◽  
World Health ◽  
Pet Tracers ◽  
Positron Emission ◽  
Significant Difference ◽  
The Mean

OBJECTIVEPositron emission tomography (PET) is important in the noninvasive diagnostic imaging of gliomas. There are many PET studies on glioma diagnosis based on the 2007 WHO classification; however, there are no studies on glioma diagnosis using the new classification (the 2016 WHO classification). Here, the authors investigated the relationship between uptake of 11C-methionine (MET), 11C-choline (CHO), and 18F-fluorodeoxyglucose (FDG) on PET imaging and isocitrate dehydrogenase (IDH) status (wild-type [IDH-wt] or mutant [IDH-mut]) in astrocytic and oligodendroglial tumors according to the 2016 WHO classification.METHODSIn total, 105 patients with newly diagnosed cerebral gliomas (6 diffuse astrocytomas [DAs] with IDH-wt, 6 DAs with IDH-mut, 7 anaplastic astrocytomas [AAs] with IDH-wt, 24 AAs with IDH-mut, 26 glioblastomas [GBMs] with IDH-wt, 5 GBMs with IDH-mut, 19 oligodendrogliomas [ODs], and 12 anaplastic oligodendrogliomas [AOs]) were included. All OD and AO patients had both IDH-mut and 1p/19q codeletion. The maximum standardized uptake value (SUV) of the tumor/mean SUV of normal cortex (T/N) ratios for MET, CHO, and FDG were calculated, and the mean T/N ratios of DA, AA, and GBM with IDH-wt and IDH-mut were compared. The diagnostic accuracy for distinguishing gliomas with IDH-wt from those with IDH-mut was assessed using receiver operating characteristic (ROC) curve analysis of the mean T/N ratios for the 3 PET tracers.RESULTSThere were significant differences in the mean T/N ratios for all 3 PET tracers between the IDH-wt and IDH-mut groups of all histological classifications (p < 0.001). Among the 27 gliomas with mean T/N ratios higher than the cutoff values for all 3 PET tracers, 23 (85.2%) were classified into the IDH-wt group using ROC analysis. In DA, there were no significant differences in the T/N ratios for MET, CHO, and FDG between the IDH-wt and IDH-mut groups. In AA, the mean T/N ratios of all 3 PET tracers in the IDH-wt group were significantly higher than those in the IDH-mut group (p < 0.01). In GBM, the mean T/N ratio in the IDH-wt group was significantly higher than that in the IDH-mut group for both MET (p = 0.034) and CHO (p = 0.01). However, there was no significant difference in the ratio for FDG.CONCLUSIONSPET imaging using MET, CHO, and FDG was suggested to be informative for preoperatively differentiating gliomas according to the 2016 WHO classification, particularly for differentiating IDH-wt and IDH-mut tumors.

scholarly journals Gliomatosis cerebri

Medicina ◽  
2010 ◽  
Vol 46 (5) ◽  
pp. 341 ◽  
Author(s):  
Rymantė Gleiznienė ◽  
Ugnius Bučinskas ◽  
Saulius Lukoševičius ◽  
Antanas Vaitkus ◽  
Simona Letautienė ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Magnetic Resonance Tomography ◽  
Gliomatosis Cerebri ◽  
Pathological Examination ◽  
Resonance Spectroscopy ◽  
Glial Tumor ◽  
Hyperintense Signal ◽  
Positron Emission ◽  
The Right

Gliomatosis cerebri is a rare diffusely infiltrating glial tumor involving two or more lobes and is frequently is bilateral. Infiltrative extent of tumor is out of proportion to histological and clinical features. We present a case in which finally the diagnosis of gliomatosis cerebri was made. In this case, computed tomography showed that midline structures were insignificantly shifted to the left, there was a mild dilatation of lateral ventricles more expressed on the right, and no pathologic changes of brain tissue density were found. On magnetic resonance tomography, T2W/SE and T2W/FLAIR images revealed zones of hyperintense signal, spreading with time, through several lobes of the brain with no enhancement on T1W images. Diagnosis of gliomatosis cerebri was suspected, stereotaxic biopsy was performed, and pathological examination revealed changes typical of diffuse glial tumor. In this article, changes typical of gliomatosis cerebri seen in other radiological methods such as computed tomography, magnetic resonance spectroscopy, dynamic contrast-enhanced T2*-weighted magnetic resonance, and positron emission tomography also are discussed.

scholarly journals Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification

2020 ◽  
Author(s):  
Tomoya Ogawa ◽  
Nobuyuki Kawai ◽  
Keisuke Miyake ◽  
Aya Shinomiya ◽  
Yuka Yamamoto ◽  
...  
Keyword(s):  
Who Classification ◽  
World Health ◽  
Histopathological Diagnosis ◽  
Newly Diagnosed ◽  
Mutation Status ◽  
Flt Pet ◽  
Molecular Features ◽  
Pet Ct ◽  
The Mean ◽  
Met Pet

Abstract Background :The molecular features of isocitrate dehydrogenase (IDH) mutation and chromosome 1p and 19q (1p/19q) codeletion status have pivotal role for differentiating gliomas and have been integrated in the World Health Organization (WHO) classification in 2016. Positron emission tomography (PET) with 3’-Deoxy-3’-[18F]fluorothymidine (FLT) has been used to evaluate tumour grade and proliferative activity and compared with L-[methyl-11C]-methionine (MET) in glioma patients. Herein, we evaluated tracer uptakes of MET-PET/CT and FLT-PET/CT for differentiating glioma based on the 2016 WHO classification especially in relation to IDH1 mutation status.Methods : In total, 81 patients with newly diagnosed supratentorial glioma were enrolled in this study. They underwent PET/CT studies with MET and FLT before surgery. The molecular features and histopathological diagnosis based on the 2016 WHO classification were determined using surgical specimens. The ratios of the maximum standardized uptake value (SUV) of the tumours to the mean SUV of the contralateral cortex (T/N ratios) were calculated on MET-PET/CT and FLT-PET/CT images. Results : The mean T/N ratios of MET-PET/CT and FLT-PET/CT in IDH1-wildtype tumours were significantly higher than those in IDH1-mutant tumours (P<0.001 and P<0.001, respectively). Receiver operating characteristic analysis for differentiating IDH1 mutation status showed that the area under the curve of the FLT T/N ratio was significantly larger than that of the MET T/N ratio (P<0.01). The mean T/N ratio of FLT-PET/CT in IDH1-wildtype tumours was significantly higher than that in IDH1-mutant tumours among grade Ⅱ and Ⅲ gliomas (P=0.005), but this was not the case for MET-PET/CT. Both MET-PET/CT and FLT-PET/CT were able to distinguish between grade Ⅱ and Ⅲ gliomas in IDH1-mutant tumours (P=0.002 and P<0.001, respectively), but only FLT-PET/CT was able to distinguish between grade Ⅲ and Ⅳ gliomas in IDH1-wildtype tumours (P=0.029).Conclusion :This study showed that FLT-PET/CT can be used to determine the IDH1 mutation status and evaluate glioma grade more accurately than MET-PET/CT. FLT-PET/CT can improve glioma differentiation based on the 2016 WHO classification, but caution must be paid for tumours without contrast enhancement and further studies should be conducted with more cases.

scholarly journals Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification

2020 ◽  
Author(s):  
Tomoya Ogawa ◽  
Nobuyuki Kawai ◽  
Keisuke Miyake ◽  
Aya Shinomiya ◽  
Yuka Yamamoto ◽  
...  
Keyword(s):  
Who Classification ◽  
World Health ◽  
Histopathological Diagnosis ◽  
Newly Diagnosed ◽  
Mutation Status ◽  
Flt Pet ◽  
Molecular Features ◽  
Pet Ct ◽  
The Mean ◽  
Met Pet

Abstract Background The molecular features of isocitrate dehydrogenase (IDH) mutation and chromosome 1p and 19q (1p/19q) codeletion status have pivotal role for differentiating gliomas and have been integrated in the World Health Organization (WHO) classification in 2006. Positron emission tomography (PET) with 18F-fluorothymidine (FLT) has been shown to evaluate tumour grade and proliferative activity more accurately than L-methyl-11C-methionine (MET) in glioma patients. Herein, we compared tracer uptakes of MET-PET/CT and FLT-PET/CT for differentiating glioma according to the 2016 WHO classification especially in relation to IDH1 mutation status.Methods In total, 81 patients with newly diagnosed supratentorial glioma were enrolled in this study. They underwent PET/CT studies with MET and FLT before surgery. The molecular features and histopathological diagnosis based on the 2016 WHO classification were determined using surgical specimens. The ratios of the maximum standardized uptake value (SUV) of the tumours to the mean SUV of the contralateral cortex (T/N ratios) were calculated on MET-PET/CT and FLT-PET/CT images. Results The mean T/N ratios of MET-PET/CT and FLT-PET/CT in IDH1-wildtype tumours were significantly higher than those in IDH1-mutant tumours (P<0.001 and P<0.001, respectively). Receiver operating characteristic analysis for differentiating IDH1 mutation status showed that the area under the curve of the FLT T/N ratio was significantly larger than that of the MET T/N ratio (P<0.01). The mean T/N ratio of FLT-PET/CT in IDH1-wildtype tumours was significantly higher than that in IDH1-mutant tumours among grade Ⅱ and Ⅲ gliomas (P=0.005), but this was not the case for MET-PET/CT. Both MET-PET/CT and FLT-PET/CT were able to distinguish between grade Ⅱ and Ⅲ gliomas in IDH1-mutant tumours (P=0.002 and P<0.001, respectively), but only FLT-PET/CT was able to distinguish between grade Ⅲ and Ⅳ gliomas in IDH1-wildtype tumours (P=0.029).Conclusion This study showed that FLT-PET/CT can be used to determine the IDH1 mutation status and evaluate glioma grade more accurately than MET-PET/CT. The characteristics of FLT-PET/CT can overcome the weakness of MET-PET/CT for differentiating gliomas according to the 2016 WHO classification.

scholarly journals P14.01 Differential diagnosis of IDH mutant/IDH wildtype of glioma by using 11C-methionine, 11C-choline, and18F-fluorodeoxyglucose positron emission tomography

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii66-iii66
Author(s):  
H Takei ◽  
J Shinoda ◽  
S Ikuta ◽  
T Maruyama ◽  
Y Muragaki ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Pet Imaging ◽  
Who Classification ◽  
Emission Tomography ◽  
World Health ◽  
Pet Tracers ◽  
Standardized Uptake Values ◽  
Positron Emission ◽  
Significant Difference ◽  
The Mean

Abstract BACKGROUND Positron emission tomography (PET) is important in noninvasive diagnostic imaging of gliomas. There are many PET studies on glioma diagnosis based on the 2007 World Health Organization (WHO) classification; however, there are no studies on glioma diagnosis using the new classification (the 2016 WHO classification).Here we investigated the relationship between PET imaging using 11C-methionine (MET), 11C-choline (CHO), and 18F-fluorodeoxyglucose (FDG) and wildtype isocitrate dehydrogenase (IDH) (IDH-wt)/mutant IDH (IDH-mut) in astrocytic and oligodendroglial tumors according to the 2016 WHO classification. MATERIAL AND METHODS In total, 105 patients with newly diagnosed cerebral gliomas (six diffuse astrocytomas [DAs] with IDH-wt, six DAs with IDH-mut, seven anaplastic astrocytomas [AAs] with IDH-wt, 24 AAs with IDH-mut, 26 glioblastomas [GBMs] with IDH-wt, five GBMs with IDH-mut, 19 oligodendrogliomas [ODs], and 12 anaplastic oligodendrogliomas [AOs]) were included. All OD and AO patients had both IDH-mut and 1p/19q codeletion. The maximum standardized uptake values (SUVs) of the tumor/normal cortex mean SUV ratios (T/N ratios) for MET, CHO, and FDG were calculated; the mean T/N ratios of DA, AA, and GBM with IDH-wt/IDH-mut were compared. The diagnostic accuracy for distinguishing gliomas with IDH-wt from those with IDH-mut was assessed using receiver operating characteristic (ROC) curve analysis of the mean T/N ratios for the three PET tracers. RESULTS There were significant differences in the mean T/N ratios for all three PET tracers between the IDH-wt and IDH-mut groups including all histological classifications (p<0.001). Among the 27 gliomas with mean T/N ratios higher than the cutoff values for all three PET tracers, 23 (85.2%) were classified into the IDH-wt group using ROC analysis. In DA, there were no significant differences in the T/N ratios for MET, CHO, and FDG between the IDH-wt and IDH-mut groups. In AA, the mean T/N ratios of all three PET tracers in the IDH-wt group were significantly higher than those in the IDH-mut group (p<0.001). In GBM, the mean T/N ratio in the IDH-wt group was significantly higher than that of the IDH-mut group for both MET (p=0.034) and CHO (p=0.01). However, there was no significant difference in the ratio for FDG. CONCLUSIONS PET imaging using MET, CHO, and FDG was confirmed to be informative for preoperatively differentiating gliomas according to the 2016 WHO classification, particularly for differentiating IDH-wt and IDH-mut tumors.

scholarly journals Voxelwise Principal Component Analysis of Dynamic [S-Methyl-11C]Methionine PET Data in Glioma Patients

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2342
Author(s):  
Corentin Martens ◽  
Olivier Debeir ◽  
Christine Decaestecker ◽  
Thierry Metens ◽  
Laetitia Lebrun ◽  
...  
Keyword(s):  
Principal Component Analysis ◽  
Principal Component ◽  
Component Analysis ◽  
Added Value ◽  
Time Activity ◽  
Positron Emission ◽  
Activity Curve ◽  
The Mean ◽  
Mean Time ◽  
Met Pet

Recent works have demonstrated the added value of dynamic amino acid positron emission tomography (PET) for glioma grading and genotyping, biopsy targeting, and recurrence diagnosis. However, most of these studies are based on hand-crafted qualitative or semi-quantitative features extracted from the mean time activity curve within predefined volumes. Voxelwise dynamic PET data analysis could instead provide a better insight into intra-tumor heterogeneity of gliomas. In this work, we investigate the ability of principal component analysis (PCA) to extract relevant quantitative features from a large number of motion-corrected [S-methyl-11C]methionine ([11C]MET) PET frames. We first demonstrate the robustness of our methodology to noise by means of numerical simulations. We then build a PCA model from dynamic [11C]MET acquisitions of 20 glioma patients. In a distinct cohort of 13 glioma patients, we compare the parametric maps derived from our PCA model to these provided by the classical one-compartment pharmacokinetic model (1TCM). We show that our PCA model outperforms the 1TCM to distinguish characteristic dynamic uptake behaviors within the tumor while being less computationally expensive and not requiring arterial sampling. Such methodology could be valuable to assess the tumor aggressiveness locally with applications for treatment planning and response evaluation. This work further supports the added value of dynamic over static [11C]MET PET in gliomas.

Differentiating Diffuse World Health Organization Grade II and IV Astrocytomas With Ex Vivo Magnetic Resonance Spectroscopy

Neurosurgery ◽  
2013 ◽  
Vol 72 (2) ◽  
pp. 186-195 ◽  
Author(s):  
Riyas Vettukattil ◽  
Michel Gulati ◽  
Torill E. Sjøbakk ◽  
Asgeir S. Jakola ◽  
Nadja A.M. Kvernmo ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
World Health Organization ◽  
Ex Vivo ◽  
World Health ◽  
Resonance Spectroscopy ◽  
Grade Ii ◽  
Health Organization

scholarly journals A case of primary central nervous system lymphoma mimic neuromyelitis optica

2020 ◽  
Vol 11 (1) ◽  
pp. 28-33
Author(s):  
Xixi Sheng ◽  
Mingwei Xu ◽  
Xia Li
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Magnetic Resonance ◽  
Neuromyelitis Optica ◽  
Central Nervous System Lymphoma ◽  
B Cell Lymphoma ◽  
Clinical Findings ◽  
Resonance Spectroscopy ◽  
Steroid Pulse ◽  
Positron Emission

AbstractPrimary central nervous system lymphoma (PCNSL) is rare. And the symptoms of PCNSL are atypical, it is extremely easy to be misdiagnosed as other diseases. However, early treatment is crucial which is requesting early diagnosis. We report a case of a 47-year-old man who was initially diagnosed as neuromyelitis optica (NMO) on the basis of clinical findings, slightly high Aquaporin4 (AQP4) (1:10) and high signals of magnetic resonance imaging. Though his symptoms progressively improved after steroid pulse treatment, but worse when steroid was decreased to 40 mg per day. We considered the patient should be diagnosed as PCNSL. After the examination of magnetic resonance spectroscopy (MRS) and positron emission tomography (PET), the results indicated PCNSL was most possible. Therefore we gave him stereotactic biopsy of deep of supratentorial, which showed non-Hodgkin malignant B-cell lymphoma.

scholarly journals Structural and Functional Brain Abnormalities in Mouse Models of Lafora Disease

2020 ◽  
Vol 21 (20) ◽  
pp. 7771
Author(s):  
Daniel F. Burgos ◽  
Lorena Cussó ◽  
Gentzane Sánchez-Elexpuru ◽  
Daniel Calle ◽  
Max Bautista Perpinyà ◽  
...  
Keyword(s):  
Cerebral Cortex ◽  
Basal Ganglia ◽  
Magnetic Resonance ◽  
Mouse Models ◽  
Autosomal Recessive Inheritance ◽  
Resonance Spectroscopy ◽  
Brain Metabolites ◽  
Lafora Disease ◽  
Progressive Myoclonus Epilepsy ◽  
Positron Emission

Mutations in the EPM2A and EPM2B genes, encoding laforin and malin proteins respectively, are responsible for Lafora disease, a fatal form of progressive myoclonus epilepsy with autosomal recessive inheritance. Neuroimaging studies of patients with Lafora disease have shown different degrees of brain atrophy, decreased glucose brain uptake and alterations on different brain metabolites mainly in the frontal cortex, basal ganglia and cerebellum. Mice deficient for laforin and malin present many features similar to those observed in patients, including cognitive, motor, histological and epileptic hallmarks. We describe the neuroimaging features found in two mouse models of Lafora disease. We found altered volumetric values in the cerebral cortex, hippocampus, basal ganglia and cerebellum using magnetic resonance imaging (MRI). Positron emission tomography (PET) of the cerebral cortex, hippocampus and cerebellum of Epm2a−/− mice revealed abnormal glucose uptake, although no alterations in Epm2b−/− mice were observed. Magnetic resonance spectroscopy (MRS) revealed significant changes in the concentration of several brain metabolites, including N-acetylaspartate (NAA), in agreement with previously described findings in patients. These data may provide new insights into disease mechanisms that may be of value for developing new biomarkers for diagnosis, prevention and treatment of Lafora disease using animal models.

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