The Role of Pre-operative MRI For Prediction of High-Grade Intracranial Meningioma: A Retrospective Study

2021 ◽  
Author(s):  
Vitit Lekhavat ◽  
Kan Radeesri
Keyword(s):  
Clinical Outcomes ◽  
Histological Grade ◽  
Intracranial Meningioma ◽  
Low Grade ◽  
High Grade ◽  
Who Grade ◽  
Intracranial Meningiomas ◽  
Mri Features ◽  
Peritumoral Brain Edema ◽  
Magnetic Resonance Imaging Mri

Abstract Introduction: High histological grade (WHO grade II and III) intracranial meningiomas have been linked to greater risk for tumor recurrence and worse clinical outcomes compared to low-grade (WHO grade I) tumors. Preoperative magnetic resonance imaging (MRI) plays a crucial role tumor evaluation prior to decisions regarding management and allows for a better understanding of the tumor grading, which could potentially alter clinical outcomes. The present study sought to determine whether preoperative MRI features of intracranial meningiomas can serve as predictors of high-grade tumors.Methods: This study retrospectively reviewed 327 confirmed cases of intracranial meningiomas, among whom 210 (64.2%) had available preoperative MRI studies. Thereafter, data were analyzed using univariate and multivariate analyses.Results: Accordingly, multivariate analysis found that peritumoral brain edema and the presence of necrosis or hemorrhage were predictors of high-grade tumors, whereas hyperostosis was a predictor of low-grade tumors.Conclusions: Our study suggested that preoperative MRI features could potentially assist in decision-making regarding the appropriate management and surgical approach in order to achieve the desired clinical outcomes.

P16.13 MenImmune: Evaluation of immune-related and prognostic biomarkers in meningioma

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii58-ii58
Author(s):  
M Truffelli ◽  
M Grassi ◽  
P Fiaschi ◽  
L Roccatagliata ◽  
E Bennicelli ◽  
...  
Keyword(s):  
Clinical Data ◽  
Checkpoint Inhibitors ◽  
Histological Grade ◽  
Progesterone Receptors ◽  
System Response ◽  
Low Grade ◽  
Electronic Patient Records ◽  
Eligibility Criteria ◽  
Mri Features ◽  
Magnetic Resonance Imaging Mri

Abstract BACKGROUND Meningiomas are the most common group of adult central nervous system primary tumor. The major known predictors for meningioma recurrence are extent of surgical resection and histological grade. Although grading system is the actual standard for risk classification, there are several exceptions in the clinical behavior. Recent studies have shown that meningiomas can express PD-L1, a known therapeutic target for checkpoint inhibitors. Tumor microenvironment and hormonal setting are known to influence the immune system response. The only standard therapeutic strategies nowadays are surgery and radiotherapy. Meningiomas microenvironment needs to be further studied looking for new therapeutic targets. New prognostic tools combining histological and radiological features (RF) are needed to better address the treatment strategy. ELIGIBILITY CRITERIA Patients diagnosed with meningioma who underwent surgery at the Department of Neurosurgery of the IRCCS Ospedale Policlinico San Martino of Genoa from 1998. - Availability of magnetic resonance imaging (MRI) at diagnosis. - Availability of histological samples. OBJECTIVES Identification and prevalence of immune-related biomarkers and their correlation with morphological and hormonal features. - Survival analyses in the study population and according to the different characteristics analyzed. - The identification of specific clinical, histological and RF of meningiomas and their inclusion in a prognostic signature. STUDY DESIGN This is a retrospective-prospective monocentric study designed to analyze clinical, radiological and histological features of meningioma patients. - Clinical data will be collected from the electronic patient records. - Analyses will be conducted on a cohort of patients enriched with higher grade meningioma to balance the proportion between high and low grade histologies. - Histological specimen will be blindly reviewed and reclassified according to histological type, morphological features and WHO 2016 criteria. - The MRI features will be analyzed at diagnosis. STUDY ANALYSIS We retrospectively enrolled 50 patients with available radiological, histological and clinical data.- All histopathological specimens will be examined with slides obtained from material fixed in 10% neutral buffered formalin, included in kerosene, sectioned at 3 µm and stained with hematoxylin-eosin. - We will look for the presence of estrogens and progesterone receptors. - Concerning immune-related biomarkers we will further assess PD-L1 positivity (cut-off: positive 1%, negative <1%), MSI status and the inflammatory infiltrate with immunohistochemistry, in particular TILs (CD45, CD3, CD4, CD8, FOXP3, CTLA4), B cell (CD20), TAM (CD68). - All histological and radiological data will be analyzed and correlated with the clinical characteristics of meningioma patients and their outcomes.

MRI features of low-grade and high-grade chondrosarcoma in enchondromatosis

2021 ◽  
Author(s):  
Ban Sharif ◽  
Ramanan Rajakulasingam ◽  
Shahab Sharifi ◽  
Paul O’Donnell ◽  
Asif Saifuddin
Keyword(s):  
Low Grade ◽  
High Grade ◽  
Mri Features

scholarly journals Stereology in Grading and Prognosis of Canine Cutaneous Mast Cell Tumors

2021 ◽  
pp. 030098582098513
Author(s):  
Mafalda Casanova ◽  
Sandra Branco ◽  
Inês Berenguer Veiga ◽  
André Barros ◽  
Pedro Faísca
Keyword(s):  
Mast Cell ◽  
Clinical Outcome ◽  
Prognostic Value ◽  
Histological Grade ◽  
Intraobserver Variability ◽  
Low Grade ◽  
High Grade ◽  
Mast Cell Tumors ◽  
Cutaneous Mast Cell ◽  
Grade Iii

Canine cutaneous mast cell tumors (ccMCTs) are currently graded according to Patnaik and Kiupel grading schemes. The qualitative and semiquantitative parameters applied in these schemes may lead to inter- and intraobserver variability. This study investigates the prognostic value of volume-weighted mean nuclear volume ([Formula: see text]), a stereological estimation that provides information about nuclear size and its variability. [Formula: see text] of 55 ccMCTs was estimated using the “point-sampled intercept” method and compared with histological grade and clinical outcome. The clinical history of dogs treated with surgical excision alone was available for 30 ccMCTs. Statistical differences in [Formula: see text] were found between grade II ([Formula: see text]= 115 ± 29 µm3) and grade III ccMCTs ([Formula: see text]= 197 ± 63 µm3), as well as between low-grade ([Formula: see text]= 113 ± 28 µm3) and high-grade ccMCTs ([Formula: see text]= 184 ± 63 µm3). An optimal cutoff value of [Formula: see text] ≥ 150 µm3 and [Formula: see text] ≥ 140 µm3 was determined for grade III and high-grade ccMCTs, respectively. In terms of prognosis, [Formula: see text] was not able to predict the clinical outcome in 42% of the cases; however, cases with [Formula: see text]<125 µm3 had a favorable outcome. These results indicate that, despite having limited prognostic value when used as a solitary parameter, [Formula: see text] is highly reproducible and is associated with histological grade as well as with benign behavior.

scholarly journals Impact of Pathological Stratification on the Clinical Outcomes of Advanced Well-Differentiated/Dedifferentiated Liposarcoma Treated with Trabectedin

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1453
Author(s):  
Chiara Fabbroni ◽  
Giovanni Fucà ◽  
Francesca Ligorio ◽  
Elena Fumagalli ◽  
Marta Barisella ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Proportional Hazards ◽  
Case Series ◽  
Progression Free Survival ◽  
Cox Proportional Hazards ◽  
Low Grade ◽  
High Grade ◽  
Retrospective Case ◽  
Well Differentiated ◽  
The Impact

Background. We previously showed that grading can prognosticate the outcome of retroperitoneal liposarcoma (LPS). In the present study, we aimed to explore the impact of pathological stratification using grading on the clinical outcomes of patients with advanced well-differentiated LPS (WDLPS) and dedifferentiated LPS (DDLPS) treated with trabectedin. Patients: We included patients with advanced WDLPS and DDLPS treated with trabectedin at the Fondazione IRCCS Istituto Nazionale dei Tumori between April 2003 and November 2019. Tumors were categorized in WDLPS, low-grade DDLPS, and high-grade DDLPS according to the 2020 WHO classification. Patients were divided in two cohorts: Low-grade (WDLPS/low-grade DDLPS) and high-grade (high-grade DDLPS). Results: A total of 49 patients were included: 17 (35%) in the low-grade cohort and 32 (65%) in the high-grade cohort. Response rate was 47% in the low-grade cohort versus 9.4% in the high-grade cohort (logistic regression p = 0.006). Median progression-free survival (PFS) was 13.7 months in the low-grade cohort and 3.2 months in the high-grade cohort. Grading was confirmed as an independent predictor of PFS in the Cox proportional-hazards regression multivariable model (adjusted hazard ratio low-grade vs. high-grade: 0.45, 95% confidence interval: 0.22–0.94; adjusted p = 0.035). Conclusions: In this retrospective case series, sensitivity to trabectedin was higher in WDLPS/low-grade DDLPS than in high-grade DDLPS. If confirmed in larger series, grading could represent an effective tool to personalize the treatment with trabectedin in patients with advanced LPS.

MRI differentiation of low-grade and high-grade chondrosarcoma of the shoulder girdle, chest wall and pelvis: a pictorial review based on 111 consecutive cases

2021 ◽  
pp. 20201404
Author(s):  
Virendra Jain ◽  
Ines Oliveira ◽  
Anesh Chavda ◽  
Michael Khoo ◽  
Asif Saifuddin
Keyword(s):  
Soft Tissue ◽  
Chest Wall ◽  
Shoulder Girdle ◽  
Low Grade ◽  
High Grade ◽  
Tissue Mass ◽  
Cortical Destruction ◽  
Pictorial Review ◽  
Mri Features ◽  
Grade One

Approximately 40% of conventional chondrosarcomas arise from the shoulder girdle, chest wall and pelvis. This pictorial review describes the MRI features which may aid in the differentiation of Grade one chondrosarcoma (G1-CS) from high-grade chondrosarcoma (HG-CS) and dedifferentiated chondrosarcoma (DD-CS) in these locations, based on literature review and assessment of 111 consecutive cases presenting to the senior authors institution over a 13 year period. Of the 111 patients reviewed (71 males and 40 females; mean age 54.3 years; range 17–92 years), 27 were Gd1-CS, 72 were HG-CS and 12 were DD-CS. Tumours arising from the scapula, acetabulum, pubis/ischium and sacrum were more likely to be HG-CS, as were intra medullary tumours. MRI features associated with HG-CS and DD-CS included cortical destruction, bone oedema, soft tissue oedema, tumour necrosis, intermediate T2W SI and joint invasion. The presence of a soft tissue mass became a significant differentiating feature for tumours arising within the medullary cavity, but this was location specific and did not differentiate between Gd1-CS and HG-CS/DD-CS arising from the sternum or clavicle.

Diverse MRI findings and clinical outcomes of acute Marchiafava-Bignami disease

2020 ◽  
pp. 028418512094304
Author(s):  
Wei Li ◽  
Chao Ran ◽  
Jun Ma
Keyword(s):  
Clinical Outcomes ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Restricted Diffusion ◽  
Type I ◽  
Type Ii ◽  
Mri Findings ◽  
Type Iii ◽  
Mri Features ◽  
Magnetic Resonance Imaging Mri

Background The acute onset of Marchiafava-Bignami disease (MBD) is difficult to capture, and its clinical manifestations are overlapped. Magnetic resonance imaging (MRI) is very useful in the diagnosis of acute MBD. Purpose To investigate the MRI features and clinical outcomes of acute MBD. Materials and Methods Sagittal T2-weighted (T2W) or T1-weighted (T1W) imaging, axial T1W and T2W imaging, and axial FLAIR and diffusion-weighted imaging (DWI) sequences were performed in 17 patients with acute MBD on 1.5-T MR. According to the different ranges of callosal restricted diffusion, MBD was divided into Type I (n = 7, the completely involved), Type II (n = 5, the mostly involved), and Type III (n = 5, the partly involved). The MRI findings and outcomes of each type were retrospectively analyzed. Results With the reduced range of the callosal restricted diffusion, the callosal atrophy or cavitation was more common: no case of Type I; 1 (20%) case of Type II; and 3 (60%) cases of Type III. With the increased range of callosal restricted diffusion, the extracallosal involvement was more common: 6 (86%) cases of Type I; 3 (60%) cases of Type II; and 1 (20%) case of Type III. During the follow-up, five cases had neuropsychiatric sequelae: 1 (14%) case of type I; 1 (20%) case of Type II; 3 (60%) cases of Type III. Conclusion The MRI findings and clinical outcomes of acute MBD are regular. The extensive restricted diffusion of acute MBD may present the curable condition. Callosal heterogeneity may affect the outcome of acute MBD.

scholarly journals Urothelial Tumors of the Urinary Bladder in Young Patients: A Clinicopathologic Study of 59 Cases

2013 ◽  
Vol 137 (10) ◽  
pp. 1337-1341 ◽  
Author(s):  
Melissa L. Stanton ◽  
Li Xiao ◽  
Bogdan A. Czerniak ◽  
Charles C. Guo
Keyword(s):  
Urinary Bladder ◽  
Clinical Outcomes ◽  
Young Patients ◽  
Muscularis Propria ◽  
Low Grade ◽  
High Grade ◽  
Urothelial Carcinomas ◽  
Pathologic Features ◽  
Urothelial Tumors

Context.—Urothelial tumors are rare in young patients. Because of their rarity, the natural history of the disease in young patients remains poorly understood. Objective.—To understand the pathologic and clinical features of urothelial tumors of the urinary bladder in young patients. Design.—We identified 59 young patients with urothelial tumors of the urinary bladder treated at our institution and analyzed the tumors' pathologic features and the patients' clinical outcomes. Results.—All patients were 30 years or younger, with a mean age of 23.5 years (range, 4–30). Thirty-eight patients (64%) were male, and 21 (36%) were female. Most tumors were noninvasive, papillary urothelial tumors (49 of 59; 83%), including papillary urothelial neoplasms of low malignant potential (7 of 49; 14%), low-grade papillary urothelial carcinomas (38 of 49; 78%), and high-grade papillary urothelial carcinomas (4 of 49; 8%). Only a few (n = 10) of the urothelial tumors were invasive, invading the lamina propria (n = 5; 50%), muscularis propria (n = 4; 40%), or perivesical soft tissue (n = 1; 10%). Clinical follow-up information was available for 41 patients (69%), with a mean follow-up time of 77 months. Of 31 patients with noninvasive papillary urothelial tumors, only 1 patient (3%) later developed an invasive urothelial carcinoma and died of the disease, and 30 of these patients (97%) were alive at the end of follow-up, although 10 (32%) had local tumor recurrences. In the 10 patients with invasive urothelial carcinomas, 3 patients (30%) died of the disease and 5 others (50%) were alive with metastases (the other 2 [20%] were alive with no recurrence). Conclusion.—Urothelial tumors in young patients are mostly noninvasive, papillary carcinomas and have an excellent prognosis; however, a small subset of patients may present with high-grade invasive urothelial carcinomas that result in poor clinical outcomes.

scholarly journals Brainstem glioma: Prediction of histopathologic grade based on conventional MR imaging

2017 ◽  
Vol 31 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Yashar Moharamzad ◽  
Morteza Sanei Taheri ◽  
Farhad Niaghi ◽  
Elham Shobeiri
Keyword(s):  
Logistic Regression ◽  
Mr Imaging ◽  
Contrast Enhancement ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Low Grade ◽  
Imaging Features ◽  
High Grade ◽  
Post Contrast ◽  
Mri Features

Objective The objective of this article is to investigate the association between specific MR imaging findings and histopathologic grading (low-grade vs. high-grade) of brainstem gliomas (BSGs). Methods Sixty-two males and 34 females (mean (standard deviation, SD) age of 24.61 (17.20) years, range = 3 to 70 years) with histologically diagnosed BSG underwent conventional 1.5 T MR imaging, which included T1-weighted (T1W), T2W, and post-contrast T1W sequences. There were 39 children (mean age of 9.38 years) and 57 adults (mean age of 35 years). A binary logistic regression analysis was used to explore associations between MRI features and histopathological grade of the BSG. Results Binary logistic regression revealed that necrosis (adjusted odds ratio (OR) = 16.07; 95% confidence interval (CI) = 3.20 to 80.52; p = 0.001) and inhomogeneous contrast enhancement (adjusted OR = 8.04; 95% CI = 1.73 to 37.41; p = 0.008) as significant predictors of high-grade BSG. The equation (Nagelkerke R2 = 0.575) is Logit ( p high-grade BSG) = (2.77 × necrosis) + (2.08 × heterogeneous contrast enhancement) – 3.13. Sensitivity and specificity values were respectively 66.7% and 96.0% for necrosis and 85.7% and 65.9% for inhomogeneous contrast-enhancing lesions. In the pediatric age group, only inhomogeneous contrast enhancement (adjusted OR = 40; 95% CI = 3.95 to 445.73; p = 0.002) was a significant predictor for high-grade BSG. Conclusion Conventional MR imaging features such as necrosis and inhomogeneous contrast enhancement in adults and heterogeneous contrast enhancement in children suggest high-grade BSG.

scholarly journals Low residual proliferation after short-term letrozole therapy is an early predictive marker of response in high proliferative ER-positive breast cancer

2011 ◽  
Vol 18 (6) ◽  
pp. 721-730 ◽  
Author(s):  
Philippe L Bedard ◽  
Sandeep K Singhal ◽  
Michail Ignatiadis ◽  
Ian Bradbury ◽  
Benjamin Haibe-Kains ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Clinical Response ◽  
Histological Grade ◽  
Low Grade ◽  
High Grade ◽  
Early Assessment ◽  
Short Term ◽  
Er Positive ◽  
Positive Breast Cancer

The gene expression grade index (GGI) is a 97-gene algorithm that measures proliferation and divides intermediate histological grade tumors into two distinct groups. We investigated the association between early changes in GGI and clinical response to neoadjuvant letrozole and compared this to Ki67 values. The paired gene expression data at the beginning and after 10–14 days of neoadjuvant letrozole treatment were available for 52 post-menopausal patients with estrogen receptor (ER)-positive breast cancer. Baseline values and changes in GGI, Ki67, and RNA expression modules representing oncogenic signaling pathways were compared to sonographic tumor volume changes after 3 months of treatment in the subsets of patients defined by high and low baseline GGI. The clinical response was observed in 80% genomic low-grade (24/30) and 59% genomic high-grade (13/22) tumors (P=0.10). Low residual proliferation after 10–14 days of neoadjuvant letrozole therapy, measured by either GGI or Ki67, was associated with sonographic response in genomic high-grade (GGI, P=0.003; Ki67, P=0.017) but not genomic low-grade (GGI, P=0.25; Ki67, P=1.0) tumors. The analysis of expression modules suggested that sonographic response to letrozole in genomic high-grade tumors was associated with an early reduction in IGF1 signaling (unadjusted P=0.018). The major conclusion of this study is that the early assessment of proliferation after short-term endocrine therapy may be useful to evaluate endocrine responsiveness, particularly in genomic high-grade ER-positive breast cancer.

scholarly journals Are there Predilection Sites for Intracranial Meningioma? A Population-Based Atlas

2021 ◽  
Author(s):  
Sayied Abdol Mohieb Hosainey ◽  
David Bouget ◽  
Ingerid Reinertsen ◽  
Lisa Millgård Sagberg ◽  
Sverre Helge Torp ◽  
...  
Keyword(s):  
Anterior Part ◽  
Middle Cranial Fossa ◽  
Tumor Location ◽  
Population Based ◽  
Tumor Segmentation ◽  
Intracranial Meningioma ◽  
Who Grade ◽  
Intracranial Meningiomas ◽  
Pre Treatment ◽  
The Brain

Abstract Meningioma is the most common benign intracranial tumor and is believed to arise from arachnoid cap cells of arachnoid granulations. We sought to develop a population-based based atlas from pre-treatment MRIs to explore the distribution of intracranial meningiomas. All adults (≥ 18 years old) diagnosed with intracranial meningiomas and referred to a department of neurosurgery from a defined catchment region between 2006 and 2015 were eligible for inclusion. Pre-treatment T1 contrast-enhanced MRI weighted brain scans were used for semi-automated tumor segmentation to develop the meningioma atlas. Patient variables used in the statistical analyses included age, gender, tumor locations, WHO grade and tumor volume. A total of 602 patients with intracranial meningiomas were identified. The spatial distribution of meningioma within the brain is not uniform and there were more tumors in the frontal region, especially parasagittally, along the anterior part of the falx, and on the skull base of the frontal and middle cranial fossa. More than 2/3 meningioma patients were females (p < 0.001) who also were more likely to have multiple meningiomas (p < 0.01), while men more often have supratentorial meningiomas (p < 0.01). Tumor location was not associated with age or WHO grade. The distribution of meningioma exhibit an anterior to posterior gradient in the brain. Distribution of meningiomas is not dependent on histopathological WHO grade, but may be gender related.

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