scholarly journals Measurement of the peritumoral edema and tumor volume ratio in differentiating malignant primary and metastatic brain tumor

2020 ◽  
Vol 13 (2) ◽  
pp. 055-061
Author(s):  
Aulia Hanum ◽  
Achmad Bayhaqi Nasir Aslam ◽  
Yuyun Yueniwati ◽  
Diah Prabawati Retnani ◽  
Nanik Setjowati
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Volume Ratio ◽  
Peritumoral Edema ◽  
Volume Data ◽  
Metastatic Brain Tumors ◽  
Cross Sectional ◽  
Primary Brain Tumors ◽  
Tumor Group ◽  
Significant Difference

Malignant primary and metastatic brain tumors are group of malignancies radiologically difficult to distinguish between one another. Meanwhile, the treatment regimens between the two entities are very different. The right regimen can maintain patient’s survival. MRI is the modality of choice for diagnosing brain tumors; although, malignant primary brain tumors and solitary metastases appear similar on conventional MRI. The difference in the pathophysiology of peritumoral edema in malignant primary and metastatic brain tumors has the potential for differentiation of the two entities. In malignant primary brain tumors, tumor cell infiltration occurs in the edema area, meaning that the peritumoral edema is narrower than that of the metastases. This study analyzed the ratio of peritumoral edema volume to tumor (EP/T volume ratio) in malignant primary and metastatic brain tumors by means of MRI examination with a cross-sectional design, using MRI data on FLAIR and T1WI sequences with contrast in malignant brain tumor of patients that have been pathologically proven. Then, volume contouring was performed on peritumoral edema (EP) and tumor (T), and comparation was done to obtain the EP/T volume ratio. The ratio of EP/T volume data in both groups was analyzed using the Mann–Whitney test with the SPSS 22 software. The results of statistical analysis revealed that the EP/T volume ratio of the malignant primary brain tumor group was smaller with a median value (max-min) of 1.1 (5.65-0.17) and in the metastatic group, 2.3 (64.03-0.09). There was a significant difference in the EP/T volume ratio between the two groups, which the brain metastatic tumor group have a double ratio of EP/T with a value of p=0.008 (p<0.05).

scholarly journals Diffusion Kurtosis Imaging in the Assessment of Peritumoral Brain Edema in Glioblastomas and Brain Metastases

2017 ◽  
pp. 97-112 ◽  
Author(s):  
A. M. Turkin ◽  
E. L. Pogosbekyan ◽  
A. C. Tonoyan ◽  
E. I. Shults ◽  
I. I. Maximov ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Contrast Enhancement ◽  
Diffusion Kurtosis Imaging ◽  
Acquisition Time ◽  
Normal Brain ◽  
Peritumoral Edema ◽  
Brain White Matter ◽  
Significant Difference ◽  
Diffusion Kurtosis

Aim: to explore the opportunities of application of diffusionkurtosis imaging (DKI) for assessment and estimation of diffusion scalar metrics in different locations of peritumoral edema for extra- and intracerebral tumors and in contralateral normal tissue.Materials and methods. 38 patients with supratentorial brain tumors were investigated: 24 (63%) patients with primarily revealed glioblastomas (GB) and 14 (37%) patients with solitary cancer brain metastasis (MTS). MRI was performed on 3.0 T MR-scanner (Signa HDxt, General Electric, USA) with the standard protocols for brain tumor and additional protocol for DKI. The standard protocol for brain tumor included: T1-, T2-weighted images, T2-FLAIR, DWI,  T1 with contrast enhancement. Diffusion kurtosis MRI based on SE  EPI with TR = 10000 ms, TE = 102 ms, FOV = 240 mm, isotropic voxel size 3 × 3 × 3 mm3, 60 noncoplanar diffusion directions. We  used three b-values: 0, 1000 and 2500 s/mm2. Аcquisition time was 22 min. Total acquisition time was near 40 min. This study was approved by Ethical committee of Burdenko National Scientific  and Practical Center for Neurosurgery. Parametric maps were  constructed for the following diffusion coefficients: mean (MK),  transverse / radial (RK), longitudinal / axial (AK) kurtozis; medium  (MD), transverse / radial (RD) and longitudinal / axial (AD) diffusion; fractional anisotropy (FA) and a bi-exponential diffusion model  coefficients: axonal water fractions (AWF), axial (AxEAD) and radial  (RadEAD) extra-axonal water diffusion and the water molecules  trajectory tortuosity index (TORT). Normative quantitative indicators  were obtained for the six regions of the peritumoral zone as they  moved away from the tumor (region 2) to the edema periphery  (regions 4–5), as well as in the normal brain on the contralateral  hemisphere (C/L) (zone 7). A comparative analysis of these  indicators was conducted for cases with GB and MTS. DKI scalar metrics were estimated using Explore DTI (http://www.exploredti.com/).Results. Anatomic MRI (T1 without/with contrast enhancement) for  all cases with GB and MTS visualized a contrast enhancement tumor.  The peritumoral edema, spreading mainly over the brain white  matter, was well visualized on T2-FLAIR. Diffusion kurtosis  coefficients decreased in the near peritumoral edema (regions 2–3)  and a gradually increased to the edema periphery (regions 5–6). In Region 2, MK in both GB and MTS groups were MKGB(2) = 0.637 ±  0.140 and MKMTS(2) = 0.550 ± 0.046; RK in this region were  RKGB(2) = 0.690 ± 0.154 and RKMTS (2) = 0.584 ± 0.051.  Differences both MK and RK coefficients in patients with GB and MTS of region 2 were significant (p < 0.001). There were no differences in AK values for GB and MTS in region 2 (p > 0.05), but in regions 3  and 4 differences were observed (p < 0.01). The minimum value of  AK in the central edema (regions 3–4) was AKMTS(3–4) = 0.433 ± 0.063 in patients with MTS. The values of MK and RK on the  contralateral side in patients with MTS were significantly higher than  in the GB group (p < 0.02); MKC/LMTC = 0.954 ± 0.140, RKC/LMTC  = 1.257 ± 0.308 and MKC/LGB = 0.829 ± 0.146, RKc/LGB = 0.989  ± 0.282. There was no significant difference for contralateral AK between the groups.Conclusions. We found that DKI scalar metrics are the sensitive  tumor biomarkers. It allows us to perform a robust differentiation  between the infiltrating GB tumor and purely vasogenic edema of  МТS. The obtained results will allow further differential diagnosis of  extra- and intracerebral tumors and can be used to plan surgical /  radiosurgical treatment for brain tumors.

scholarly journals Fertility preservation in primary brain tumor patients

2016 ◽  
Vol 4 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Jacqueline B. Stone ◽  
Joanne F. Kelvin ◽  
Lisa M. DeAngelis
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Fertility Preservation ◽  
Primary Brain Tumor ◽  
Nurse Specialist ◽  
Tumor Patients ◽  
Related Factors ◽  
Patients Âgés ◽  
Primary Brain Tumors ◽  
Significant Difference

Abstract Background Fertility preservation (FP) is an infrequently addressed issue for young adults with primary brain tumors. Given the improved prognosis and enhanced technology in reproductive medicine, more primary brain tumor patients see procreation as feasible, making the discussion of FP increasingly important. The goals of this study were to describe patients who received FP counseling by a fertility nurse specialist (FNS) and determine which sociodemographic and disease-related factors predict acceptance of referral to a reproductive specialist. Methods Institutional review board-approved retrospective review of primary brain tumor patients, ages 18 to 45, who were referred for FP counseling with a FNS from 2009 to 2013. Results Seventy patients were referred for FP counseling: 38 men, 32 women, with a median age of 32 years and median KPS of 90. Eighty-nine percent had gliomas; 58% grade III, 17% grade IV. Sixty-seven percent were referred for counseling at initial diagnosis. Of those referred, 73% accepted referral to a sperm bank (87% of men) or reproductive endocrinologist (56% of women). Patients were more likely to accept referral if they had no prior children (P = .048). There was no statistically significant difference in referral acceptance by age, race/ethnicity, marital status, religion, or tumor grade. After treatment, 3 men conceived naturally, 2 men conceived using banked sperm, and 2 women conceived naturally. Conclusions Despite the historically poor prognosis of patients with primary brain tumors, there is significant interest in FP among these patients, particularly if they have no prior children. Clinicians should develop strategies to incorporate FP counseling into practice.

Gamma knife radiosurgery for metastatic brain tumors from lung cancer: a comparison between small cell and non—small cell carcinoma

2002 ◽  
Vol 97 ◽  
pp. 484-488 ◽  
Author(s):  
Toru Serizawa ◽  
Junichi Ono ◽  
Toshihiko Iichi ◽  
Shinji Matsuda ◽  
Makoto Sato ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Tumors ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Metastatic Brain Tumors ◽  
Cell Lung Carcinoma ◽  
Content Type ◽  
Significant Difference ◽  
Fine Print

Object. The purpose of this retrospective study was to evaluate the effectiveness of gamma knife radiosurgery (GKS) for the treatment of metastatic brain tumors from lung cancer, with particular reference to small cell lung carcinoma (SCLC) compared with non-SCLC (NSCLC). Methods. Two hundred forty-five consecutive patients meeting the following five criteria were evaluated in this study: 1) no prior brain tumor treatment; 2) 25 or fewer lesions; 3) a maximum of three tumors with a diameter of 20 mm or larger; 4) no surgically inaccessible tumor 30 mm or greater in diameter; and 5) more than 3 months of life expectancy. According to the same treatment protocol, large tumors (≥ 30 mm) were surgically removed and the other small lesions (< 30 mm) were treated with GKS. New lesions were treated with repeated GKS. Chemotherapy was administered, according to the primary physician's protocol, as aggressively as possible. Progression-free, overall, neurological, qualitative, and new lesion—free survival were calculated with the Kaplan—Meier method and were compared in the SCLC and NSCLC groups by using the log-rank test. The poor prognostic factors for each type of survival were also analyzed with the Cox proportional hazard model. Conclusions. Tumor control rate at 1 year was 94.5% in the SCLC group and 98% in the NSCLC group. The median survival time was 9.1 months in the SCLC group and 8.6 months in the NSCLC group. The 1-year survival rates in the SCLC group were 86.5% for neurological survival and 68.9% for qualitative survival; those in the NSCLC group were 87.9% for neurological and 78.9% for qualitative survival. The estimated median interval to emergence of a new lesion was 6.9 months in the SCLC group and 9.8 months in the NSCLC group. There was no significant difference between the two groups for any type of survival; this finding was verified by multivariate analysis. The results of this study suggest that GKS appears to be as effective in treating brain metastases from SCLC as for those from NSCLC.

EPID-17. COMPARATIVE EPIDEMIOLOGY OF PRIMARY BRAIN TUMORS AMONG ADOLESCENTS AND YOUNG ADULTS (AYA)

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi89-vi89
Author(s):  
Nayan Lamba ◽  
Bryan Iorgulescu
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Cox Regression ◽  
Adolescent And Young Adult ◽  
Lower Grade ◽  
Diffuse Glioma ◽  
Tumor Type ◽  
Primary Brain Tumors ◽  
Diffuse Gliomas ◽  
Hiv Aids

Abstract INTRODUCTION We utilized national registry data to evaluate the unique epidemiology of primary adolescent and young adult (AYA) brain tumors according to the WHO2016 classification. METHODS AYA patients (15≤age≤39) presenting between 2004-2017 with a brain tumor were identified by ICD-O-3 coding from the National Cancer Database (comprising &gt;70% of newly-diagnosed cancers in the U.S.), and compared to pediatric and adult populations. Epidemiology and overall survival (estimated by Kaplan-Meier techniques and multivariable Cox regression) were assessed by WHO2016 tumor type. RESULTS 108,705 AYA brain tumor patients were identified (56.9% female), compared to 23,928 pediatric (46.8% female) and 748,272 adult (55.6% female) patients. Among the 69.4% of AYA brain tumors with pathological diagnosis, diffuse gliomas (31.4%), sellar tumors (19.2%), and meningiomas (15.3%) predominated in both sexes. Diffuse glioma (31.4%), sellar (19.2%), cranial nerve (7.3%), and mesenchymal non-meningothelial (4.1%) tumors represented a greater proportion of AYA brain tumors than in either pediatric or adult populations. A majority of all intracranial GCTs (59.2%) and neuronal & mixed neuronal-glial tumors (51.6%) presented during AYA. Although the prevalence of diffuse gliomas was similar between AYAs and adults, AYA gliomas were more likely to be grade 2-3 astrocytomas (38.9% vs 14.3%) and oligodendrogliomas (19.3% vs 4.3%) than in adults. GBMs represented 76.0% of adult diffuse gliomas vs. only 25.7% of AYA diffuse gliomas, but with a similar prevalence of MGMT promoter methylation (40.8% vs 38.4%). Notably, 50.7% of AYA PCNSLs were associated with HIV/AIDS, vs only 7.1% in adults (p&lt; 0.001). CONCLUSIONS The distribution, epidemiology, and survival outcomes of primary brain tumors in the AYA population are distinct from their pediatric and adult counterparts. Notably, AYA infiltrative gliomas were more often of lower grade than adults and AYA PCNSL were far more likely to be associated with HIV/AIDS. Primary brain tumors in AYA patients require specialized management.

scholarly journals Longterm Antiepileptic Therapy and Bone Health: Implications for Patients with Brain Tumors

2021 ◽  
Vol 49 (1, 2, 3) ◽  
pp. 23
Author(s):  
Admir Mehičević ◽  
Nevena Mahmutbegović ◽  
Ibrahim Omerhodžić ◽  
Enra Mehmedika Suljić
Keyword(s):  
Vitamin D ◽  
Brain Tumors ◽  
Bone Health ◽  
Monotherapy Group ◽  
Z Score ◽  
Mineral Density ◽  
Cross Sectional ◽  
Antiepileptic Agents ◽  
T Score ◽  
Significant Difference

<p><strong>Objective. </strong>The objective of our study was to investigate the effects of carbamazepine (CBZ) and lamotrigine (LTG) treatment on bone metabolism in epileptic patients.</p><p><strong>Patients and Methods. </strong>A cross-sectional study was performed on normal controls (N=30) and 100 patients with symptomatic epilepsy caused by a primary brain tumor, divided into two groups according to the treatment: LTG monotherapy group (N=50) and CBZ monotherapy group (N=50). For each participant serum levels of 25-OHD and osteocalcin (OCLN) were measured, and bone mineral density (BMD) was evaluated by the dual-energy X-ray absorptiometry method.</p><p><strong>Results</strong>. There was no statistically significant difference in the average values of vitamin D in serum between the CBZ and LTG groups (Vitamin D CBZ 17.03±}12.86 vs. Vitamin D LTG 17.97±}9.15; F=0.171, P=0.680). There was no statistically significant difference in the average values of OCLN between the CBZ and LTG groups (OCLN CBZ 26.06±}10.87 vs. OCLN LTG 27.87±}28.45; F=0.171, P=0.674). The BMD value was lower in both groups using antiepileptic agents compared to the controls, but when comparing the CBZ group to the LTG group, a statistically significant difference was only observed for the Z score (T-score CBZ: 0.08±} 1.38 vs. T-score LTG: 0.37±} 1.02; F=1.495, P=0.224; Z score CBZ: -0.05±}1.17 vs. Z. Score CBZ: 0.38±}0.96; F=4.069, P=0.046) (Table 3).</p><strong>Conclusion</strong>. The choice of antiepileptic agents for treating seizures in patients with brain tumors should be carefully evaluated in relation to their impact on bone health. These patients could benefit from supplementation and regular measurement of biochemical markers of bone turnover and BMD.

scholarly journals GENE-03. SPECIFIC SIGNATURES OF microRNA IN CEREBROSPINAL FLUID OF PATIENTS WITH PRIMARY BRAIN TUMORS AND METASTASES

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi98-vi98
Author(s):  
Radim Jancalek ◽  
Martin Smrcka ◽  
Alena Kopkova ◽  
Jiri Sana ◽  
Marek Vecera ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Czech Republic ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Brain Metastases ◽  
Independent Set ◽  
Low Grade ◽  
Primary Brain Tumors ◽  
Csf Analysis ◽  
Different Levels

Abstract Cerebrospinal fluid (CSF) baths extracellular environment of the central nervous system, and thus, it is ideal source of tumor diagnostic biomarkers like microRNAs (miRNAs), short non-coding RNAs involved in the pathogenesis of many cancers. As dysregulated levels of brain tumor specific miRNAs have been already observed in CSF, analysis of CSF miRNAs in brain tumor patients might help to develop new diagnostic platform. Next-Generation sequencing (NGS) was performed for analysis of small RNAs in 89 CSF samples taken from 32 glioblastomas (GBM), 14 low-grade gliomas (LGG), 11 meningiomas, 13 brain metastases and 19 non-tumor donors. Subsequently, according to NGS results levels of 10 miRNAs were measured in independent set of CSF samples (41 GBM, 44 meningiomas, 12 brain metastases and 20 non-tumor donors) using TaqMan Advanced miRNA Assays. NGS analysis revealed 22, 12 and 35 CSF miRNAs with significantly different levels in GBM, meningiomas, and brain metastases (adj.p < 0.0005, adj.p < 0.01, and adj.p < 0.005) respectively, in comparison with non-tumor CSF samples. Subsequent validation of selected CSF miRNAs has confirmed different levels of 7 miRNAs in GBM, 2 in meningiomas, and 2 in brain metastases compared to non-tumors. Panel of miR-30e-5p and miR-140-5p was able to distinguish brain metastases with 65% sensitivity and 100% specificity compared to non-tumor samples (AUC = 0.8167); panel of miR-21-3p and miR-196-5p classified metastatic patients with 78% sensitivity and 92 % specificity in comparison to GBM (AUC = 0.90854) and with 75% sensitivity and 83% specificity compared to meningiomas (AUC = 0.84848). We have observed that CSFs from patients with various primary brain tumors and metastases are characterized by specific miRNA signatures. This work was supported by the Ministry of Health, Czech Republic grant nr. NV18-03-00398 and the Ministry of Education, Youth and Sports, Czech Republic under the project CEITEC 2020 (LQ1601).

scholarly journals PS1 - 188 Rehabilitation Consultation: An Integrated Model for Addressing Rehabilitation Concerns in the Primary Brain Tumor Population

2016 ◽  
Vol 43 (S4) ◽  
pp. S9-S10
Author(s):  
I. Lax ◽  
M. Daniels ◽  
C. Kanter ◽  
W. Mason ◽  
K. Edelstein
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Disease Process ◽  
Primary Brain Tumor ◽  
Rehabilitation Services ◽  
Face To Face ◽  
Primary Brain Tumors ◽  
Common Diagnosis ◽  
Consultation Model ◽  
Oncology Treatment

Individuals with primary brain tumors experience a range of physical, cognitive and psychosocial sequelae which impact their independence, safety and quality of life. These impairments may be addressed through rehabilitation intervention. Despite acknowledgement that timely rehabilitation services over the course of the disease process is of benefit, few outpatient neuro-oncology treatment teams include a rehabilitation professional. Purpose: The aims are: (1) to describe a rehabilitation consultation model of care integrated into outpatient neuro-oncology treatment for individuals with primary brain tumors; and (2) to describe the characteristics of individuals referred for rehabilitation services. Methods: This retrospective descriptive study examined data from 200 individuals that received rehabilitation consultation from January 2015 to March 2016 at Princess Margaret Hospital, Pencer Brain Tumor Centre. Information on patient demographics, referral characteristics, and number of patient care visits was collected. Descriptive statistics were calculated. Preliminary Results: Of all patients, (n=195), the most common diagnosis is glioblastoma, 39% (n=76), and 50% are 50-69 years of age (M=55, SD=15.0). The most common reason for initial referral was decline in physical functioning, strength and balance (41%). In 77% of cases, patients were seen immediately at the time of referral. In total, 540 consultations were completed (face-to-face=230, telephone=310) with 2.78 on average (SD=4.0) per patient. Conclusion: Given the range of symptoms that individuals with primary brain tumors experience coupled with changes in functional status as the disease progresses, integrated and timely rehabilitation consultation is feasible.

scholarly journals Podoplanin expression in primary brain tumors induces platelet aggregation and increases risk of venous thromboembolism

Blood ◽  
2017 ◽  
Vol 129 (13) ◽  
pp. 1831-1839 ◽  
Author(s):  
Julia Riedl ◽  
Matthias Preusser ◽  
Pegah Mir Seyed Nazari ◽  
Florian Posch ◽  
Simon Panzer ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Venous Thromboembolism ◽  
Platelet Aggregation ◽  
High Risk ◽  
Brain Tumors ◽  
Tumor Patients ◽  
Primary Brain Tumors ◽  
Key Points ◽  
Podoplanin Expression ◽  
Very High

Key Points Brain tumor patients have a very high risk of VTE. Podoplanin expression by primary brain tumors induces platelet aggregation and is associated with hypercoagulability and a high risk of VTE.

Immunohistochemical Study of Erythropoietin in Cerebellar Hemangioblastomas Associated with Secondary Polycythemia

Neurosurgery ◽  
1991 ◽  
Vol 28 (1) ◽  
pp. 24-26 ◽  
Author(s):  
Osamu Tachibana ◽  
Tetsumori Yamashima ◽  
Junkoh Yamashita
Keyword(s):  
Monoclonal Antibody ◽  
Brain Tumor ◽  
Mast Cells ◽  
Brain Tumors ◽  
Stromal Cells ◽  
Immunohistochemical Study ◽  
Metastatic Brain Tumors ◽  
Secondary Polycythemia

Abstract Although cerebellar hemangioblastomas are known to be associated with secondary polycythemia, the cellular derivation of erythropoietin (EPO) in hemangioblastomas still remains obscure. Specimens from 18 patients with cerebellar hemangioblastomas were immunohistochemically studied using anti-EPO monoclonal antibody. Eight cases of brain tumors, including 2 meningiomas, 2 medulloblastomas, 2 glioblastomas, and 2 metastatic brain tumors were studied as controls. In 9 of 18 cases, EPO-positive cells were scattered around the capillaries and were ultrastructurally shown to be mast cells. These cases were not, however, associated with secondary polycythemia. In contrast, the stromal cells were positive for EPO in 3 cases. Among them, one was associated with secondary polycythemia. Furthermore, one-half of the control cases of brain tumor contained EPO-positive mast cells. Accordingly, it was suggested that mast cells (or small granulocytes) have little relationship to the release of EPO; however, some stromal cells might release EPO with a resultant polycythemia.

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