1
|
Santiago RACB, Ali A, Ibrahim B, Mandel M, Muhsen BA, Obrzut M, Ranjan S, Borghei-Razavi H, Adada B. Safety of craniotomy for brain tumor resection in octogenarians and older patients - a matched - cohort analysis. Int J Neurosci 2024; 134:958-964. [PMID: 36724879 DOI: 10.1080/00207454.2023.2174866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The incidence of brain tumors has increased in elderly population overtime. Their eligibility to a major surgery remains a questionable subject. This study evaluated prognostic factors and 30-days morbidity and mortality in octogenarian population who underwent craniotomy for resection of brain tumor. MATERIALS AND METHODS A total of 154 patients were divided into two different groups: patients above 80 years old and patients below 65 years old. In both groups, patients were stratified based on diagnosis with benign tumors [meningioma] and malignant tumors [high-grade gliomas and metastases]. Multivariable logistic regression model with backward elimination method was utilized to identify the independent risk factors for 30-days readmission and post-operative complications. RESULTS The analysis revealed no significant difference in 30-day readmission (p = 0.7329), 30-day mortality (0.6854) or in post-operative complication (p = 0.3291) between age ≥ 80 and age ≤ 65 groups. A longer length of stay (LOS) was observed in the older patients (p = 0.0479). There was a significant difference in the pre-post KPS between the two groups (p < 0.0001). ASA (p = 0.0315) and KPS (p = 0.071) were found as important prognostic factors associated with post-operative mortality in both groups. CONCLUSION Octogenarians can withstand craniotomy without any significant increase in 30-day readmission, 30-day mortality and post-operative complications as compared to patients younger than age 65. The ASA score (>3) and/or KPS (<70) were the most important prognostic factors for 30-days readmission and mortality.
Collapse
Affiliation(s)
| | - Assad Ali
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
| | - Bilal Ibrahim
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
| | - Mauricio Mandel
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
| | | | - Michal Obrzut
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
| | - Surabhi Ranjan
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
| | | | - Badih Adada
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
| |
Collapse
|
2
|
Leskinen S, Singha S, Mehta NH, Quelle M, Shah HA, D'Amico RS. Applications of Functional Magnetic Resonance Imaging to the Study of Functional Connectivity and Activation in Neurological Disease: A Scoping Review of the Literature. World Neurosurg 2024; 189:185-192. [PMID: 38843969 DOI: 10.1016/j.wneu.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 06/02/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Functional magnetic resonance imaging (fMRI) has transformed our understanding of brain's functional architecture, providing critical insights into neurological diseases. This scoping review synthesizes the current landscape of fMRI applications across various neurological domains, elucidating the evolving role of both task-based and resting-state fMRI in different settings. METHODS We conducted a comprehensive scoping review following the Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews guidelines. Extensive searches in Medline/PubMed, Embase, and Web of Science were performed, focusing on studies published between 2003 and 2023 that utilized fMRI to explore functional connectivity and regional activation in adult patients with neurological conditions. Studies were selected based on predefined inclusion and exclusion criteria, with data extracted. RESULTS We identified 211 studies, covering a broad spectrum of neurological disorders including mental health, movement disorders, epilepsy, neurodegeneration, traumatic brain injury, cerebrovascular accidents, vascular abnormalities, neurorehabilitation, neuro-critical care, and brain tumors. The majority of studies utilized resting-state fMRI, underscoring its prominence in identifying disease-specific connectivity patterns. Results highlight the potential of fMRI to reveal the underlying pathophysiological mechanisms of various neurological conditions, facilitate diagnostic processes, and potentially guide therapeutic interventions. CONCLUSIONS fMRI serves as a powerful tool for elucidating complex neural dynamics and pathologies associated with neurological diseases. Despite the breadth of applications, further research is required to standardize fMRI protocols, improve interpretative methodologies, and enhance the translation of imaging findings to clinical practice. Advances in fMRI technology and analytics hold promise for improving the precision of neurological assessments and interventions.
Collapse
Affiliation(s)
- Sandra Leskinen
- State University of New York Downstate Medical Center, New York, USA
| | - Souvik Singha
- Department of Neurological Surgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA.
| | - Neel H Mehta
- Department of Neurosurgery, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | | | - Harshal A Shah
- Department of Neurological Surgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Randy S D'Amico
- Department of Neurological Surgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| |
Collapse
|
3
|
Vaz-Salgado MÁ, García BC, Pérez IF, Munárriz BJ, Domarco PS, González AH, Villar MV, Caro RL, Delgado MLV, Sánchez JMS. SEOM-GEINO clinical guidelines for grade 2 gliomas (2023). Clin Transl Oncol 2024:10.1007/s12094-024-03456-x. [PMID: 38662171 DOI: 10.1007/s12094-024-03456-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/26/2024]
Abstract
The 2021 World Health Organization (WHO) classification has updated the definition of grade 2 gliomas and the presence of isocitrate dehydrogenase (IDH) mutation has been deemed the cornerstone of diagnosis. Though slow-growing and having a low proliferative index, grade 2 gliomas are incurable by surgery and complementary treatments are vital to improving prognosis. This guideline provides recommendations on the multidisciplinary treatment of grade 2 astrocytomas and oligodendrogliomas based on the best evidence available.
Collapse
Affiliation(s)
- María Ángeles Vaz-Salgado
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (Irycis) CIBERONC, Madrid, Spain.
| | - Belén Cigarral García
- Medical Oncology Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Isaura Fernández Pérez
- Medical Oncology Department, Hospital Alvaro Cunqueiro-Complejo Hospitalario Universitario de Vigo, Pontevedra, Spain
| | | | - Paula Sampedro Domarco
- Medical Oncology Department, Complexo Hospitalario Universitario de Ourense (CHUO), Orense, Spain
| | - Ainhoa Hernández González
- Medical Oncology Department, Hospital Germans Trias I Pujol(ICO)-Badalona, Instituto Catalán de Oncología, Barcelona, Spain
| | - María Vieito Villar
- Medical Oncology Department, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Raquel Luque Caro
- Medical Oncology Department, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria Ibs.Granada, Granada, Spain
| | | | - Juan Manuel Sepúlveda Sánchez
- Neuro-Oncology Unit, HM Universitario Sanchinarro-CIOCC, Madrid, Spain.
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación 12 de Octubre (I+12), Madrid, Spain.
| |
Collapse
|
4
|
Bankole NDA, Kanmounye US, Ouahabi AE, Zemmoura I. Asleep-awake-asleep versus hypnosis for low-grade glioma surgery: long term follow-up outcome. Neurochirurgie 2023; 69:101494. [PMID: 37714375 DOI: 10.1016/j.neuchi.2023.101494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/16/2023] [Accepted: 09/05/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Hypnosis-aided craniotomy is a safe alternative to standard asleep-awake-asleep (AAA) surgery in glioma surgery. The impact of these two anesthetic methods on tumor prognosis has never been assessed. OBJECTIVE This study aimed to evaluate the possible impact of the type of sedation (i.e., hypnosedation vs. standard sedation) on postoperative outcomes in awake surgery for gliomas. METHODS Adult patients who underwent awake surgery for a diffuse glioma, excluding glioblastomas, between May 2011 and December 2019 at the authors' institution were included in the analysis. Pearson Chi-square, Fisher exact, and Mann-Whitney U tests were used for inferential analyses. RESULTS Sixty-one (61) patients were included, thirty-one were female (50.8 %), and the mean age was 41.8 years (SD = 11.88). Most patients had IDH mutated tumors (n = 51; 83.6%). Twenty-six patients (42.6%) were hypnosedated while 35 (57.4%) received standard AAA procedure. The overall median follow-up time was 48 months (range: 10 months-120 months). Our results did not identify any significant difference between both techniques in terms of extent of resection (sub-total resection >95% rates were 11.48% vs. 8.20%, OR = 2.2, 95% CI = 0.62-8.44; P = 0.34) and of overall survival (87.5% of patients in the AAA surgery group reach 9 years OS vs. 79% in the hypnosis cohort, cHR = 0.85, 95% CI = 0.12-6.04; P = 0.87). CONCLUSION Hypnosis for awake craniotomy is rarely proposed although it is a suitable alternative to standard sedation in awake craniotomy for LGGs, with similar results in terms of extent of resection or survival.
Collapse
Affiliation(s)
- Nourou Dine Adeniran Bankole
- CHRU de Tours, Neurosurgery Department, Tours, France; CHU Ibn Sina, Neurosurgery Department, Mohammed V University of Rabat, Morocco; Clinical Investigation Center (CIC), 1415, INSERM, CHRU de Tours, Tours, France.
| | | | | | - Ilyess Zemmoura
- CHRU de Tours, Neurosurgery Department, Tours, France; UMR Inserm U1253, iBrain, University of Tours, Tours, France.
| |
Collapse
|
5
|
Zhu E, Shi W, Chen Z, Wang J, Ai P, Wang X, Zhu M, Xu Z, Xu L, Sun X, Liu J, Xu X, Shan D. Reasoning and causal inference regarding surgical options for patients with low-grade gliomas using machine learning: A SEER-based study. Cancer Med 2023; 12:20878-20891. [PMID: 37929878 PMCID: PMC10709720 DOI: 10.1002/cam4.6666] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/17/2023] [Accepted: 10/07/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Due to the heterogeneity of low-grade gliomas (LGGs), the lack of randomized control trials, and strong clinical evidence, the effect of the extent of resection (EOR) is currently controversial. AIM To determine the best choice between subtotal resection (STR) and gross-total resection (GTR) for individual patients and to identify features that are potentially relevant to treatment heterogeneity. METHODS Patients were enrolled from the SEER database. We used a novel DL approach to make treatment recommendations for patients with LGG. We also made causal inference of the average treatment effect (ATE) of GTR compared with STR. RESULTS The patients were divided into the Consis. and In-consis. groups based on whether their actual treatment and model recommendations were consistent. Better brain cancer-specific survival (BCSS) outcomes in the Consis. group was observed. Overall, we also identified two subgroups that showed strong heterogeneity in response to GTR. By interpreting the models, we identified numerous variables that may be related to treatment heterogeneity. CONCLUSIONS This is the first study to infer the individual treatment effect, make treatment recommendation, and guide surgical options through deep learning approach in LGG research. Through causal inference, we found that heterogeneous responses to STR and GTR exist in patients with LGG. Visualization of the model yielded several factors that contribute to treatment heterogeneity, which are worthy of further discussion.
Collapse
Affiliation(s)
- Enzhao Zhu
- School of MedicineTongji UniversityShanghaiChina
| | - Weizhong Shi
- Shanghai Hospital Development CenterShanghaiChina
| | - Zhihao Chen
- School of BusinessEast China University of Science and TechnologyShanghaiChina
| | - Jiayi Wang
- School of MedicineTongji UniversityShanghaiChina
| | - Pu Ai
- School of MedicineTongji UniversityShanghaiChina
| | - Xiao Wang
- School of MedicineTongji UniversityShanghaiChina
| | - Min Zhu
- Department of Computer Science and Technology, School of Electronics and Information EngineeringTongji UniversityShanghaiChina
| | - Ziqin Xu
- Department of Industrial Engineering and Operations ResearchColumbia UniversityNew YorkNew YorkUSA
| | - Lingxiao Xu
- School of MedicineTongji UniversityShanghaiChina
| | - Xueyi Sun
- School of Ocean and Earth ScienceTongji UniversityShanghaiChina
| | - Jingyu Liu
- School of Ocean and Earth ScienceTongji UniversityShanghaiChina
| | - Xuetong Xu
- College of Civil EngineeringTongji UniversityShanghaiChina
| | - Dan Shan
- Regenerative Medicine Institute, School of MedicineNational University of IrelandGalwayIreland
| |
Collapse
|
6
|
Damodharan S, Puccetti D. Pediatric Central Nervous System Tumor Overview and Emerging Treatment Considerations. Brain Sci 2023; 13:1106. [PMID: 37509034 PMCID: PMC10377074 DOI: 10.3390/brainsci13071106] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Pediatric central nervous system (CNS) tumors are the most common solid tumor in children, with the majority being glial in origin. These tumors are classified by the World Health Organization (WHO) as either being low grade (WHO grade 1 and 2) or high grade (WHO grade 3 and 4). Our knowledge of the molecular landscape of pediatric brain tumors has advanced over the last decade, which has led to newer categorizations along with an expansion of therapeutic targets and options. In this review, we will give an overview of common CNS tumors seen in children along with a focus on treatment options and future considerations.
Collapse
Affiliation(s)
- Sudarshawn Damodharan
- Department of Pediatrics, Division of Pediatric Hematology, Oncology and Bone Marrow Transplant, University of Wisconsin School of Medicine & Public Health, Madison, WI 53792, USA
| | - Diane Puccetti
- Department of Pediatrics, Division of Pediatric Hematology, Oncology and Bone Marrow Transplant, University of Wisconsin School of Medicine & Public Health, Madison, WI 53792, USA
| |
Collapse
|
7
|
Chaulagain D, Smolanka V, Smolanka A, Munakomi S, Havryliv T. The role of extent of resection on the prognosis of low-grade astrocytoma: a systematic review and meta-analysis. EGYPTIAN JOURNAL OF NEUROSURGERY 2022. [DOI: 10.1186/s41984-022-00161-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Purpose
To investigate the predictor factors of mortality describing the prognosis of primary surgical resection of low-grade astrocytoma.
Materials and methods
A systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to November 14, 2021. All statistical analysis was conducted in Review Manager 5.4.1. Studies meeting inclusion criteria were selected. A random-effect model was used when heterogeneity was seen to pool the studies, and the result were reported in the hazards ratio (HR) and corresponding 95% confidence interval.
Result
Five cohort studies were selected for meta-analysis. There was statistically significant effect of total resection on increase mortality after surgery in low-grade astrocytoma patients (HR = 0.70 [0.52, 0.94]; p = 0.02; I2 = Not applicable). On the other hand, there was statistically nonsignificant effect of patient’s age (HR = 1.27 [0.95, 1.68]; p = 0.11; I2 = 83%), tumor size (HR = 1.13 [0.94, 1.35]; p = 0.19; I2 = 73%), and increasing KPS (HR = 0.59 [0.20, 1.77]; p = 0.35; I2 = 86%) on prognosis of low-grade astrocytoma after surgery.
Conclusion
The results of meta-analysis showed significant relationship of extent of resection and mortality, while factors such age, KPS score, and tumor size were nonsignificant to determine mortality in patient diagnosed with low-grade astrocytoma. The gross total resection surgery should be preferred over subtotal resection since the incidence of malignant formation is low in gross total resection.
Collapse
|
8
|
Zhang K, Liu X, Li G, Chang X, Li S, Chen J, Zhao Z, Wang J, Jiang T, Chai R. Clinical management and survival outcomes of patients with different molecular subtypes of diffuse gliomas in China (2011-2017): a multicenter retrospective study from CGGA. Cancer Biol Med 2022; 19:j.issn.2095-3941.2022.0469. [PMID: 36350010 PMCID: PMC9630520 DOI: 10.20892/j.issn.2095-3941.2022.0469] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/05/2022] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE We aimed to summarize the clinicopathological characteristics and prognostic features of various molecular subtypes of diffuse gliomas (DGs) in the Chinese population. METHODS In total, 1,418 patients diagnosed with DG between 2011 and 2017 were classified into 5 molecular subtypes according to the 2016 WHO classification of central nervous system tumors. The IDH mutation status was determined by immunohistochemistry and/or DNA sequencing, and 1p/19q codeletion was detected with fluorescence in situ hybridization. The median clinical follow-up time was 1,076 days. T-tests and chi-square tests were used to compare clinicopathological characteristics. Kaplan-Meier and Cox regression methods were used to evaluate prognostic factors. RESULTS Our cohort included 15.5% lower-grade gliomas, IDH-mutant and 1p/19q-codeleted (LGG-IDHm-1p/19q); 18.1% lower-grade gliomas, IDH-mutant (LGG-IDHm); 13.1% lower-grade gliomas, IDH-wildtype (LGG-IDHwt); 36.1% glioblastoma, IDH-wildtype (GBM-IDHwt); and 17.2% glioblastoma, IDH-mutant (GBM-IDHm). Approximately 63.3% of the enrolled primary gliomas, and the median overall survival times for LGG-IDHm, LGG-IDHwt, GBM-IDHwt, and GBM-IDHm subtypes were 75.97, 34.47, 11.57, and 15.17 months, respectively. The 5-year survival rate of LGG-IDHm-1p/19q was 76.54%. We observed a significant association between high resection rate and favorable survival outcomes across all subtypes of primary tumors. We also observed a significant role of chemotherapy in prolonging overall survival for GBM-IDHwt and GBM-IDHm, and in prolonging post-relapse survival for the 2 recurrent GBM subtypes. CONCLUSIONS By controlling for molecular subtypes, we found that resection rate and chemotherapy were 2 prognostic factors associated with survival outcomes in a Chinese cohort with DG.
Collapse
Affiliation(s)
- Kenan Zhang
- Department of Molecular Pathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Xing Liu
- Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Guanzhang Li
- Department of Molecular Pathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Xin Chang
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Shouwei Li
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Jing Chen
- Department of Molecular Pathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Zheng Zhao
- Department of Molecular Pathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Jiguang Wang
- Division of Life Science and State Key Laboratory of Molecular Neuroscience, Department of Chemical and Biological Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR 999077, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong SAR 999077, China
- HKUST Shenzhen-Hong Kong Collaborative Innovation Research Institute, Futian, Shenzhen 518057, China
| | - Tao Jiang
- Department of Molecular Pathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Ruichao Chai
- Department of Molecular Pathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
- Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
- Division of Life Science and State Key Laboratory of Molecular Neuroscience, Department of Chemical and Biological Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR 999077, China
| |
Collapse
|
9
|
Uribe-Cardenas R, Giantini-Larsen AM, Garton A, Juthani RG, Schwartz TH. Innovations in the Diagnosis and Surgical Management of Low-Grade Gliomas. World Neurosurg 2022; 166:321-327. [PMID: 36192864 DOI: 10.1016/j.wneu.2022.06.070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 12/15/2022]
Abstract
Low-grade gliomas are a broad category of tumors that can manifest at different stages of life. As a group, their prognosis has historically been considered to be favorable, and surgery is a mainstay of treatment. Advances in the molecular characterization of individual lesions has led to newer classification systems, a better understanding of the biological behavior of different neoplasms, and the identification of previously unrecognized entities. New prospective genetic and molecular data will help delineate better treatment paradigms and will continue to change the taxonomy of central nervous system tumors in the coming years. Advances in the field of radiomics will help predict the molecular profile of a particular tumor through noninvasive testing. Similarly, more precise methods of intraoperative tumor tissue analysis will aid surgical planning. Improved surgical outcomes propelled by novel surgical techniques and intraoperative adjuncts and emerging forms of medical treatment in the field of immunotherapy have enriched the management of these lesions. We review the contemporary management and innovations in the treatment of low-grade gliomas.
Collapse
Affiliation(s)
- Rafael Uribe-Cardenas
- Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York, USA
| | - Alexandra M Giantini-Larsen
- Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York, USA
| | - Andrew Garton
- Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York, USA
| | - Rupa Gopalan Juthani
- Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York, USA.
| | - Theodore H Schwartz
- Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York, USA
| |
Collapse
|
10
|
Liu ZM, Liao CH, An X, Zhou WT, Ma ZY, Liu W, Tian YJ. The role of imaging features and resection status in the survival outcome of sporadic optic pathway glioma children receiving different adjuvant treatments. Neurosurg Rev 2022; 45:2277-2287. [PMID: 35106677 DOI: 10.1007/s10143-022-01743-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/30/2022]
Abstract
Optic pathway glioma (OPG) is a rare brain tumor affecting children, with no standard treatment strategy. This study described the sporadic OPG survival outcomes after surgical treatment and analyzed the role of imaging features and resection status in children receiving different adjuvant treatments. This retrospective study included 165 OPG patients whose clinical information were obtained from the hospital record system. Tumor volume and residual tumor volume were calculated by delineating the lesion area. Kaplan-Meier method and Cox proportional hazards model were conducted to analyze the independent prognosis factor. A total of 165 patients were included in this study. Respectively, the 5-year overall survival (OS) and progression-free survival (PFS) were 87.58% and 77.87%. Residual tumor size and first adjuvant treatment (AT) after surgery were both associated with PFS. In patients with small-size residual tumors, there was no significant difference in PFS between the AT treatment groups. Moreover, age, exophytic cystic components, leptomeningeal metastases, and AT were associated with OS. In patients with exophytic cystic components and those with leptomeningeal metastases, there was no significant difference in OS. Our results revealed that OPG patients could avoid or defer AT by maximized resection. Age ≤ 2 years was a disadvantageous factor for OS. Patients with exophytic cystic components were more likely to benefit from primary surgery, and CT or RT was not beneficial for these patients. Patients with leptomeningeal metastases had a poor prognosis regardless of the treatment they received. Future prospective clinical studies are needed to develop more effective treatment regimens.
Collapse
Affiliation(s)
- Zhi-Ming Liu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No. 119, South 4th Ring Road, Fengtai District, Beijing, 100070, China
| | - Chi-Hyi Liao
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No. 119, South 4th Ring Road, Fengtai District, Beijing, 100070, China
| | - Xu An
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No. 119, South 4th Ring Road, Fengtai District, Beijing, 100070, China
| | - Wen-Tao Zhou
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No. 119, South 4th Ring Road, Fengtai District, Beijing, 100070, China
| | - Zhen-Yu Ma
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No. 119, South 4th Ring Road, Fengtai District, Beijing, 100070, China
| | - Wei Liu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No. 119, South 4th Ring Road, Fengtai District, Beijing, 100070, China
| | - Yong-Ji Tian
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No. 119, South 4th Ring Road, Fengtai District, Beijing, 100070, China.
- Laboratory of Neural Reconstruction, Beijing Key Laboratory of Central Nervous System Injury, Beijing Neurosurgical Institute, Capital Medical University, No. 119, South 4th Ring Road, Fengtai District, Beijing, 100070, China.
| |
Collapse
|
11
|
The Clinical Value of High-Quality Nursing in Concurrent Radiotherapy and Chemotherapy after Glioma Surgery and Its Influence on the Stress Indicators Cor, ACTH, and CRP. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:8335400. [PMID: 35126950 PMCID: PMC8808127 DOI: 10.1155/2022/8335400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/31/2021] [Indexed: 12/30/2022]
Abstract
Objective The purpose of this study is to explore the clinical value of high-quality nursing in concurrent radiotherapy and chemotherapy after glioma surgery and its influence on the stress indicators such as cortisol (Cor), adrenocorticotrophic hormone (ACTH), and C-reactive protein (CRP). Methods A total of 94 glioma patients diagnosed and treated in our hospital were randomly divided into a research group and a control group, with 47 cases in each group. Both groups of patients were given concurrent radiotherapy and chemotherapy. On this basis, patients in the control group were given basic care, while patients in the research group were given a combination of basic care and high-quality care. The nursing satisfaction and adverse reactions of the two groups were compared. The pain degree and the levels of stress indicators Cor, ACTH, and CRP at different time points were compared between the two groups. The sleep quality, bad mood, and quality of life before and after nursing were compared between the two groups. Results After nursing, the nursing satisfaction of the research group (95.74%) was higher than that of the control group (80.85%), and the difference between the two groups was statistically significant (X2 = 11.678, P < 0.05). There was no significant difference between patients in the Visual Analogue Scale (VAS) score and the levels of stress indicators Cor, ACTH, and CRP at the T1 time point between the two groups (P > 0.05). With the passage of time, the levels of Cor and ACTH of the two groups showed an upward trend. At T4, the increased levels of Cor and ACTH in the research group were less than those in the control group, and the difference was statistically significant (P < 0.05). The VAS scores and CRP levels of the two groups showed an upward trend at T1 and T2 and a downward trend at T3 and T4. And, at T4, the decrease in CRP level of the research group was greater than that in the control group, and the difference was statistically significant (P < 0.05). Before nursing, there was no statistically significant difference between two groups of patients in the time to fall asleep, sleep time, number of awakenings, SAS score, self-rating depression scale (SDS) score, quality of life index scores, and total scores (P > 0.05). After nursing, the time to fall asleep and the number of awakenings in the two groups of patients showed an upward trend, and the increase in the control group was higher (P < 0.05). The sleep time of the two groups showed a downward trend, and the degree of decline in the control group was higher (P < 0.05). After nursing, the SAS score and SDS score of the two groups of patients decreased (∗P < 0.05), and the decrease in the research group was more obvious (#P < 0.05). After nursing, the scores of all indicators of the quality of life and the total score of the two groups increased and the score of the research group increased more significantly (P < 0.05). After nursing, the control group had 5 cases of gastrointestinal reactions, 7 cases of bone marrow suppression, 6 cases of leukopenia, 6 cases of thrombocytopenia, and 10 cases of dizziness and nausea. In the research group, there were 1 case of gastrointestinal reaction, 2 cases of bone marrow suppression, 1 case of leukopenia, 1 case of thrombocytopenia, and 2 cases of dizziness and nausea. The difference between the two groups was statistically significant (P < 0.05). Conclusion Glioma patients are given high-quality care during the course of concurrent radiotherapy and chemotherapy, which can reduce the pain and bad mood of the patient, reduce the stress response of the patient, and improve the quality of sleep and the quality of life of the patient, thereby improving nursing satisfaction and patients compliance, reducing adverse reactions, and having a good prognosis.
Collapse
|
12
|
Ibrahim O, Hafez MA, Haleem HA, El Maghraby H. Recent Advances in the Treatment of Gliomas: The Multimodal Care Therapy. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Glioblastoma (GBM) is the most devastating primary malignancy of the central nervous system in adults. At present, standard treatment consists of maximal safe surgical resection followed by radiotherapy (60 Gray) with concomitant daily temozolomide chemotherapy. Low-grade gliomas constitute approximately 15% of the nearly primary brain tumors diagnosed in adults each year. Extent of tumor resection has become a strong predictor of patient outcomes, alongside patient age, performance status, tumor histology, and molecular genetics (isocitrate dehydrogenase-1 and 1p/19q codeletion status). Over the past two decades, surgeons have emphasized the importance of maximizing extent of resection and its impact on overall survival, progression-free survival, and time to malignant transformation.
AIM: We aimed to present recent advances in the treatment of gliomas.
METHODS: This is a prospective analysis of 50 patients diagnosed with gliomas which are enrolled in a joint supervision between Kasr Al Aini Hospital, Cairo University, Egypt, and Coventry University Hospitals, England.
RESULTS: The study included 50 patients, 31 males and 19 females, ages ranged from 21 to 75 years (mean age 47.5 years). Gross total resection was achieved in 28 patients (56%). The most common surgical complication in our series was post-operative transient weakness in 4 patients (8%). Mean true survival of low-grade glioma patients was 40.5 months while the mean true survival for anaplastic astrocytoma (Grade 3) patients was 38 months and that of GBM (Grade 4) patients was 18.8 months.
CONCLUSION: Despite persistent limitations in the quality of data, mounting evidence suggests that more extensive surgical resection is associated with longer life expectancy for both low- and high-grade gliomas.
Collapse
|
13
|
Yang Y, Ma Y, Lu J, Du S, Zhang J, Meng H, Chen Z, Zhang Q, Zhang X, Shi W, Girolamo F, Cepeda S, Kang J. Evaluation of the reporting quality of clinical practice guidelines on gliomas using the RIGHT checklist. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1002. [PMID: 34277802 PMCID: PMC8267264 DOI: 10.21037/atm-21-2604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/03/2021] [Indexed: 11/29/2022]
Abstract
Background The reporting quality of clinical practice guidelines (CPGs) for gliomas has not yet been thoroughly assessed. The International Reporting Items for Practice Guidelines in Healthcare (RIGHT) statement developed in 2016 provides a reporting framework to improve the quality of CPGs. We aimed to estimate the reporting quality of glioma guidelines using the RIGHT checklist and investigate how the reporting quality differs by selected characteristics. Methods We systematically searched electronic databases, guideline databases, and medical society websites to retrieve CPGs on glioma published between 2018 and 2020. We calculated the compliance of the CPGs to individual items, domains and the RIGHT checklist overall. We performed stratified analyses by publication year, country of development, reporting of funding, and impact factor (IF) of the journal. Results Our search revealed 20 eligible guidelines. Mean overall adherence to the RIGHT statement was 54.6%. Eight CPGs reported more than 60% of the items, and five reported less than 50%. All guidelines adhered to the items 1a, 3, 7a, 13a, while no guidelines reported the items 17 or 18b (see http://www.right-statement.org/right-statement/checklist for a description of the items). Two of the seven domains, “Basic information” and “Background”, had mean reporting rates above 60%. The “Review and quality assurance” domain had the lowest mean reporting rate, 12.5%. The reporting quality of guidelines published in 2020, guidelines developed in the United States, and guidelines that reported funding tended to be above average. Conclusions The reporting quality of CPGs on gliomas is low and needs improvement. Particular attention should be paid on reporting the external review and quality assurance process. The use of the RIGHT criteria should be encouraged to guide the development, reporting and evaluation of CPGs.
Collapse
Affiliation(s)
- Yongjie Yang
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Yanfang Ma
- School of Chinese Medicine of Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Jingli Lu
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Shuzhang Du
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Jingmin Zhang
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Haiyang Meng
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Zhe Chen
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Qiwen Zhang
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Xiaojian Zhang
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Wenyin Shi
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Francesco Girolamo
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari School of Medicine, Bari, Italy
| | - Santiago Cepeda
- Department of Neurosurgery, University Hospital Río Hortega, Valladolid, Spain
| | - Jian Kang
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| |
Collapse
|
14
|
Hollon T, Orringer DA. Label-free brain tumor imaging using Raman-based methods. J Neurooncol 2021; 151:393-402. [PMID: 33611706 DOI: 10.1007/s11060-019-03380-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 12/20/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Label-free Raman-based imaging techniques create the possibility of bringing chemical and histologic data into the operation room. Relying on the intrinsic biochemical properties of tissues to generate image contrast and optical tissue sectioning, Raman-based imaging methods can be used to detect microscopic tumor infiltration and diagnose brain tumor subtypes. METHODS Here, we review the application of three Raman-based imaging methods to neurosurgical oncology: Raman spectroscopy, coherent anti-Stokes Raman scattering (CARS) microscopy, and stimulated Raman histology (SRH). RESULTS Raman spectroscopy allows for chemical characterization of tissue and can differentiate normal and tumor-infiltrated tissue based on variations in macromolecule content, both ex vivo and in vivo. To improve signal-to-noise ratio compared to conventional Raman spectroscopy, a second pulsed excitation laser can be used to coherently drive the vibrational frequency of specific Raman active chemical bonds (i.e. symmetric stretching of -CH2 bonds). Coherent Raman imaging, including CARS and stimulated Raman scattering microscopy, has been shown to detect microscopic brain tumor infiltration in fresh brain tumor specimens with submicron image resolution. Advances in fiber-laser technology have allowed for the development of intraoperative SRH as well as artificial intelligence algorithms to facilitate interpretation of SRH images. With molecular diagnostics becoming an essential part of brain tumor classification, preliminary studies have demonstrated that Raman-based methods can be used to diagnose glioma molecular classes intraoperatively. CONCLUSIONS These results demonstrate how label-free Raman-based imaging methods can be used to improve the management of brain tumor patients by detecting tumor infiltration, guiding tumor biopsy/resection, and providing images for histopathologic and molecular diagnosis.
Collapse
|
15
|
Bø HK, Solheim O, Kvistad KA, Berntsen EM, Torp SH, Skjulsvik AJ, Reinertsen I, Iversen DH, Unsgård G, Jakola AS. Intraoperative 3D ultrasound-guided resection of diffuse low-grade gliomas: radiological and clinical results. J Neurosurg 2020; 132:518-529. [PMID: 30717057 DOI: 10.3171/2018.10.jns181290] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 10/02/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Extent of resection (EOR) and residual tumor volume are linked to prognosis in low-grade glioma (LGG) and there are various methods for facilitating safe maximal resection in such patients. In this prospective study the authors assess radiological and clinical results in consecutive patients with LGG treated with 3D ultrasound (US)-guided resection under general anesthesia. METHODS Consecutive LGGs undergoing primary surgery guided with 3D US between 2008 and 2015 were included. All LGGs were classified according to the WHO 2016 classification system. Pre- and postoperative volumetric assessments were performed, and volumetric results were linked to overall and malignant-free survival. Pre- and postoperative health-related quality of life (HRQoL) was evaluated. RESULTS Forty-seven consecutive patients were included. Twenty LGGs (43%) were isocitrate dehydrogenase (IDH)-mutated, 7 (14%) were IDH wild-type, 19 (40%) had both IDH mutation and 1p/19q codeletion, and 1 had IDH mutation and inconclusive 1p/19q status. Median resection grade was 93.4%, with gross-total resection achieved in 14 patients (30%). An additional 24 patients (51%) had small tumor remnants < 10 ml. A more conspicuous tumor border (p = 0.02) and lower University of California San Francisco prognostic score (p = 0.01) were associated with less remnant tumor tissue, and overall survival was significantly better with remnants < 10 ml (p = 0.03). HRQoL was maintained or improved in 86% of patients at 1 month. In both cases with severe permanent deficits, relevant ischemia was present on diffusion-weighted postoperative MRI. CONCLUSIONS Three-dimensional US-guided LGG resections under general anesthesia are safe and HRQoL is preserved in most patients. Effectiveness in terms of EOR appears to be consistent with published studies using other advanced neurosurgical tools. Avoiding intraoperative vascular injury is a key factor for achieving good functional outcome.
Collapse
Affiliation(s)
- Hans Kristian Bø
- 1Department of Diagnostic Imaging, Nordland Hospital Trust, Bodø
- Departments of2Circulation and Medical Imaging
| | - Ole Solheim
- Departments of3Neurosurgery
- 4Neuromedicine and Movement Science, and
| | | | - Erik Magnus Berntsen
- Departments of2Circulation and Medical Imaging
- 5Radiology and Nuclear Medicine, and
| | - Sverre Helge Torp
- 6Pathology, St. Olavs University Hospital, Trondheim
- 7Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim
| | - Anne Jarstein Skjulsvik
- 6Pathology, St. Olavs University Hospital, Trondheim
- 7Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim
| | - Ingerid Reinertsen
- 8Department of Health Research, SINTEF Technology and Society, Trondheim, Norway
| | - Daniel Høyer Iversen
- Departments of2Circulation and Medical Imaging
- 8Department of Health Research, SINTEF Technology and Society, Trondheim, Norway
| | - Geirmund Unsgård
- Departments of3Neurosurgery
- 4Neuromedicine and Movement Science, and
| | - Asgeir Store Jakola
- Departments of3Neurosurgery
- 9Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg; and
- 10Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
| |
Collapse
|
16
|
A Multi-Institutional Analysis of Factors Influencing Surgical Outcomes for Patients with Newly Diagnosed Grade I Gliomas. World Neurosurg 2019; 135:e754-e764. [PMID: 31901497 DOI: 10.1016/j.wneu.2019.12.156] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/25/2019] [Accepted: 12/26/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the impact of intraoperative magnetic resonance imaging (iMRI), extent of resection (EOR), and other factors on overall survival (OS) and progression-free survival (PFS) for patients with newly diagnosed grade I gliomas. METHODS A multicenter database was queried to identify patients with grade I gliomas. Retrospective analyses assessed the impact of patient, treatment, and tumor characteristics on OS and PFS. RESULTS A total of 284 patients underwent treatment for grade I gliomas, including 248 resections (205 with iMRI, 43 without), 23 biopsies, and 13 laser interstitial thermal therapy treatments. Log-rank analyses of Kaplan-Meier plots showed improved 5-year OS (P = 0.0107) and PFS (P = 0.0009) with increasing EOR, and a trend toward improved 5-year OS for patients with lower American Society of Anesthesiologists score (P = 0.0528). Greater EOR was associated with significantly increased 5-year PFS for pilocytic astrocytoma (P < 0.0001), but not for ganglioglioma (P = 0.10) or dysembryoplastic neuroepithelial tumor (P = 0.57). Temporal tumors (P = 0.04) and location of "other" (P = 0.04) were associated with improved PFS, and occipital/parietal tumors (P = 0.02) were associated with decreased PFS compared with all other locations. Additional tumor resection was performed after iMRI in 49.7% of cases using iMRI, which produced gross total resection in 64% of these additional resection cases. CONCLUSIONS Patients with grade I gliomas have extended OS and PFS, which correlates positively with increasing EOR, especially for patients with pilocytic astrocytoma. iMRI may increase EOR, indicated by the rate of gross total resection after iMRI use but was not independently associated with increased OS or PFS.
Collapse
|
17
|
Zhao YY, Chen SH, Hao Z, Zhu HX, Xing ZL, Li MH. A Nomogram for Predicting Individual Prognosis of Patients with Low-Grade Glioma. World Neurosurg 2019; 130:e605-e612. [DOI: 10.1016/j.wneu.2019.06.169] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 01/25/2023]
|
18
|
Mehidine H, Sibai M, Poulon F, Pallud J, Varlet P, Zanello M, Devaux B, Abi Haidar D. Multimodal imaging to explore endogenous fluorescence of fresh and fixed human healthy and tumor brain tissues. JOURNAL OF BIOPHOTONICS 2019; 12:e201800178. [PMID: 30203459 DOI: 10.1002/jbio.201800178] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 09/07/2018] [Indexed: 06/08/2023]
Abstract
To complement a project toward label-free optical biopsy and enhanced resection which the overall goal is to develop a multimodal nonlinear endomicroscope, this multimodal approach aims to enhance the accuracy in classifying brain tissue into solid tumor, infiltration and normal tissue intraoperatively. Multiple optical measurements based on one- and two-photon spectral and lifetime autofluorescence, including second harmonic generation imaging, were acquired. As a prerequisite, studying the effect of the time of measurement postexcision on tissue's spectral/lifetime fluorescence properties was warranted, so spectral and lifetime fluorescences of fresh brain tissues were measured using a point-based linear endoscope. Additionally, a comparative study on tissue's optical properties obtained by multimodal nonlinear optical imaging microscope from fresh and fixed tissue was necessary to test whether clinical validation of the nonlinear endomicroscope is feasible by extracting optical signatures from fixed tissue rather than from freshly excised samples. The former is generally chosen for convenience. Results of this study suggest that an hour is necessary postexcision to have consistent fluorescence intensities\lifetimes. The fresh (a,b,c) vs fixed (d,e,f) tissue study indicates that while all optical signals differ after fixation. The characteristic features extracted from one- and two-photon excitation still discriminate normal brain (a,d) cortical tissue, glioblastoma (GBM) (b,e) and metastases (c,f).
Collapse
Affiliation(s)
- Hussein Mehidine
- IMNC Laboratory, UMR 8165-CNRS/ IN2P3, Paris-Saclay University, Orsay, France
- Paris Diderot University, Sorbonne Paris Cité, F-75013, Paris, France
| | - Mira Sibai
- IMNC Laboratory, UMR 8165-CNRS/ IN2P3, Paris-Saclay University, Orsay, France
| | - Fanny Poulon
- IMNC Laboratory, UMR 8165-CNRS/ IN2P3, Paris-Saclay University, Orsay, France
| | - Johan Pallud
- Neurosurgery Department, Sainte-Anne Hospital, Paris, France
- IMA BRAIN, INSERMU894, Centre de Psychiatrie et de Neurosciences, Paris, France
- Paris Descartes University, Paris, France
| | - Pascale Varlet
- IMA BRAIN, INSERMU894, Centre de Psychiatrie et de Neurosciences, Paris, France
- Paris Descartes University, Paris, France
- Neuropathology Department, Sainte-Anne Hospital, Paris, France
| | - Marc Zanello
- Neurosurgery Department, Sainte-Anne Hospital, Paris, France
- Paris Descartes University, Paris, France
| | - Bertrand Devaux
- Neurosurgery Department, Sainte-Anne Hospital, Paris, France
- Paris Descartes University, Paris, France
| | - Darine Abi Haidar
- IMNC Laboratory, UMR 8165-CNRS/ IN2P3, Paris-Saclay University, Orsay, France
- Paris Diderot University, Sorbonne Paris Cité, F-75013, Paris, France
| |
Collapse
|
19
|
Sun H, Yang B, Zhang H, Song J, Zhang Y, Xing J, Yang Z, Wei C, Xu T, Yu Z, Xu Z, Hou M, Ji M, Zhang Y. RRM2 is a potential prognostic biomarker with functional significance in glioma. Int J Biol Sci 2019; 15:533-543. [PMID: 30745840 PMCID: PMC6367584 DOI: 10.7150/ijbs.30114] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 11/09/2018] [Indexed: 12/11/2022] Open
Abstract
Glioma is one of the most common brain tumors, suggesting the importance of investigating the molecular mechanism of gliomas. We studied the roles of Ribonucleotide Reductase Regulatory Subunit M2 (RRM2) in glioma. Expressions of RRM2 are higher in glioma tissues evidenced by TCGA data, western blot and immunohistochemistry. RRM2 is negatively correlated with glioma patient's survival. RNA-seq showed that genes involved in apoptosis, proliferation, cell adhesion and negative regulation of signaling were up-regulated upon RNAi-mediated knock-down of RRM2. Cell phenotypes specific for stably knocking down RRM2 were determined using stable transfection in vitro. In an in vivo model, knock-down of RRM2 inhibited tumor growth and caused suppression of AKT and ERK1/2 signalings. Interfering RRM2 also down-regulated the expression of cyclin A, cyclin B1, cyclin D1, Vimentin, and N-cadherin, and elevated E-cadherin expression. Moreover, overexpression of RRM2 failed to increase the expression of cyclin B1, cyclin D1, and N-cadherin when phosphorylation of AKT and ERK1/2 was suppressed by LY294002 or PD98059. These findings indicated that RRM2 is a positive regulator of glioma progression which contributes to the migration and proliferation of glioma cells through ERK1/2 and AKT signalings and might be a novel prognostic indicator for glioma patients.
Collapse
Affiliation(s)
- Hongzhi Sun
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Bingya Yang
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
- Jiangsu Province Key Laboratory of Modern Pathogen Biology, Nanjing, Jiangsu, 211166, China
| | - Hao Zhang
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Jingwei Song
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Yenan Zhang
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Jicheng Xing
- Department of Clinical laboratory, Bayi Hospital Affiliated to Nanjing University Of Chinese Medicine, Nanjing, Jiangsu, 210002, China
| | - Zhihui Yang
- Department of Clinical laboratory, Bayi Hospital Affiliated to Nanjing University Of Chinese Medicine, Nanjing, Jiangsu, 210002, China
| | - Changyong Wei
- Department of Hematology and Medical Oncology, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Tuoye Xu
- Department of Neurosurgery, Brain Hospital, affiliated to Nanjing medical University, Nanjing, 210029, China
| | - Zhennan Yu
- Department of Neurosurgery, Brain Hospital, affiliated to Nanjing medical University, Nanjing, 210029, China
| | - Zhipeng Xu
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
- Jiangsu Province Key Laboratory of Modern Pathogen Biology, Nanjing, Jiangsu, 211166, China
| | - Min Hou
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Minjun Ji
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
- Jiangsu Province Key Laboratory of Modern Pathogen Biology, Nanjing, Jiangsu, 211166, China
| | - Yansong Zhang
- Department of Neurosurgery, Brain Hospital, affiliated to Nanjing medical University, Nanjing, 210029, China
| |
Collapse
|
20
|
Nguyen JQM, McWade M, Thomas G, Beddard BT, Herington JL, Paria BC, Schwartz HS, Halpern JL, Holt GE, Mahadevan-Jansen A. Development of a modular fluorescence overlay tissue imaging system for wide-field intraoperative surgical guidance. J Med Imaging (Bellingham) 2018. [PMID: 29531968 DOI: 10.1117/1.jmi.5.2.021220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Fluorescence imaging is a well-established optical modality that has been used to localize and track fluorophores in vivo and has demonstrated great potential for surgical guidance. Despite the variety of fluorophores currently being researched, many existing intraoperative fluorescence imaging systems are specifically designed for a limited number of applications. We present a modular wide-field fluorescence overlay tissue imaging system for intraoperative surgical guidance that is comprised of commercially available standardized components. Its modular layout allows for the accommodation of a broad range of fluorophores, fields of view (FOV), and spatial resolutions while maintaining an integrated portable design for intraoperative use. Measurements are automatic and feature a real-time projection overlay technique that intuitively displays fluorescence maps directly onto a [Formula: see text] FOV from a working distance of 35 cm. At a 20-ms exposure time, [Formula: see text] samples of indocyanine green could be measured with high signal-to-noise ratio and was later tested in an in vivo mouse model before finally being demonstrated for intraoperative autofluorescence imaging of human soft tissue sarcoma margins. The system's modular design and ability to enable naked-eye visualization of wide-field fluorescence allow for the flexibility to adapt to numerous clinical applications and can potentially extend the adoption of fluorescence imaging for intraoperative use.
Collapse
Affiliation(s)
| | - Melanie McWade
- Vanderbilt University, Biophotonics Center, Nashville, Tennessee, United States
| | - Giju Thomas
- Vanderbilt University, Biophotonics Center, Nashville, Tennessee, United States
| | - Bryce T Beddard
- Vanderbilt University, Biophotonics Center, Nashville, Tennessee, United States
| | - Jennifer L Herington
- Vanderbilt University, Department of Pediatrics, Nashville, Tennessee, United States
| | - Bibhash C Paria
- Vanderbilt University, Department of Pediatrics, Nashville, Tennessee, United States
| | - Herbert S Schwartz
- Vanderbilt University Medical Center, Department of Orthopaedic Surgery and Rehabilitation, Nashville, Tennessee, United States
| | - Jennifer L Halpern
- Vanderbilt University Medical Center, Department of Orthopaedic Surgery and Rehabilitation, Nashville, Tennessee, United States
| | - Ginger E Holt
- Vanderbilt University Medical Center, Department of Orthopaedic Surgery and Rehabilitation, Nashville, Tennessee, United States
| | | |
Collapse
|
21
|
Yang BY, Song JW, Sun HZ, Xing JC, Yang ZH, Wei CY, Xu TY, Yu ZN, Zhang YN, Wang YF, Chang H, Xu ZP, Hou M, Ji MJ, Zhang YS. PSMB8 regulates glioma cell migration, proliferation, and apoptosis through modulating ERK1/2 and PI3K/AKT signaling pathways. Biomed Pharmacother 2018; 100:205-212. [PMID: 29428669 DOI: 10.1016/j.biopha.2018.01.170] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 01/04/2018] [Accepted: 01/28/2018] [Indexed: 01/17/2023] Open
Abstract
Glioma has been considered as one of the most aggressive and popular brain tumors of patients. It is essential to explore the mechanism of glioma. In this study, we established PSMB8 as a therapeutic target for glioma treatment. Expression of PSMB8 as well as Ki-67 was higher in glioma tissues demonstrated by western blot and immunohistochemistry. Then, the role of PSMB8 in migration and proliferation of glioma cells was investigated by conducting wound-healing, trans-well assay, cell counting kit (CCK)-8, flow cytometry assay and colony formation analysis. The data showed that interfering PSMB8 may inhibit the migration and proliferation of glioma cells by reducing expression of cyclin A, cyclin B1, cyclin D1, Vimentin, and N-cadherin, and by increasing expression of E-cadherin. Additionally, interfering PSMB8 may induce apoptosis of glioma cells by upregulating caspase-3 expression. Furthermore, these in vitro findings were validated in vivo and the ERK1/2 and PI3k/AKT signaling pathways were involved in PSMB8-triggered migration and proliferation of glioma cells. In an in vivo model, downregulation of PSMB8 suppressed tumor growth. In conclusion, PSMB8 is closely associated with migration, proliferation, and apoptosis of glioma cells, and might be considered as a novel prognostic indicator in patients with gliomas.
Collapse
Affiliation(s)
- Bing-Ya Yang
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China; Jiangsu Province Key Laboratory of Modern Pathogen Biology, Nanjing, Jiangsu, 211166, China
| | - Jing-Wei Song
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Hong-Zhi Sun
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Ji-Cheng Xing
- Department of Clinical Laboratory, Bayi Hospital, Affiliated to Nanjing University Of Chinese Medicine, Nanjing, Jiangsu, 210002, China
| | - Zhi-Hui Yang
- Department of Clinical Laboratory, Bayi Hospital, Affiliated to Nanjing University Of Chinese Medicine, Nanjing, Jiangsu, 210002, China
| | - Chang-Yong Wei
- Department of Hematology and Medical Oncology, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Tuo-Ye Xu
- Department of Neurosurgery, Brain Hospital, Affiliated to Nanjing Medical University, Nanjing, 210029, China
| | - Zhen-Nan Yu
- Department of Neurosurgery, Brain Hospital, Affiliated to Nanjing Medical University, Nanjing, 210029, China
| | - Ye-Nan Zhang
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Ying-Fan Wang
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Hao Chang
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Zhi-Peng Xu
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China; Jiangsu Province Key Laboratory of Modern Pathogen Biology, Nanjing, Jiangsu, 211166, China
| | - Min Hou
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Min-Jun Ji
- Department of Pathogen Biology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China; Jiangsu Province Key Laboratory of Modern Pathogen Biology, Nanjing, Jiangsu, 211166, China.
| | - Yan-Song Zhang
- Department of Neurosurgery, Brain Hospital, Affiliated to Nanjing Medical University, Nanjing, 210029, China
| |
Collapse
|
22
|
Li N, Shi H, Zhang L, Li X, Gao L, Zhang G, Shi Y, Guo S. miR-188 Inhibits Glioma Cell Proliferation and Cell Cycle Progression Through Targeting β-Catenin. Oncol Res 2017; 26:785-794. [PMID: 29268818 PMCID: PMC7844764 DOI: 10.3727/096504017x15127309628257] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
MicroRNAs (miRNAs) play important roles in several human cancers. Although miR-188 has been suggested to function as a tumor repressor in cancers, its precise role in glioma and the molecular mechanism remain unknown. In the present study, we investigated the effect of miR-188 on glioma and explored its relevant mechanisms. We found that the expression of miR-188 is dramatically downregulated in glioma tissues and cell lines. Subsequent investigation revealed that miR-188 expression was inversely correlated with β-catenin expression in glioma tissue samples. Using a luciferase reporter assay, β-catenin was determined to be a direct target of miR-188. Overexpression of miR-188 reduced β-catenin expression at both the mRNA and protein levels, and inhibition of miR-188 increased β-catenin expression. Moreover, we found that overexpression of miR-188 suppressed glioma cell proliferation and cell cycle G1–S transition, whereas inhibition of miR-188 promoted glioma cell proliferation. Importantly, silencing β-catenin recapitulated the cellular and molecular effects seen upon miR-188 overexpression, which included inhibiting glioma cell proliferation and G1–S transition. Taken together, our results demonstrated that miR-188 inhibits glioma cell proliferation by targeting β-catenin, representing an effective therapeutic strategy for glioma.
Collapse
Affiliation(s)
- Nan Li
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Hangyu Shi
- Department of Neurosurgery, Xi'an Children's Hospital, Xi'an, Shaanxi, P.R. China
| | - Lu Zhang
- Department of Foreign Languages, Ming De College of Northwestern Polytechnical University, Xi'an, Shaanxi, P.R. China
| | - Xu Li
- Department of First Internal Medicine, Shaanxi Province Tumor Hospital, Xi'an, Shaanxi, P.R. China
| | - Lu Gao
- Department of Neurosurgery, Xi'an Children's Hospital, Xi'an, Shaanxi, P.R. China
| | - Gang Zhang
- Department of Neurosurgery, Xi'an Children's Hospital, Xi'an, Shaanxi, P.R. China
| | - Yongqiang Shi
- Department of Neurosurgery, Xi'an Children's Hospital, Xi'an, Shaanxi, P.R. China
| | - Shiwen Guo
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| |
Collapse
|
23
|
SEOM clinical guideline of diagnosis and management of low-grade glioma (2017). Clin Transl Oncol 2017; 20:3-15. [PMID: 29124520 PMCID: PMC5785601 DOI: 10.1007/s12094-017-1790-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 10/26/2017] [Indexed: 11/09/2022]
Abstract
Diffuse infiltrating low-grade gliomas include oligodendrogliomas
and astrocytomas, and account for about 5% of all primary brain tumors. Treatment strategies for these low-grade gliomas in adults have recently changed. The 2016 World Health Organization (WHO) classification has updated the definition of these tumors to include their molecular characterization, including the presence of isocitrate dehydrogenase (IDH) mutation and 1p/19p codeletion. In this new classification, the histologic subtype of grade II-mixed oligoastrocytoma has also been eliminated. The precise optimal management of patients with low-grade glioma after resection remains to be determined. The risk–benefit ratio of adjuvant treatment must be weighed for each individual.
Collapse
|
24
|
Diwanji TP, Engelman A, Snider JW, Mohindra P. Epidemiology, diagnosis, and optimal management of glioma in adolescents and young adults. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2017; 8:99-113. [PMID: 28989289 PMCID: PMC5624597 DOI: 10.2147/ahmt.s53391] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Neoplasms of the central nervous system (CNS) are the most frequently encountered solid tumors of childhood, but are less common in adolescents and young adults (AYA), aged 15–39 years. Gliomas account for 29%–35% of the CNS tumors in AYA, with approximately two-thirds being low-grade glioma (LGG) and the remaining being high-grade glioma (HGG). We review the epidemiology, work-up, and management of LGG and HGG, focusing on the particular issues faced by the AYA population relative to pediatric and adult populations. Visual pathway glioma and brainstem glioma, which represent unique clinical entities, are only briefly discussed. As a general management approach for both LGG and HGG, maximal safe resection should be attempted. AYA with LGG who undergo gross total resection (GTR) may be safely observed. As age increases and the risk factors for recurrence accumulate, adjuvant therapy should be more strongly considered with a strong consideration of advanced radiation techniques such as proton beam therapy to reduce long-term radiation-related toxicity. Recent results also suggest survival advantage for adult patients with the use of adjuvant chemotherapy when radiation is indicated. Whenever possible, AYA patients with HGG should be enrolled in a clinical trial for the benefit of centralized genetic and molecular prognostic review and best clinical care. Chemoradiation should be offered to all World Health Organization grade IV patients with concurrent and adjuvant chemotherapy after maximal safe resection. Younger adolescents with GTR of grade III lesions may consider radiotherapy alone or sequential radiotherapy and chemotherapy if unable to tolerate concurrent treatment. A more comprehensive classification of gliomas integrating pathology and molecular data is emerging, and this integrative strategy offers the potential to be more accurate and reproducible in guiding diagnostic, prognostic, and management decisions.
Collapse
Affiliation(s)
- Tejan P Diwanji
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alexander Engelman
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - James W Snider
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Pranshu Mohindra
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| |
Collapse
|
25
|
Sibai M, Fisher C, Veilleux I, Elliott JT, Leblond F, Roberts DW, Wilson BC. Preclinical evaluation of spatial frequency domain-enabled wide-field quantitative imaging for enhanced glioma resection. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:76007. [PMID: 28697235 PMCID: PMC5995142 DOI: 10.1117/1.jbo.22.7.076007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 06/21/2017] [Indexed: 05/19/2023]
Abstract
5-Aminolevelunic acid-induced protoporphyrin IX (PpIX) fluorescence-guided resection (FGR) enables maximum safe resection of glioma by providing real-time tumor contrast. However, the subjective visual assessment and the variable intrinsic optical attenuation of tissue limit this technique to reliably delineating only high-grade tumors that display strong fluorescence. We have previously shown, using a fiber-optic probe, that quantitative assessment using noninvasive point spectroscopic measurements of the absolute PpIX concentration in tissue further improves the accuracy of FGR, extending it to surgically curable low-grade glioma. More recently, we have shown that implementing spatial frequency domain imaging with a fluorescent-light transport model enables recovery of two-dimensional images of [PpIX], alleviating the need for time-consuming point sampling of the brain surface. We present first results of this technique modified for <italic<in vivo</italic< imaging on an RG2 rat brain tumor model. Despite the moderate errors in retrieving the absorption and reduced scattering coefficients in the subdiffusive regime of 14% and 19%, respectively, the recovered [PpIX] maps agree within 10% of the point [PpIX] values measured by the fiber-optic probe, validating its potential as an extension or an alternative to point sampling during glioma resection.
Collapse
Affiliation(s)
- Mira Sibai
- University of Toronto, Department of Medical Biophysics, Faculty of Medicine, Ontario, Canada
- University Health Network, Princess Margaret Cancer Center, Ontario, Canada
| | - Carl Fisher
- University of Toronto, Department of Medical Biophysics, Faculty of Medicine, Ontario, Canada
- University Health Network, Princess Margaret Cancer Center, Ontario, Canada
| | - Israel Veilleux
- University Health Network, Princess Margaret Cancer Center, Ontario, Canada
| | - Jonathan T. Elliott
- Dartmouth College, Thayer School of Engineering, New Hampshire, United States
| | - Frederic Leblond
- École Polytechnique De Montreal, Department of Engineering Physics, Québec, Canada
| | - David W. Roberts
- Dartmouth Hitchcock Medical Center, Department of Neurosurgery, New Hampshire, United States
| | - Brian C. Wilson
- University of Toronto, Department of Medical Biophysics, Faculty of Medicine, Ontario, Canada
- University Health Network, Princess Margaret Cancer Center, Ontario, Canada
- Address all correspondence to: Brian C. Wilson, E-mail:
| |
Collapse
|
26
|
Zhao H, Ji B, Chen J, Huang Q, Lu X. Gpx 4 is involved in the proliferation, migration and apoptosis of glioma cells. Pathol Res Pract 2017; 213:626-633. [DOI: 10.1016/j.prp.2017.04.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 04/03/2017] [Accepted: 04/26/2017] [Indexed: 01/18/2023]
|
27
|
Tang J, Huang N, Zhang X, Zhou T, Tan Y, Pi J, Pi L, Cheng S, Zheng H, Cheng Y. Aptamer-conjugated PEGylated quantum dots targeting epidermal growth factor receptor variant III for fluorescence imaging of glioma. Int J Nanomedicine 2017; 12:3899-3911. [PMID: 28579776 PMCID: PMC5446962 DOI: 10.2147/ijn.s133166] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The extent of resection is a significant prognostic factor in glioma patients. However, the maximum safe resection level is difficult to determine due to the inherent infiltrative character of tumors. Recently, fluorescence-guided surgery has emerged as a new technique that allows safe resection of glioma. In this study, we constructed a new kind of quantum dot (QD)-labeled aptamer (QD-Apt) nanoprobe by conjugating aptamer 32 (A32) to the QDs surface, which can specially bind to the tumors. A32 is a single-stranded DNA capable of binding to the epidermal growth factor receptor variant III (EGFRvIII) specially distributed on the surface of glioma cells. To detect the expression of EGFRvIII in human brain tissues, 120 specimens, including 110 glioma tissues and 10 normal brain tissues, were examined by immunohistochemistry, and the results showed that the rate of positive expression of EGFRvIII in the glioma tissues was 41.82%, and 0.00% in normal brain tissues. Besides, the physiochemical properties of QD-Apt nanoparticles (NPs) were thoroughly characterized. Biocompatibility of the NPs was evaluated, and the results suggested that the QD-Apt was nontoxic in vivo and vitro. Furthermore, the use of the QD-Apt in labeling glioma cell lines and human brain glioma tissues, and target gliomas in situ was also investigated. We found that not only could QD-Apt specially bind to the U87-EGFRvIII glioma cells but also bind to human glioma tissues in vitro. Fluorescence imaging in vivo with orthotopic glioma model mice bearing U87-EGFRvIII showed that QD-Apt could penetrate the blood-brain barrier and then selectively accumulate in the tumors through binding to EGFRvIII, and consequently, generate a strong fluorescence, which contributed to the margins of gliomas that were visualized clearly, and thus, help the surgeons realize the maximum safe resection of glioma. In addition, QD-Apt can also be applied in preoperative diagnosis and postoperative examination of glioma. Therefore, these achievements facilitate the use of tumor-targeted fluorescence imaging in the diagnosis, surgical resection, and postoperative examination of glioma.
Collapse
Affiliation(s)
- Jiaze Tang
- Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University
| | - Ning Huang
- Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University
| | - Xiang Zhang
- Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University.,Chongqing Key Laboratory of Ultrasound Molecular Imaging, Institute of Ultrasound Imaging
| | - Tao Zhou
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology
| | - Ying Tan
- Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University.,Institute of Life Sciences, Chongqing Medical University
| | - Jiangli Pi
- Key Laboratory on Luminescent and Real-Time Analytical Chemistry, Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University
| | - Li Pi
- Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University
| | - Si Cheng
- Department of Orthopaedics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Huzhi Zheng
- Key Laboratory on Luminescent and Real-Time Analytical Chemistry, Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University
| | - Yuan Cheng
- Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University
| |
Collapse
|
28
|
Hok P, Kell C. EP 133. Structural connectivity of eloquent speech areas defined by direct cortical stimulation mapping. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
29
|
Zhang M, Guo Y, Wu J, Chen F, Dai Z, Fan S, Li P, Song T. Roles of microRNA-99 family in human glioma. Onco Targets Ther 2016; 9:3613-9. [PMID: 27382299 PMCID: PMC4920231 DOI: 10.2147/ott.s99363] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective Deregulation of microRNA (miR)-99 family members (miR-99a, miR-99b, and miR-100) has been reported to play a crucial role in many cancer types. However, their roles in human gliomas have not been fully elucidated. This study aimed to investigate the expression patterns of miR-99a, miR-99b, and miR-100 in glioma tissues and to evaluate their expression profiles with respect to tumor progression. Methods Quantitative real-time polymerase chain reaction was performed to detect the expression levels of miR-99a, miR-99b, and miR-100 in glioma and matched non-neoplastic brain tissues. Then, the associations of their expression with various clinicopathological features of glioma patients were statistically analyzed. Moreover, the roles of miR-99a, miR-99b, and miR-100 in regulating glioma cell migration and invasion were determined via transwell assay in vitro. Results Compared with non-neoplastic brain tissues, miR-99a, miR-99b, and miR-100 expression levels were all significantly decreased in glioma tissues (all P<0.001). miR-99a-low, miR-99b-low, and miR-100-low expression more frequently occurred in glioma patients with low Karnofsky performance score (<90) and high World Health Organization grade (III–IV). Further functional experiments revealed that the enforced expression of miR-99a, miR-99b, and miR-100 resulted in the inhibition of cellular migration and invasion in glioma cells. Conclusion Our results strongly suggest that the aberrant expression of miR-99a, miR-99b, and miR-100 may be a common feature in human gliomas with aggressive clinicopathological features and may participate in malignant phenotypes of the tumors. These findings highlight the potential of the three miR-99 family members as novel therapeutic targets for human gliomas.
Collapse
Affiliation(s)
- Mingyu Zhang
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha
| | - Yong Guo
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha
| | - Jun Wu
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha
| | - Fenghua Chen
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha
| | - Zhijie Dai
- Institute of Endocrinology and Metabolism, Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Shuangshi Fan
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha
| | - Pengcheng Li
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha
| | - Tao Song
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha
| |
Collapse
|
30
|
Le Rhun E, Taillibert S, Chamberlain MC. Current Management of Adult Diffuse Infiltrative Low Grade Gliomas. Curr Neurol Neurosci Rep 2016; 16:15. [PMID: 26750130 DOI: 10.1007/s11910-015-0615-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Diffuse infiltrative low grade gliomas (LGG) account for approximately 15 % of all gliomas. The prognosis of LGG differs between high-risk and low-risk patients notwithstanding varying definitions of what constitutes a high-risk patient. Maximal safe resection optimally is the initial treatment. Surgery that achieves a large volume resection improves both progression-free and overall survival. Based on results of three randomized clinical trials (RCT), radiotherapy (RT) may be deferred in patients with low-risk LGG (defined as age <40 years and having undergone a complete resection), although combined chemoradiotherapy has never been prospectively evaluated in the low-risk population. The recent RTOG 9802 RCT established a new standard of care in high-risk patients (defined as age >40 years or incomplete resection) by demonstrating a nearly twofold improvement in overall survival with the addition of PCV (procarbazine, CCNU, vincristine) chemotherapy following RT as compared to RT alone. Chemotherapy alone as a treatment of LGG may result in less toxicity than RT; however, this has only been prospectively studied once (EORTC 22033) in high-risk patients. A challenge remains to define when an aggressive treatment improves survival without impacting quality of life (QoL) or neurocognitive function and when an effective treatment can be delayed in order to preserve QoL without impacting survival. Current WHO histopathological classification is poorly predictive of outcome in patients with LGG. The integration of molecular biomarkers with histology will lead to an improved classification that more accurately reflects underlying tumor biology, prognosis, and hopefully best therapy.
Collapse
Affiliation(s)
- Emilie Le Rhun
- Neuro-oncology, Department of Neurosurgery, Lille University Hospital, Lille, France.
- Breast unit, Department of Medical Oncology, Oscar Lambret Center, Lille, France.
- PRISM Inserm U1191, Villeneuve d'Ascq, France.
| | - Sophie Taillibert
- Department of Neurology, Pitié-Salpétrière Hospital, UPMC-Paris VI University, Paris, France.
- Department of Radiation Oncology, Pitié-Salpétrière Hospital, UPMC-Paris VI University, Paris, France.
| | - Marc C Chamberlain
- Division of Neuro-Oncology, Department of Neurology and Neurological Surgery, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, University of Washington, 825 Eastlake Ave E, MS G4940, PO Box 19023, Seattle, WA, 98109, USA.
| |
Collapse
|
31
|
Kuzmin NV, Wesseling P, Hamer PCDW, Noske DP, Galgano GD, Mansvelder HD, Baayen JC, Groot ML. Third harmonic generation imaging for fast, label-free pathology of human brain tumors. BIOMEDICAL OPTICS EXPRESS 2016; 7:1889-904. [PMID: 27231629 PMCID: PMC4871089 DOI: 10.1364/boe.7.001889] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/08/2016] [Accepted: 03/12/2016] [Indexed: 05/07/2023]
Abstract
In brain tumor surgery, recognition of tumor boundaries is key. However, intraoperative assessment of tumor boundaries by the neurosurgeon is difficult. Therefore, there is an urgent need for tools that provide the neurosurgeon with pathological information during the operation. We show that third harmonic generation (THG) microscopy provides label-free, real-time images of histopathological quality; increased cellularity, nuclear pleomorphism, and rarefaction of neuropil in fresh, unstained human brain tissue could be clearly recognized. We further demonstrate THG images taken with a GRIN objective, as a step toward in situ THG microendoscopy of tumor boundaries. THG imaging is thus a promising tool for optical biopsies.
Collapse
Affiliation(s)
- N. V. Kuzmin
- LaserLab Amsterdam, VU University, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, VU University, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - P. Wesseling
- Dept. of Pathology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Dept. of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid, 6525 GA Nijmegen, The Netherlands
- Amsterdam Brain Tumor Center, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - P. C. de Witt Hamer
- Dept. of Neurosurgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Amsterdam Brain Tumor Center, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - D. P. Noske
- Dept. of Neurosurgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Amsterdam Brain Tumor Center, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - G. D. Galgano
- LaserLab Amsterdam, VU University, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands
| | - H. D. Mansvelder
- Neuroscience Campus Amsterdam, VU University, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - J. C. Baayen
- Dept. of Neurosurgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - M. L. Groot
- LaserLab Amsterdam, VU University, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, VU University, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| |
Collapse
|
32
|
Jiang T, Mao Y, Ma W, Mao Q, You Y, Yang X, Jiang C, Kang C, Li X, Chen L, Qiu X, Wang W, Li W, Yao Y, Li S, Li S, Wu A, Sai K, Bai H, Li G, Chen B, Yao K, Wei X, Liu X, Zhang Z, Dai Y, Lv S, Wang L, Lin Z, Dong J, Xu G, Ma X, Cai J, Zhang W, Wang H, Chen L, Zhang C, Yang P, Yan W, Liu Z, Hu H, Chen J, Liu Y, Yang Y, Wang Z, Wang Z, Wang Y, You G, Han L, Bao Z, Liu Y, Wang Y, Fan X, Liu S, Liu X, Wang Y, Wang Q. CGCG clinical practice guidelines for the management of adult diffuse gliomas. Cancer Lett 2016; 375:263-273. [PMID: 26966000 DOI: 10.1016/j.canlet.2016.01.024] [Citation(s) in RCA: 304] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 01/15/2016] [Accepted: 01/15/2016] [Indexed: 02/05/2023]
Abstract
The Chinese Glioma Cooperative Group (CGCG) Guideline Panel for adult diffuse gliomas provided recommendations for diagnostic and therapeutic procedures. The Panel covered all fields of expertise in neuro-oncology, i.e. neurosurgeons, neurologists, neuropathologists, neuroradiologists, radiation and medical oncologists and clinical trial experts. The task made clearer and more transparent choices about outcomes considered most relevant through searching the references considered most relevant and evaluating their value. The scientific evidence of papers collected from the literature was evaluated and graded based on the Oxford Centre for Evidence-based Medicine Levels of Evidence and recommendations were given accordingly. The recommendations will provide a framework and assurance for the strategy of diagnostic and therapeutic measures to reduce complications from unnecessary treatment and cost. The guideline should serve as an application for all professionals involved in the management of patients with adult diffuse glioma and also as a source of knowledge for insurance companies and other institutions involved in the cost regulation of cancer care in China.
Collapse
Affiliation(s)
- Tao Jiang
- Beijing Neurosurgical Institute, Beijing 100050, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing 100069, China; China National Clinical Research Center for Neurological Diseases, Beijing 100050, China.
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Wenbin Ma
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
| | - Qing Mao
- Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China.
| | - Yongping You
- Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
| | - Xuejun Yang
- Department of Neurosurgery, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Medical University General Hospital, Tianjin 300052, China.
| | - Chuanlu Jiang
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Chunsheng Kang
- Department of Neurosurgery, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xuejun Li
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Ling Chen
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Xiaoguang Qiu
- Department of Radiotherapy, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Weimin Wang
- Department of Neurosurgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong 510010, China
| | - Wenbin Li
- Department of Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yu Yao
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Shaowu Li
- Beijing Neurosurgical Institute, Beijing 100050, China
| | - Shouwei Li
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Anhua Wu
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Ke Sai
- Department of Neurosurgery, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - Hongmin Bai
- Department of Neurosurgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong 510010, China
| | - Guilin Li
- Beijing Neurosurgical Institute, Beijing 100050, China
| | - Baoshi Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Kun Yao
- Department of Pathology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Xinting Wei
- Department of Neurosurgery, The 1st Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Xianzhi Liu
- Department of Neurosurgery, The 1st Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Zhiwen Zhang
- Department of Neurosurgery, The First Hospital Affiliated to the Chinese PLA General Hospital, Beijing 100048, China
| | - Yiwu Dai
- Department of Neurosurgery, Beijing Military Region General Hospital, Beijing 100700, China
| | - Shengqing Lv
- Department of Neurosurgery, Xinqiao Hospital, The Third Military Medical University, Chongqing 400038, China
| | - Liang Wang
- Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038, China
| | - Zhixiong Lin
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Jun Dong
- Department of Neurosurgery, Medical College of Soochow University, Suzhou 215123, China
| | - Guozheng Xu
- Department of Neurosurgery, Wuhan General Hospital of Guangzhou Military Command, Guangzhou, Wuhan 430070, China
| | - Xiaodong Ma
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Jinquan Cai
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Wei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Hongjun Wang
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Lingchao Chen
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | | | - Pei Yang
- Beijing Neurosurgical Institute, Beijing 100050, China
| | - Wei Yan
- Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhixiong Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Huimin Hu
- Beijing Neurosurgical Institute, Beijing 100050, China
| | - Jing Chen
- Beijing Neurosurgical Institute, Beijing 100050, China
| | - Yuqing Liu
- Beijing Neurosurgical Institute, Beijing 100050, China
| | - Yuan Yang
- Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
| | - Zheng Wang
- Beijing Neurosurgical Institute, Beijing 100050, China
| | - Zhiliang Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Yongzhi Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Gan You
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Lei Han
- Department of Neurosurgery, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Zhaoshi Bao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Yanwei Liu
- Beijing Neurosurgical Institute, Beijing 100050, China
| | - Yinyan Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Xing Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Shuai Liu
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xing Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Yu Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Qixue Wang
- Department of Neurosurgery, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Medical University General Hospital, Tianjin 300052, China
| | | |
Collapse
|
33
|
Hollon T, Nguyen V, Smith BW, Lewis S, Junck L, Orringer DA. Supratentorial hemispheric ependymomas: an analysis of 109 adults for survival and prognostic factors. J Neurosurg 2016; 125:410-8. [PMID: 26745489 DOI: 10.3171/2015.7.jns151187] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Survival rates and prognostic factors for supratentorial hemispheric ependymomas have not been determined. The authors therefore designed a retrospective study to determine progression-free survival (PFS), overall survival (OS), and prognostic factors for hemispheric ependymomas. METHODS The study population consisted of 8 patients from our institution and 101 patients from the literature with disaggregated survival information (n = 109). Patient age, sex, tumor side, tumor location, extent of resection (EOR), tumor grade, postoperative chemotherapy, radiation, time to recurrence, and survival were recorded. Kaplan-Meier survival analyses and Cox proportional hazard models were completed to determine survival rates and prognostic factors. RESULTS Anaplastic histology/WHO Grade III tumors were identified in 62% of cases and correlated with older age. Three-, 5-, and 10-year PFS rates were 57%, 51%, and 42%, respectively. Three-, 5-, and 10-year OS rates were 77%, 71%, and 58%, respectively. EOR and tumor grade were identified on both Kaplan-Meier log-rank testing and univariate Cox proportional hazard models as prognostic for PFS and OS. Both EOR and tumor grade remained prognostic on multivariate analysis. Subtotal resection (STR) predicted a worse PFS (hazard ratio [HR] 4.764, p = 0.001) and OS (HR 4.216, p = 0.008). Subgroup survival analysis of patients with STR demonstrated a 5- and 10-year OS of 28% and 0%, respectively. WHO Grade III tumors also had worse PFS (HR 10.2, p = 0.004) and OS (HR 9.1, p = 0.035). Patients with WHO Grade III tumors demonstrated 5- and 10-year OS of 61% and 46%, respectively. Postoperative radiation was not prognostic for PFS or OS. CONCLUSIONS A high incidence of anaplastic histology was found in hemispheric ependymomas and was associated with older age. EOR and tumor grade were prognostic factors for PFS and OS on multivariate analysis. STR or WHO Grade III pathology, or both, predicted worse overall prognosis in patients with hemispheric ependymoma.
Collapse
Affiliation(s)
| | - Vincent Nguyen
- Temple University Medical School, Philadelphia, Pennsylvania
| | | | | | - Larry Junck
- Neurology, University of Michigan, Ann Arbor, Michigan; and
| | | |
Collapse
|
34
|
Jermyn M, Gosselin Y, Valdes PA, Sibai M, Kolste K, Mercier J, Angulo L, Roberts DW, Paulsen KD, Petrecca K, Daigle O, Wilson BC, Leblond F. Improved sensitivity to fluorescence for cancer detection in wide-field image-guided neurosurgery. BIOMEDICAL OPTICS EXPRESS 2015; 6:5063-74. [PMID: 26713218 PMCID: PMC4679278 DOI: 10.1364/boe.6.005063] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 11/11/2015] [Accepted: 11/16/2015] [Indexed: 05/19/2023]
Abstract
In glioma surgery, Protoporphyrin IX (PpIX) fluorescence may identify residual tumor that could be resected while minimizing damage to normal brain. We demonstrate that improved sensitivity for wide-field spectroscopic fluorescence imaging is achieved with minimal disruption to the neurosurgical workflow using an electron-multiplying charge-coupled device (EMCCD) relative to a state-of-the-art CMOS system. In phantom experiments the EMCCD system can detect at least two orders-of-magnitude lower PpIX. Ex vivo tissue imaging on a rat glioma model demonstrates improved fluorescence contrast compared with neurosurgical fluorescence microscope technology, and the fluorescence detection is confirmed with measurements from a clinically-validated spectroscopic probe. Greater PpIX sensitivity in wide-field fluorescence imaging may improve the residual tumor detection during surgery with consequent impact on survival.
Collapse
Affiliation(s)
- Michael Jermyn
- Brain Tumour Research Centre, Montreal Neurological Institute and Hospital, Dept. Neurology and Neurosurgery, McGill University, 3801 University St., Montreal, QC, H3A 2B4,
Canada
- Dept. Engineering Physics, Polytechnique Montreal, CP 6079, Succ. Centre-Ville, Montreal, QC, H3C 3A7,
Canada
| | - Yoann Gosselin
- Dept. Engineering Physics, Polytechnique Montreal, CP 6079, Succ. Centre-Ville, Montreal, QC, H3C 3A7,
Canada
| | - Pablo A. Valdes
- Dept. Neurosurgery, Harvard Medical School, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115,
USA
| | - Mira Sibai
- Dept. Medical Biophysics, University of Toronto/University Health Network, Toronto, ON, M5G 1L7,
Canada
| | - Kolbein Kolste
- Thaver School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH 03755,
USA
| | - Jeanne Mercier
- Dept. Engineering Physics, Polytechnique Montreal, CP 6079, Succ. Centre-Ville, Montreal, QC, H3C 3A7,
Canada
| | - Leticia Angulo
- Dept. Engineering Physics, Polytechnique Montreal, CP 6079, Succ. Centre-Ville, Montreal, QC, H3C 3A7,
Canada
| | - David W. Roberts
- Dept. Neurosurgery, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756,
USA
| | - Keith D. Paulsen
- Thaver School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH 03755,
USA
| | - Kevin Petrecca
- Brain Tumour Research Centre, Montreal Neurological Institute and Hospital, Dept. Neurology and Neurosurgery, McGill University, 3801 University St., Montreal, QC, H3A 2B4,
Canada
| | - Olivier Daigle
- Nuvu cameras, 5155 Decelles avenue, Pavillon JA Bombardier, Montreal, QC, H3T 2B1,
Canada
| | - Brian C. Wilson
- Dept. Medical Biophysics, University of Toronto/University Health Network, Toronto, ON, M5G 1L7,
Canada
| | - Frederic Leblond
- Dept. Engineering Physics, Polytechnique Montreal, CP 6079, Succ. Centre-Ville, Montreal, QC, H3C 3A7,
Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, rue Saint-Denis, Que, H2X 0A9,
Canada
| |
Collapse
|
35
|
Barrett TF, Sarkiss CA, Dyvorne HA, Lee J, Balchandani P, Shrivastava RK. Application of Ultrahigh Field Magnetic Resonance Imaging in the Treatment of Brain Tumors: A Meta-Analysis. World Neurosurg 2015; 86:450-65. [PMID: 26409071 DOI: 10.1016/j.wneu.2015.09.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is the imaging modality of choice for the clinical management of brain tumors, and the majority of scanners operate with static magnetic field strengths of 1.5 or 3.0 Tesla (T). During the past decade, ultrahigh field (UHF) MRI has been investigated for its clinical applicability. This meta-analysis evaluates studies pertaining to the application of UHF MRI to patients with brain tumors. METHODS The authors performed a systematic review of the literature. Articles relating to application of UHF MRI to brain anatomy and brain tumors with living subjects were included. Studies were grouped into 1 of 3 categories based on area of focus: "Anatomical Structures Involved with Brain Tumors," "Tumor characterization," and "Treatment Monitoring." Comparison studies with extractable outcomes measure data were analyzed for performance of UHF MRI versus clinical field strengths (1.5 T and 3 T). RESULTS Twenty-four studies (361 subjects) met inclusion criteria. The field of study was heterogeneous and rigorous statistical analysis was not possible. Overall, 279 patients with brain tumors scanned at UHF MRI have been reported. Of these, glioma and glioblastoma multiforme are the most commonly studied lesions (38.9% and 24.4%, respectively). In comparison studies between UHF MRI and clinical field strengths, 24 of 51 patients had outcome measures that were better with UHF MRI, 17 of 24 were equivalent at both field strengths, and 9 were worse at UHF MRI. The most common causes of a worse performance were susceptibility artifacts and magnetic field inhomogeneities (3 of 9). Imaging of the pituitary gland, pineal gland veins, cranial nerves, and tumor microvasculature were all shown to be feasible. CONCLUSIONS UHF MRI shows promise to improve detection and characterization of brain tumors, preoperative planning for neurosurgical resection, and longitudinal monitoring of the effects of radiation and antibody-based therapies. Technical innovations are needed to overcome field inhomogeneity and susceptibility artifacts in certain regions of the skull. Finally, larger studies comparing 1.5 T, 3.0 T, and 7.0 T or greater will determine whether UHF MRI gains acceptance as a clinical standard.
Collapse
Affiliation(s)
- Thomas F Barrett
- Department of Neurosurgery, The Mount Sinai Hospital, New York, New York, USA
| | | | - Hadrien A Dyvorne
- The Translational and Molecular Imaging Institute, Mount Sinai Health System, New York, New York, USA
| | - James Lee
- Department of Neurosurgery, The Mount Sinai Hospital, New York, New York, USA
| | - Priti Balchandani
- The Translational and Molecular Imaging Institute, Mount Sinai Health System, New York, New York, USA
| | - Raj K Shrivastava
- Department of Neurosurgery, The Mount Sinai Hospital, New York, New York, USA.
| |
Collapse
|