scholarly journals Multimodal Analysis of Vasogenic Edema in Glioblastoma Patients for Radiotherapy Planning

2014 ◽  
Author(s):  
Matthieu Lê ◽  
Hervé Delingette ◽  
Jayashree Kalpathy-cramer ◽  
Elizabeth Gerstner ◽  
Helen Shih ◽  
...  
Keyword(s):  
Diffusion Tensor ◽  
Vasogenic Edema ◽  
Primary Brain Tumor ◽  
Brain Parenchyma ◽  
Radiotherapy Planning ◽  
Normal Brain ◽  
Data Set ◽  
Substantial Impact ◽  
Target Delineation ◽  
Infiltrative Tumor

Glioblastoma (GBM) is the most common type of primary brain tumor, which is characterized by an infiltrative growth pattern. In current practice, radiotherapy planning is primarily based upon T2 FLAIR MRI despite its known lack of specificity in the detection of tu- mor infiltration. While hyperintensity on T2 FLAIR is widely considered to represent infiltrative tumor, it may also be caused by the presence of vasogenic edema (VE), caused by a leakage of fluid into the brain parenchyma. Distinguishing VE from infiltrative tumor could have im- pact on improving radiotherapy planning. In this paper we study a data set of 17 GBM patients treated with anti-angiogenic therapy for which a fast decrease of T2 FLAIR hypersignal is observed, which indicates the resolution of VE. We investigate if multimodal MRI acquisitions in- cluding diffusion tensor imaging can distinguish between VE and tumor infiltration prior to therapy. Using a random forest classifier, we show that, in this study, morphological information based on the contrast en- hanced T1 image explains up to 75% of the extent of VE. The information from different imaging modalities did not significantly improve the clas- sification. We then show that delineating the VE prior to therapy can have substantial impact on radiotherapy target delineation, leading to smaller treatment volumes and reducing potentially harmful radiation dose to normal brain tissue.

scholarly journals MCP-1 and MIP-3α Secreted from Necrotic Cell-Treated Glioblastoma Cells Promote Migration/Infiltration of Microglia

2018 ◽  
Vol 48 (3) ◽  
pp. 1332-1346 ◽  
Author(s):  
Yieun Jung ◽  
So-Hee Ahn ◽  
Hyunju Park ◽  
Sang Hui Park ◽  
Kyungsun Choi ◽  
...  
Keyword(s):  
Protein Expression ◽  
Primary Brain Tumor ◽  
Brain Parenchyma ◽  
Migration And Invasion ◽  
Normal Brain ◽  
Glioblastoma Cells ◽  
Mobility Shift ◽  
Diffuse Infiltration ◽  
Nuclear Extracts ◽  
Mrna And Protein Expression

Background/Aims: Glioblastoma multiforme (GBM) is the most common primary brain tumor in adults. The defining characteristics of GBM are diffuse infiltration of tumor cells into normal brain parenchyma, rapid growth, a high degree of infiltration of microglia and macrophages, and the presence of necrosis. Microglia/macrophages are frequently found in gliomas and they extensively infiltrate GBM tissue, up to 30% of total tumor mass. However, little is known about the effect of necrotic cells (NCs) on microglia infiltration in GBM and the tumor-infiltrating microglia-induced factors in GBMs. Methods: In this study, to address whether necrosis or necrosis-exposed GBM cells affect the degree of microglia/macrophage infiltration, migration and invasion/infiltration assays were performed. Culture supernatants and nuclear extracts of CRT-MG cells treated or untreated with necrotic cells were analyzed using a chemokine array and electrophoretic mobility shift assay, respectively. Results: The presence of NCs promoted the migration/infiltration of microglia, and GBM cell line CRT-MG cells exposed to NCs further enhanced the migration and infiltration of HMO6 microglial cells. Treatment with NCs induced mRNA and protein expression of chemokines such as <unterline>M</unterline>onocyte <unterline>C</unterline>hemoattractant <unterline>P</unterline>rotein-1 (CCL2/MCP-1) and <unterline>M</unterline>acrophage <unterline>I</unterline>nflammatory <unterline>P</unterline>rotein-3α (CCL20/MIP-3α) in CRT-MG cells. In particular, CCL2/MCP-1 and CCL20/MIP-3α were significantly increased in NC-treated CRT-MG cells. NCs induced DNA binding of the transcription factors <unterline>N</unterline>uclear <unterline>F</unterline>actor (NF)-κB and <unterline>A</unterline>ctivator <unterline>P</unterline>rotein 1 (AP-1) to the CCL2/MCP-1 and CCL20/MIP-3α promoters, leading to increased CCL2/MCP-1 and CCL20/MIP-3α mRNA and protein expression in CRT-MG cells. Conclusion: These results provide evidence that NCs induce the expression of CCL2/MCP-1 and CCL20/MIP-3α in glioblastoma cells through activation of NF-κB and AP-1 and facilitate the infiltration of microglia into tumor tissues.

Cerebral Amebiasis: MRI, DWI, Perfusion and MRS Features

2005 ◽  
Vol 18 (5-6) ◽  
pp. 559-563 ◽  
Author(s):  
H. Celik ◽  
D.A. Karaosmanoglu ◽  
S. Gultekin ◽  
N. Tokgoz ◽  
T.E. Tali
Keyword(s):  
Magnetic Resonance ◽  
Brain Abscess ◽  
Perfusion Imaging ◽  
Vasogenic Edema ◽  
Clinical Findings ◽  
Brain Parenchyma ◽  
Contributory Factor ◽  
Resonance Spectroscopy ◽  
Normal Brain ◽  
Magnetic Resonance Perfusion

Entamoeba histolytica brain abscess is a rare clinical entity. Here we present a case with magnetic resonance imaging, diffusion weighted imaging (DWI), magnetic resonance perfusion imaging and magnetic resonance spectroscopy (MRS) findings of a patient with pathologically proven E. Histolytica brain abscess. To our knowledge, these findings have not been described before in a patient with E. Histolytica brain abscess. MRI examination revealed multiple mass lesions with vasogenic edema and prominent contrast enhancement located at both gray and white matter of the right temporal, left parietooccipital, and bilateral frontal regions. T2-weighted images demonstrated hypointense foci within the lesions thought to be consistent with hemorrhage. Despite the large size and the radiologically aggressive appearance of the lesions, the gyral configuration seems to be relatively well preserved. DWI study revealed increased diffusion particularly in the central portion of the lesions. Perfusion imaging of the lesions demonstrated decreased perfusion compared with normal brain parenchyma. MRS examination of the left frontal lesion showed decreased N-acetylaspartate (NAA)/choline (Cho) ratio, and increased Cho/creatine (Cr) ratio at the peripheral thick enhancing rim. A resonance peak for Cho (3.2 ppm), lipid (1.2 ppm), and negative lactate (1.3 ppm) was detected at the central non-enhancing part of the frontal mass lesion. Nearly all patients with amebic intracranial abscess reported in the medical literature died despite aggressive medical and surgical treatment. It is likely that intense pharmacologic treatment or early neurosurgical intervention in single lesions may be life-saving in these patients and late diagnosis may be a contributory factor in the high mortality rate. Although it is not at the top of the differential diagnosis list, we think that amebic encephalitis must be entertained in a patient with ancillary radiological and clinical findings.

A Multi-targeted Natural Flavonoid Myricetin Suppresses Lamellipodia and Focal Adhesions Formation and Impedes Glioblastoma Cell Invasiveness and Abnormal Motility

2018 ◽  
Vol 17 (7) ◽  
pp. 557-567 ◽  
Author(s):  
Hua-Fu Zhao ◽  
Gang Wang ◽  
Chang-Peng Wu ◽  
Xiu-Ming Zhou ◽  
Jing Wang ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Vasculogenic Mimicry ◽  
Focal Adhesions ◽  
Inhibitory Effect ◽  
Primary Brain Tumor ◽  
Brain Parenchyma ◽  
Migration And Invasion ◽  
Normal Brain ◽  
Anti Oxidant ◽  
Cell Invasiveness

Background: Glioblastoma multiforme (GBM) is the most aggressive and malignant primary brain tumor characterized by rapid growth and extensive infiltration to neighboring normal brain parenchyma, which contribute to tumor recurrence and poor prognosis. Myricetin is a natural flavonoid with potent anti-oxidant, anti-inflammatory and anti-cancer activities, which may serve as a potential and harmless agent for GBM treatment. Methods: To investigate the anti-glioblastoma effects of myricetin, GBM cells were treated with myricetin alone or in combination with temozolomide. Its effects on GBM cell motility and cytoskeletal structures including lamellipodia, focal adhesions and membrane ruffles were also evaluated. Results: We showed that myricetin alone inhibited glioblastoma U-87 MG cell proliferation, migration and invasion, whereas combination of myricetin and temozolomide did not exhibit any synergistic effect. The inhibitory effect on GBM cell proliferation is independent of PTEN status. Moreover, myricetin showed less cytotoxicity to normal astrocytes than GBM cells. Formation of lamellipodia, focal adhesions, membrane ruffles and vasculogenic mimicry were blocked by myricetin, and phosphorylation of ROCK2, paxillin and cortactin was suppressed. In addition, myricetin could inhibit PI3K/Akt and JNK signaling, and bind to a series of kinases and scaffold proteins including PI3K catalytic isoforms (p110α, p110β and p110δ), PDK1, JNK, c-Jun, ROCK2, paxillin, vinculin and VEcadherin. Conclusions: In conclusion, myricetin is a multi-targeted drug that has potent anti-migratory and antiinvasive effects on GBM cells, and suppresses formation of lamellipodia and focal adhesions, suggesting that it may serve as an alternative option for GBM treatment.

Radiotherapy for Brain Tumors: Current Practice and Future Directions

2020 ◽  
Vol 16 (3) ◽  
pp. 182-195
Author(s):  
Sarah Baker ◽  
Natalie Logie ◽  
Kim Paulson ◽  
Adele Duimering ◽  
Albert Murtha
Keyword(s):  
Brain Tumors ◽  
Treatment Strategies ◽  
Brain Parenchyma ◽  
Benign Tumors ◽  
Tumor Control ◽  
Normal Brain ◽  
Neurocognitive Deficits ◽  
Close Proximity ◽  
Recent Developments ◽  
High Level

Radiotherapy is an important component of the treatment for primary and metastatic brain tumors. Due to the close proximity of critical structures and normal brain parenchyma, Central Nervous System (CNS) radiotherapy is associated with adverse effects such as neurocognitive deficits, which must be weighed against the benefit of improved tumor control. Advanced radiotherapy technology may help to mitigate toxicity risks, although there is a paucity of high-level evidence to support its use. Recent advances have been made in the treatment for gliomas, meningiomas, benign tumors, and metastases, although outcomes remain poor for many high grade tumors. This review highlights recent developments in CNS radiotherapy, discusses common treatment toxicities, critically reviews advanced radiotherapy technologies, and highlights promising treatment strategies to improve clinical outcomes in the future.

A Case of Neurosarcoidosis Mimicking Brain Tumor

2020 ◽  
Vol 16 ◽  
Author(s):  
Lutfullah Sari ◽  
Abdusselim Adil Peker ◽  
Dilek Hacer Cesme ◽  
Alpay Alkan
Keyword(s):  
Brain Tumor ◽  
Contrast Enhancement ◽  
Clinical Laboratory ◽  
Vasogenic Edema ◽  
Pulmonary Sarcoidosis ◽  
Brain Parenchyma ◽  
The Body ◽  
Oligoclonal Bands ◽  
Flair Sequence ◽  
History Of

Background: Neurosarcoidosis manifests symptomatically in 5% of patients with sarcoidosis and diagnosis can be challenging if not clinically suspected. Cerebral mass-like presentation of neurosarcoidosis rarely reported in the literature. We presented a woman with neurosarcoidosis who had a cerebral mass-like lesion which completely disappeared after medical treatment. Discussion: A 37-year-old woman with history of pulmonary sarcoidosis referred to the emergency service of our hospital with a one-month history of progressive dizziness, nausea and seeing flashing lights. At neurologic examination, numbness and weakness on the left side of the body, deviation of uvula toward the right side was seen. Cranial MRI demonstrated a 2.5x2 cm in size mass lesion which hypointense on T1 WI, heterogeneous hyperintense on T2 and FLAIR sequence with peripheral vasogenic edema and heterogeneous, irregular contrast enhancement simulating brain tumor. Also, leptomeningeal and nodular contrast enhancement was seen on brainstem, cerebellar vermis, perimesencephalic cistern and left frontal, bilateral parietooccipital sulcus. In laboratory tests; The level of serum angiotensin-converting enzyme (ACE) was 53 IU/mL (N:8-52 IU/mL) and cerebrospinal fluid (CSF) ACE was 23 IU/mL (N:0-2.6 IU/mL). CSF cytology analysis was normal. Pattern 2 oligoclonal bands were present. With these clinical, laboratory and radiological findings, cerebral involvement of sarcoidosis was suspected. Biopsy was not performed due to the high risk of morbidity caused by the deep location of the lesion.Patient was treated with methylprednisolone and Azathioprine for a month.On post-treatment control imaging; lesion disappeared completely without residual leptomeningeal and nodular contrast enhancement.Also, neurologic symptoms were decreased remarkably. Conclusion: Multi-system inflammatory disorders like sarcoidosis, can present with mass-like lesion in the brain parenchyma. While early diagnosis is important to prevent unnecessary interventions like biopsy and surgery, it is crucial to initiate the necessary treatment with the aim of recovery without sequelae. Radiological and clinical follow-up are fundamental in differential diagnosis.

scholarly journals MS-2 Minimally invasive glioma surgery with navigation system and tubular retractor

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii2-ii3
Author(s):  
Kazuhiko Kurozumi
Keyword(s):  
Navigation System ◽  
Diffusion Tensor ◽  
Therapeutic Option ◽  
Normal Brain ◽  
Navigation Systems ◽  
Glioma Surgery ◽  
Tubular Retractor ◽  
Neuronavigation System ◽  
Magnetic Resonance Imaging Mri ◽  
Neurological Surgery

Abstract Navigation systems are reliable and safe for neurological surgery. Navigation is an attractive and innovative therapeutic option. Recently, endo and exoscopic surgeries have been gradually increasing in neurosurgery. We are currently trialing to use 4K and 8K systems to improve the accuracy and safety of our surgical procedures. Surgeries for deep-seated tumors are challenging because of the difficulty in creating a corridor and observing the interface between lesions and the normal area. In total, 315 patients underwent surgery at Okayama University between 2017 and 2019. Among them, we experienced 92 glioma surgeries using navigation systems. Preoperatively, we performed computed tomography imaging and contrast-enhanced magnetic resonance imaging (MRI) for the neuronavigation system. We experienced Curve(TM) Image Guided Surgery (BrainLab, Munich, Germany). The surgical trajectory was planned with functional MRI and diffusion tensor imaging to protect the eloquent area and critical vasculature of the brain. We used a clear plastic tubular retractor system, the ViewSite Brain Access System, for surgery of deep seated gliomas. We gently inserted and placed the ViewSite using the neuronavigation. The tumor was observed and resected through the ViewSite tubular retractor under a microscope and endoscope. If the tumor was large, we switched the ViewSite tubular retractor to brain spatulas to identify the boundary between the normal brain and lesion. We are currently using the combination of the tubular retractor and brain spatulas using navigation system. Here, we present and analyze our preoperative simulation, surgical procedure, and outcomes.

scholarly journals Phosphorous Magnetic Resonance Spectroscopy to Detect Regional Differences of Energy and Membrane Metabolism in Naïve Glioblastoma Multiforme

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2598
Author(s):  
Lisa Maria Walchhofer ◽  
Ruth Steiger ◽  
Andreas Rietzler ◽  
Johannes Kerschbaumer ◽  
Christian Franz Freyschlag ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Healthy Volunteers ◽  
Regional Differences ◽  
Primary Brain Tumor ◽  
Brain Parenchyma ◽  
Resonance Spectroscopy ◽  
31P Mrs ◽  
Diffusion Parameters

Background: Glioblastoma multiforme (GBM) is a highly malignant primary brain tumor with infiltration of, on conventional imaging, normal-appearing brain parenchyma. Phosphorus magnetic resonance spectroscopy (31P-MRS) enables the investigation of different energy and membrane metabolites. The aim of this study is to investigate regional differences of 31P-metabolites in GBM brains. Methods: In this study, we investigated 32 patients (13 female and 19 male; mean age 63 years) with naïve GBM using 31P-MRS and conventional MRI. Contrast-enhancing (CE), T2-hyperintense, adjacent and distant ipsilateral areas of the contralateral brain and the brains of age- and gender-matched healthy volunteers were assessed. Moreover, the 31P-MRS results were correlated with quantitative diffusion parameters. Results: Several metabolite ratios between the energy-dependent metabolites and/or the membrane metabolites differed significantly between the CE areas, the T2-hyperintense areas, the more distant areas, and even the brains of healthy volunteers. pH values and Mg2+ concentrations were highest in visible tumor areas and decreased with distance from them. These results are in accordance with the literature and correlated with quantitative diffusion parameters. Conclusions: This pilot study shows that 31P-MRS is feasible to show regional differences of energy and membrane metabolism in brains with naïve GBM, particularly between the different “normal-appearing” regions and between the contralateral hemisphere and healthy controls. Differences between various genetic mutations or clinical applicability for follow-up monitoring have to be assessed in a larger cohort.

scholarly journals The diffusion tensor imaging (DTI) component of the NIH MRI study of normal brain development (PedsDTI)

NeuroImage ◽  
2016 ◽  
Vol 124 ◽  
pp. 1125-1130 ◽  
Author(s):  
Lindsay Walker ◽  
Lin-Ching Chang ◽  
Amritha Nayak ◽  
M. Okan Irfanoglu ◽  
Kelly N. Botteron ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Brain Development ◽  
Diffusion Tensor ◽  
Normal Brain ◽  
Mri Study ◽  
Normal Brain Development ◽  
Diffusion Tensor Imaging Dti

Neuroimaging-based brain-age prediction of first-episode schizophrenia and the alteration of brain age after early medication

2021 ◽  
pp. 1-8
Author(s):  
Yi-Bin Xi ◽  
Xu-Sha Wu ◽  
Long-Biao Cui ◽  
Li-Jun Bai ◽  
Shuo-Qiu Gan ◽  
...  
Keyword(s):  
Diffusion Tensor ◽  
First Episode ◽  
Age Difference ◽  
Healthy Controls ◽  
Data Set ◽  
Brain Ageing ◽  
First Episode Schizophrenia ◽  
Brain Age ◽  
The Brain ◽  
Age Prediction

Background Neuroimaging- and machine-learning-based brain-age prediction of schizophrenia is well established. However, the diagnostic significance and the effect of early medication on first-episode schizophrenia remains unclear. Aims To explore whether predicted brain age can be used as a biomarker for schizophrenia diagnosis, and the relationship between clinical characteristics and brain-predicted age difference (PAD), and the effects of early medication on predicted brain age. Method The predicted model was built on 523 diffusion tensor imaging magnetic resonance imaging scans from healthy controls. First, the brain-PAD of 60 patients with first-episode schizophrenia, 60 healthy controls and 21 follow-up patients from the principal data-set and 40 pairs of individuals in the replication data-set were calculated. Next, the brain-PAD between groups were compared and the correlations between brain-PAD and clinical measurements were analysed. Results The patients showed a significant increase in brain-PAD compared with healthy controls. After early medication, the brain-PAD of patients decreased significantly compared with baseline (P < 0.001). The fractional anisotropy value of 31/33 white matter tract features, which related to the brain-PAD scores, had significantly statistical differences before and after measurements (P < 0.05, false discovery rate corrected). Correlation analysis showed that the age gap was negatively associated with the positive score on the Positive and Negative Syndrome Scale in the principal data-set (r = −0.326, P = 0.014). Conclusions The brain age of patients with first-episode schizophrenia may be older than their chronological age. Early medication holds promise for improving the patient's brain ageing. Neuroimaging-based brain-age prediction can provide novel insights into the understanding of schizophrenia.

scholarly journals In utero diffusion tensor imaging of the fetal brain: a reproducibility study

2017 ◽  
Author(s):  
András Jakab ◽  
Ruth O`Gorman Tuura ◽  
Christian Kellenberger ◽  
Ianina Scheer
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Corpus Callosum ◽  
Coefficient Of Variation ◽  
Motion Correction ◽  
Diffusion Tensor ◽  
Structural Similarity ◽  
Image Correlation ◽  
Normal Brain ◽  
Slice Thickness

AbstractOur purpose was to evaluate the within-subject reproducibility of in utero diffusion tensor imaging (DTI) metrics and the visibility of major white matter structures.Images for 30 fetuses (20-33. postmenstrual weeks, normal neurodevelopment: 6 cases, cerebral pathology: 24 cases) were acquired on 1.5T or 3.0T MRI. DTI with 15 diffusion-weighting directions was repeated three times for each case, TR/TE: 2200/63 ms, voxel size: 1*1 mm, slice thickness: 3-5 mm, b-factor: 700 s/mm2. Reproducibility was evaluated from structure detectability, variability of DTI measures using the coefficient of variation (CV), image correlation and structural similarity across repeated scans for six selected structures. The effect of age, scanner type, presence of pathology was determined using Wilcoxon rank sum test.White matter structures were detectable in the following percentage of fetuses in at least two of the three repeated scans: corpus callosum genu 76%, splenium 64%, internal capsule, posterior limb 60%, brainstem fibers 40% and temporooccipital association pathways 60%. The mean CV of DTI metrics ranged between 3% and 14.6% and we measured higher reproducibility in fetuses with normal brain development. Head motion was negatively correlated with reproducibility, this effect was partially ameliorated by motion-correction algorithm using image registration. Structures on 3.0 T had higher variability both with- and without motion correction.Fetal DTI is reproducible for projection and commissural bundles during mid-gestation, however, in 16-30% of the cases, data were corrupted by artifacts, resulting in impaired detection of white matter structures. To achieve robust results for the quantitative analysis of diffusivity and anisotropy values, fetal-specific image processing is recommended and repeated DTI is needed to ensure the detectability of fiber pathways.AbbreviationsADaxial diffusivity;CCAcorpus callosum agenesis;CVcoefficient of variation,DTIdiffusion tensor imaging;FAfractional anisotropy;GWgestational week;MDmean diffusivity;RDradial diffusivity;ROIregion of interest;SSIMstructural similarity index

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