83 Volumetric assessment of tumour size changes in paediatric low grade gliomas: comparison with linear measurements and implications for determining response to therapy

Author(s):  
F D’Arco ◽  
P O’Hare ◽  
F Dashti ◽  
A Lassaletta ◽  
T Loka ◽  
...  
2018 ◽  
Vol 60 (4) ◽  
pp. 427-436 ◽  
Author(s):  
Felice D’Arco ◽  
Patricia O’Hare ◽  
Fatima Dashti ◽  
Alvaro Lassaletta ◽  
Thalia Loka ◽  
...  

2018 ◽  
Vol 17 ◽  
pp. 117693511880279 ◽  
Author(s):  
Srikanth Kuthuru ◽  
William Deaderick ◽  
Harrison Bai ◽  
Chang Su ◽  
Tiep Vu ◽  
...  

Radiomics is a rapidly growing field in which sophisticated imaging features are extracted from radiology images to predict clinical outcomes/responses, genetic alterations, and other outcomes relevant to a patient’s prognosis or response to therapy. This approach can effectively capture intratumor phenotypic heterogeneity by interrogating the “larger” image field, which is not possible with traditional biopsy procedures that interrogate specific subregions alone. Most models in radiomics derive numerous imaging features (eg, texture, shape, size) from a radiology data set and then learn complex nonlinear hypotheses to solve a given prediction task. This presents the challenge of visual interpretability of radiomic features necessary for effective adoption of radiomic models into the clinical decision-making process. To this end, we employed a dictionary learning approach to derive visually interpretable imaging features relevant to genetic alterations in low-grade gliomas. This model can identify regions of a medical image that potentially influence the prediction process. Using a publicly available data set of magnetic resonance imaging images from patients diagnosed with low-grade gliomas, we demonstrated that the dictionary-based model performs well in predicting 2 biomarkers of interest (1p/19q codeletion and IDH1 mutation). Furthermore, the visual regions (atoms) associated with these dictionaries show association with key molecular pathways implicated in gliomagenesis. Our results show that dictionary learning is a promising approach to obtain insights into the diagnostic process and to potentially aid radiologists in selecting physiologically relevant biopsy locations.


2018 ◽  
Vol 20 (suppl_2) ◽  
pp. i117-i117
Author(s):  
Scott Ryall ◽  
Michal Zapotocky ◽  
Kohei Fukuoka ◽  
Ana Guerreiro-Stucklin ◽  
Julie Bennet ◽  
...  

2021 ◽  
Vol 3 (Supplement_1) ◽  
pp. i20-i20
Author(s):  
Georgios Batsios ◽  
Pavithra Viswanath ◽  
Celine Taglang ◽  
Robert Flavell ◽  
Joseph Costello ◽  
...  

Abstract Telomerase reverse transcriptase (TERT) expression is essential for tumor proliferation and is an attractive therapeutic target for gliomas. TERT expression has previously been shown to enhance glucose flux via the pentose phosphate pathway (PPP) in low grade gliomas expressing TERT. Hyperpolarized δ-[1-13C]gluconolactone has been used to detect flux via the PPP by monitoring its conversion to 6-phospho-[1-13C]gluconate (6PG) in isolated perfused liver. The goal of our study was to evaluate whether hyperpolarized δ-[1-13C]gluconolactone can be used to monitor elevated PPP flux induced by TERT expression in low grade gliomas, thereby providing a non-invasive method of assessing TERT expression in vivo. Immortalized normal human astrocytes without (NHApre) and with TERT expression (NHApost) were used in cell bioreactor experiments. In vivo experiment with rats bearing orthotopic NHApost or patient-derived low-grade oligodendroglioma (SF10417) tumors were contacted. Dynamic 13C MR spectra were acquired at 14T (cells) or 3T (rats) following injection of hyperpolarized δ-[1-13C]gluconolactone. NHApost cells showed significantly higher flux through the PPP compared to NHApre. This finding was in agreement with previous results indicating that TERT expression elevates PPP flux. In all rats δ-[1-13C]gluconolactone and 6PG were observed indicating that δ-[1-13C]gluconolactone crosses the blood-brain barrier and is rapidly metabolized. Furthermore, both models presented homogeneous distribution of δ-[1-13C]gluconolactone in the brain and higher ratio of 6PG-to-δ-[1-13C]gluconolactone in the tumor area. In summary we show in vivo that hyperpolarized δ-[1-13C]gluconolactone metabolism to 6-phospho-[1-13C]gluconate is significantly higher in tumor compared to contralateral normal brain in TERT-expressing genetically-engineered and patient-derived low-grade oligodendrogliomas. Due to its fundamental role in tumor proliferation, TERT is both a tumor biomarker and a therapeutic target. Monitoring HP δ-[1-13C]gluconolactone metabolism, therefore, has the potential to inform on tumor burden and response to therapy in the clinic.


2020 ◽  
Vol 10 (7) ◽  
pp. 463 ◽  
Author(s):  
Muhaddisa Barat Ali ◽  
Irene Yu-Hua Gu ◽  
Mitchel S. Berger ◽  
Johan Pallud ◽  
Derek Southwell ◽  
...  

Brain tumors, such as low grade gliomas (LGG), are molecularly classified which require the surgical collection of tissue samples. The pre-surgical or non-operative identification of LGG molecular type could improve patient counseling and treatment decisions. However, radiographic approaches to LGG molecular classification are currently lacking, as clinicians are unable to reliably predict LGG molecular type using magnetic resonance imaging (MRI) studies. Machine learning approaches may improve the prediction of LGG molecular classification through MRI, however, the development of these techniques requires large annotated data sets. Merging clinical data from different hospitals to increase case numbers is needed, but the use of different scanners and settings can affect the results and simply combining them into a large dataset often have a significant negative impact on performance. This calls for efficient domain adaption methods. Despite some previous studies on domain adaptations, mapping MR images from different datasets to a common domain without affecting subtitle molecular-biomarker information has not been reported yet. In this paper, we propose an effective domain adaptation method based on Cycle Generative Adversarial Network (CycleGAN). The dataset is further enlarged by augmenting more MRIs using another GAN approach. Further, to tackle the issue of brain tumor segmentation that requires time and anatomical expertise to put exact boundary around the tumor, we have used a tight bounding box as a strategy. Finally, an efficient deep feature learning method, multi-stream convolutional autoencoder (CAE) and feature fusion, is proposed for the prediction of molecular subtypes (1p/19q-codeletion and IDH mutation). The experiments were conducted on a total of 161 patients consisting of FLAIR and T1 weighted with contrast enhanced (T1ce) MRIs from two different institutions in the USA and France. The proposed scheme is shown to achieve the test accuracy of 74 . 81 % on 1p/19q codeletion and 81 . 19 % on IDH mutation, with marked improvement over the results obtained without domain mapping. This approach is also shown to have comparable performance to several state-of-the-art methods.


2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii369-iii369
Author(s):  
Antonella Cacchione ◽  
Evelina Miele ◽  
Maria Chiara Lodi ◽  
Andrea Carai ◽  
Giovanna Stefania Colafati ◽  
...  

Abstract BACKGROUND MAPK pathway is the hallmark of pediatric low grade gliomas (pLGGs); hyperactivation of mTOR (mammalian target of rapamycin) might be a suitable biomarker for therapeutic response. We investigated the feasibility of Everolimus, mTOR inhibitor, in patients affected by pLGGs. METHODS Patients 1 to 18 years old, diagnosed with pLGG, with a positive tumor biopsy for mTOR/phospho-mTOR and radiological and / or clinical disease progression, treated at Bambino Gesù Children’s Hospital in Rome were evaluated. Tumor DNA methylation analysis was performed in 10 cases. Exclusion criteria included: Tuberous Sclerosis patients, Sub Ependymal Giant Astrocytoma. Everolimus was administered orally at a dose of 2.5 mg or 5 mg daily based on body weight. Patients were evaluated with brain MRI every 4, 8 and 12 months after treatment start and every six months thereafter. RESULTS 16 patients were enrolled from September 2014 and 2019. The median age was 7.5 years old. All patients had at least one adverse event. Events rated as severe (grade 3/4) were reported in 6 patients. Stomatitis was the most frequent adverse event. One patient discontinued treatment due to grade 4 toxicity (ulcerative stomatitis and fatigue). The median duration of treatment was 21 months (4–57 months). Brain MRI evaluations have showed disease stability in 11 patients, partial response in 2 patients and disease progression in 3 patients. CONCLUSIONS Everolimus has proven to be well tolerated and effective treatment in terms of disease stability in patients with pLGGs. It’s also an excellent example of chemo-free personalized approach.


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