1
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Śledzińska-Bebyn P, Furtak J, Bebyn M, Serafin Z. Beyond conventional imaging: Advancements in MRI for glioma malignancy prediction and molecular profiling. Magn Reson Imaging 2024; 112:63-81. [PMID: 38914147 DOI: 10.1016/j.mri.2024.06.004] [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: 04/04/2024] [Revised: 05/20/2024] [Accepted: 06/20/2024] [Indexed: 06/26/2024]
Abstract
This review examines the advancements in magnetic resonance imaging (MRI) techniques and their pivotal role in diagnosing and managing gliomas, the most prevalent primary brain tumors. The paper underscores the importance of integrating modern MRI modalities, such as diffusion-weighted imaging and perfusion MRI, which are essential for assessing glioma malignancy and predicting tumor behavior. Special attention is given to the 2021 WHO Classification of Tumors of the Central Nervous System, emphasizing the integration of molecular diagnostics in glioma classification, significantly impacting treatment decisions. The review also explores radiogenomics, which correlates imaging features with molecular markers to tailor personalized treatment strategies. Despite technological progress, MRI protocol standardization and result interpretation challenges persist, affecting diagnostic consistency across different settings. Furthermore, the review addresses MRI's capacity to distinguish between tumor recurrence and pseudoprogression, which is vital for patient management. The necessity for greater standardization and collaborative research to harness MRI's full potential in glioma diagnosis and personalized therapy is highlighted, advocating for an enhanced understanding of glioma biology and more effective treatment approaches.
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Affiliation(s)
- Paulina Śledzińska-Bebyn
- Department of Radiology, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland.
| | - Jacek Furtak
- Department of Clinical Medicine, Faculty of Medicine, University of Science and Technology, Bydgoszcz, Poland; Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
| | - Marek Bebyn
- Department of Internal Diseases, 10th Military Clinical Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
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2
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Guillevin R, Naudin M, Fayolle P, Giraud C, Le Guillou X, Thomas C, Herpe G, Miranville A, Fernandez-Maloigne C, Pellerin L, Guillevin C. Diagnostic and Therapeutic Issues in Glioma Using Imaging Data: The Challenge of Numerical Twinning. J Clin Med 2023; 12:7706. [PMID: 38137775 PMCID: PMC10744312 DOI: 10.3390/jcm12247706] [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: 11/06/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Glial tumors represent the leading etiology of primary brain tumors. Their particularities lie in (i) their location in a highly functional organ that is difficult to access surgically, including for biopsy, and (ii) their rapid, anisotropic mode of extension, notably via the fiber bundles of the white matter, which further limits the possibilities of resection. The use of mathematical tools enables the development of numerical models representative of the oncotype, genotype, evolution, and therapeutic response of lesions. The significant development of digital technologies linked to high-resolution NMR exploration, coupled with the possibilities offered by AI, means that we can envisage the creation of digital twins of tumors and their host organs, thus reducing the use of physical sampling.
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Affiliation(s)
- Rémy Guillevin
- Department of Imaging, University Hospital Center of Poitiers, 86000 Poitiers, France
- Labcom I3M, University of Poitiers, 86000 Poitiers, France
- DACTIM-MIS Team, Laboratoire de Mathématiques Appliquées LMA, CNRS UMR 7348, 86021 Poitiers, France
| | - Mathieu Naudin
- Department of Imaging, University Hospital Center of Poitiers, 86000 Poitiers, France
- Labcom I3M, University of Poitiers, 86000 Poitiers, France
- DACTIM-MIS Team, Laboratoire de Mathématiques Appliquées LMA, CNRS UMR 7348, 86021 Poitiers, France
| | - Pierre Fayolle
- Department of Imaging, University Hospital Center of Poitiers, 86000 Poitiers, France
- Labcom I3M, University of Poitiers, 86000 Poitiers, France
- DACTIM-MIS Team, Laboratoire de Mathématiques Appliquées LMA, CNRS UMR 7348, 86021 Poitiers, France
| | - Clément Giraud
- Department of Imaging, University Hospital Center of Poitiers, 86000 Poitiers, France
- Labcom I3M, University of Poitiers, 86000 Poitiers, France
- DACTIM-MIS Team, Laboratoire de Mathématiques Appliquées LMA, CNRS UMR 7348, 86021 Poitiers, France
| | - Xavier Le Guillou
- Labcom I3M, University of Poitiers, 86000 Poitiers, France
- DACTIM-MIS Team, Laboratoire de Mathématiques Appliquées LMA, CNRS UMR 7348, 86021 Poitiers, France
- Department of Genetic, University Hospital Center of Poitiers, 86000 Poitiers, France
| | - Clément Thomas
- Department of Imaging, University Hospital Center of Poitiers, 86000 Poitiers, France
- Labcom I3M, University of Poitiers, 86000 Poitiers, France
- DACTIM-MIS Team, Laboratoire de Mathématiques Appliquées LMA, CNRS UMR 7348, 86021 Poitiers, France
| | - Guillaume Herpe
- Department of Imaging, University Hospital Center of Poitiers, 86000 Poitiers, France
- Labcom I3M, University of Poitiers, 86000 Poitiers, France
- DACTIM-MIS Team, Laboratoire de Mathématiques Appliquées LMA, CNRS UMR 7348, 86021 Poitiers, France
| | - Alain Miranville
- Labcom I3M, University of Poitiers, 86000 Poitiers, France
- DACTIM-MIS Team, Laboratoire de Mathématiques Appliquées LMA, CNRS UMR 7348, 86021 Poitiers, France
| | | | - Luc Pellerin
- IRMETIST Laboratory, INSERM U1313, University of Poitiers and University Hospital Center of Poitiers, 86000 Poitiers, France
| | - Carole Guillevin
- Department of Imaging, University Hospital Center of Poitiers, 86000 Poitiers, France
- Labcom I3M, University of Poitiers, 86000 Poitiers, France
- DACTIM-MIS Team, Laboratoire de Mathématiques Appliquées LMA, CNRS UMR 7348, 86021 Poitiers, France
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3
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Hangel G, Schmitz‐Abecassis B, Sollmann N, Pinto J, Arzanforoosh F, Barkhof F, Booth T, Calvo‐Imirizaldu M, Cassia G, Chmelik M, Clement P, Ercan E, Fernández‐Seara MA, Furtner J, Fuster‐Garcia E, Grech‐Sollars M, Guven NT, Hatay GH, Karami G, Keil VC, Kim M, Koekkoek JAF, Kukran S, Mancini L, Nechifor RE, Özcan A, Ozturk‐Isik E, Piskin S, Schmainda KM, Svensson SF, Tseng C, Unnikrishnan S, Vos F, Warnert E, Zhao MY, Jancalek R, Nunes T, Hirschler L, Smits M, Petr J, Emblem KE. Advanced MR Techniques for Preoperative Glioma Characterization: Part 2. J Magn Reson Imaging 2023; 57:1676-1695. [PMID: 36912262 PMCID: PMC10947037 DOI: 10.1002/jmri.28663] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 03/14/2023] Open
Abstract
Preoperative clinical MRI protocols for gliomas, brain tumors with dismal outcomes due to their infiltrative properties, still rely on conventional structural MRI, which does not deliver information on tumor genotype and is limited in the delineation of diffuse gliomas. The GliMR COST action wants to raise awareness about the state of the art of advanced MRI techniques in gliomas and their possible clinical translation. This review describes current methods, limits, and applications of advanced MRI for the preoperative assessment of glioma, summarizing the level of clinical validation of different techniques. In this second part, we review magnetic resonance spectroscopy (MRS), chemical exchange saturation transfer (CEST), susceptibility-weighted imaging (SWI), MRI-PET, MR elastography (MRE), and MR-based radiomics applications. The first part of this review addresses dynamic susceptibility contrast (DSC) and dynamic contrast-enhanced (DCE) MRI, arterial spin labeling (ASL), diffusion-weighted MRI, vessel imaging, and magnetic resonance fingerprinting (MRF). EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Gilbert Hangel
- Department of NeurosurgeryMedical University of ViennaViennaAustria
- High Field MR Centre, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
- Christian Doppler Laboratory for MR Imaging BiomarkersViennaAustria
- Medical Imaging ClusterMedical University of ViennaViennaAustria
| | - Bárbara Schmitz‐Abecassis
- Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
- Medical Delta FoundationDelftthe Netherlands
| | - Nico Sollmann
- Department of Diagnostic and Interventional RadiologyUniversity Hospital UlmUlmGermany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der IsarTechnical University of MunichMunichGermany
- TUM‐Neuroimaging Center, Klinikum rechts der IsarTechnical University of MunichMunichGermany
| | - Joana Pinto
- Institute of Biomedical Engineering, Department of Engineering ScienceUniversity of OxfordOxfordUK
| | | | - Frederik Barkhof
- Department of Radiology & Nuclear MedicineAmsterdam UMC, Vrije UniversiteitAmsterdamNetherlands
- Queen Square Institute of Neurology and Centre for Medical Image ComputingUniversity College LondonLondonUK
| | - Thomas Booth
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
- Department of NeuroradiologyKing's College Hospital NHS Foundation TrustLondonUK
| | | | | | - Marek Chmelik
- Department of Technical Disciplines in Medicine, Faculty of Health CareUniversity of PrešovPrešovSlovakia
| | - Patricia Clement
- Department of Diagnostic SciencesGhent UniversityGhentBelgium
- Department of Medical ImagingGhent University HospitalGhentBelgium
| | - Ece Ercan
- Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Maria A. Fernández‐Seara
- Department of RadiologyClínica Universidad de NavarraPamplonaSpain
- IdiSNA, Instituto de Investigación Sanitaria de NavarraPamplonaSpain
| | - Julia Furtner
- Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
- Research Center of Medical Image Analysis and Artificial IntelligenceDanube Private UniversityAustria
| | - Elies Fuster‐Garcia
- Biomedical Data Science Laboratory, Instituto Universitario de Tecnologías de la Información y ComunicacionesUniversitat Politècnica de ValènciaValenciaSpain
| | - Matthew Grech‐Sollars
- Centre for Medical Image Computing, Department of Computer ScienceUniversity College LondonLondonUK
- Lysholm Department of Neuroradiology, National Hospital for Neurology and NeurosurgeryUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - N. Tugay Guven
- Institute of Biomedical EngineeringBogazici University IstanbulIstanbulTurkey
| | - Gokce Hale Hatay
- Institute of Biomedical EngineeringBogazici University IstanbulIstanbulTurkey
| | - Golestan Karami
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
| | - Vera C. Keil
- Department of Radiology & Nuclear MedicineAmsterdam UMC, Vrije UniversiteitAmsterdamNetherlands
- Cancer Center AmsterdamAmsterdamNetherlands
| | - Mina Kim
- Centre for Medical Image Computing, Department of Medical Physics & Biomedical Engineering and Department of NeuroinflammationUniversity College LondonLondonUK
| | - Johan A. F. Koekkoek
- Department of NeurologyLeiden University Medical CenterLeidenthe Netherlands
- Department of NeurologyHaaglanden Medical CenterNetherlands
| | - Simran Kukran
- Department of BioengineeringImperial College LondonLondonUK
- Department of Radiotherapy and ImagingInstitute of Cancer ResearchUK
| | - Laura Mancini
- Lysholm Department of Neuroradiology, National Hospital for Neurology and NeurosurgeryUniversity College London Hospitals NHS Foundation TrustLondonUK
- Department of Brain Repair and Rehabilitation, Institute of NeurologyUniversity College LondonLondonUK
| | - Ruben Emanuel Nechifor
- Department of Clinical Psychology and Psychotherapy, International Institute for the Advanced Studies of Psychotherapy and Applied Mental HealthBabes‐Bolyai UniversityRomania
| | - Alpay Özcan
- Electrical and Electronics Engineering DepartmentBogazici University IstanbulIstanbulTurkey
| | - Esin Ozturk‐Isik
- Institute of Biomedical EngineeringBogazici University IstanbulIstanbulTurkey
| | - Senol Piskin
- Department of Mechanical Engineering, Faculty of Natural Sciences and EngineeringIstinye University IstanbulIstanbulTurkey
| | | | - Siri F. Svensson
- Department of Physics and Computational RadiologyOslo University HospitalOsloNorway
- Department of PhysicsUniversity of OsloOsloNorway
| | - Chih‐Hsien Tseng
- Medical Delta FoundationDelftthe Netherlands
- Department of Imaging PhysicsDelft University of TechnologyDelftthe Netherlands
| | - Saritha Unnikrishnan
- Faculty of Engineering and DesignAtlantic Technological University (ATU) SligoSligoIreland
- Mathematical Modelling and Intelligent Systems for Health and Environment (MISHE), ATU SligoSligoIreland
| | - Frans Vos
- Medical Delta FoundationDelftthe Netherlands
- Department of Radiology & Nuclear MedicineErasmus MCRotterdamNetherlands
- Department of Imaging PhysicsDelft University of TechnologyDelftthe Netherlands
| | - Esther Warnert
- Department of Radiology & Nuclear MedicineErasmus MCRotterdamNetherlands
| | - Moss Y. Zhao
- Department of RadiologyStanford UniversityStanfordCaliforniaUSA
- Stanford Cardiovascular InstituteStanford UniversityStanfordCaliforniaUSA
| | - Radim Jancalek
- Department of NeurosurgerySt. Anne's University HospitalBrnoCzechia
- Faculty of MedicineMasaryk UniversityBrnoCzechia
| | - Teresa Nunes
- Department of NeuroradiologyHospital Garcia de OrtaAlmadaPortugal
| | - Lydiane Hirschler
- C.J. Gorter MRI Center, Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Marion Smits
- Medical Delta FoundationDelftthe Netherlands
- Department of Radiology & Nuclear MedicineErasmus MCRotterdamNetherlands
- Brain Tumour CentreErasmus MC Cancer InstituteRotterdamthe Netherlands
| | - Jan Petr
- Helmholtz‐Zentrum Dresden‐RossendorfInstitute of Radiopharmaceutical Cancer ResearchDresdenGermany
| | - Kyrre E. Emblem
- Department of Physics and Computational RadiologyOslo University HospitalOsloNorway
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4
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Liserre R, Branzoli F, Pagani F, Gryzik M, Cominelli M, Miele E, Marjańska M, Doglietto F, Poliani PL. Exceptionally rare IDH1-mutant adult medulloblastoma with concurrent GNAS mutation revealed by in vivo magnetic resonance spectroscopy and deep sequencing. Acta Neuropathol Commun 2023; 11:47. [PMID: 36941703 PMCID: PMC10029199 DOI: 10.1186/s40478-023-01531-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/17/2023] [Indexed: 03/23/2023] Open
Abstract
Medulloblastoma (MB) is the most common malignant brain tumor occurring in childhood and rarely found in adults. Based on transcriptome profile, MB are currently classified into four major molecular groups reflecting a considerable biological heterogeneity: WNT-activated, SHH-activated, group 3 and group 4. Recently, DNA methylation profiling allowed the identification of additional subgroups within the four major molecular groups associated with different clinic-pathological and molecular features. Isocitrate dehydrogenase-1 and 2 (IDH1 and IDH2) mutations have been described in several tumors, including gliomas, while in MB are rarely reported and not routinely investigated. By means of magnetic resonance spectroscopy (MRS), we unequivocally assessed the presence the oncometabolite D-2-hydroxyglutarate (2HG), a marker of IDH1 and IDH2 mutations, in a case of adult MB. Immunophenotypical work-up and methylation profiling assigned the diagnosis of MB, subclass SHH-A, and molecular testing revealed the presence of the non-canonical somatic IDH1(p.R132C) mutation and an additional GNAS mutation, also rarely described in MB. To the best of our knowledge, this is the first reported case of MB simultaneously harboring both mutations. Of note, tumor exhibited a heterogeneous phenotype with a tumor component displaying glial differentiation, with robust GFAP expression, and a component with conventional MB features and selective presence of GNAS mutation, suggesting co-existence of two different major tumor subclones. These findings drew attention to the need for a deeper genetic characterization of MB, in order to get insights into their biology and improve stratification and clinical management of the patients. Moreover, our results underlined the importance of performing MRS for the identification of IDH mutations in non-glial tumors. The use of throughput molecular profiling analysis and advanced medical imaging will certainly increase the frequency with which tumor entities with rare molecular alterations will be identified. Whether these findings have any specific therapeutic implications or prognostic relevance requires further investigations.
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Affiliation(s)
- Roberto Liserre
- Department of Radiology, Neuroradiology Unit, ASST Spedali Civili University Hospital, Brescia, Italy
| | - Francesca Branzoli
- Paris Brain Institute - Institut du Cerveau (ICM), Centre de NeuroImagerie de Recherche (CENIR), Paris, France
- Sorbonne Université, UMR S 1127, Inserm U 1127, CNRS UMR 7225, ICM, F-75013, Paris, France
| | - Francesca Pagani
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, P.le Spedali Civili 1, 25125, Brescia, BS, Italy
| | - Magdalena Gryzik
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, P.le Spedali Civili 1, 25125, Brescia, BS, Italy
| | - Manuela Cominelli
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, P.le Spedali Civili 1, 25125, Brescia, BS, Italy
| | - Evelina Miele
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Małgorzata Marjańska
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Francesco Doglietto
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University School of Medicine, Rome, Italy
| | - Pietro Luigi Poliani
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, P.le Spedali Civili 1, 25125, Brescia, BS, Italy.
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5
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Bonosi L, Marrone S, Benigno UE, Buscemi F, Musso S, Porzio M, Silven MP, Torregrossa F, Grasso G. Maximal Safe Resection in Glioblastoma Surgery: A Systematic Review of Advanced Intraoperative Image-Guided Techniques. Brain Sci 2023; 13:brainsci13020216. [PMID: 36831759 PMCID: PMC9954589 DOI: 10.3390/brainsci13020216] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/15/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
Glioblastoma multiforme (GBM) represents the most common and aggressive central nervous system tumor associated with a poor prognosis. The aim of this study was to depict the role of intraoperative imaging techniques in GBM surgery and how they can ensure the maximal extent of resection (EOR) while preserving the functional outcome. The authors conducted a systematic review following PRISMA guidelines on the PubMed/Medline and Scopus databases. A total of 1747 articles were identified for screening. Studies focusing on GBM-affected patients, and evaluations of EOR and functional outcomes with the aid of advanced image-guided techniques were included. The resulting studies were assessed for methodological quality using the Risk of Bias in Systematic Review tool. Open Science Framework registration DOI 10.17605/OSF.IO/3FDP9. Eighteen studies were eligible for this systematic review. Among the selected studies, eight analyzed Sodium Fluorescein, three analyzed 5-aminolevulinic acid, two evaluated IoMRI imaging, two evaluated IoUS, and three evaluated multiple intraoperative imaging techniques. A total of 1312 patients were assessed. Gross Total Resection was achieved in the 78.6% of the cases. Follow-up time ranged from 1 to 52 months. All studies assessed the functional outcome based on the Karnofsky Performance Status scale, while one used the Neurologic Assessment in Neuro-Oncology score. In 77.7% of the cases, the functional outcome improved or was stable over the pre-operative assessment. Combining multiple intraoperative imaging techniques could provide better results in GBM surgery than a single technique. However, despite good surgical outcomes, patients often present a neurocognitive decline leading to a marked deterioration of the quality of life. Advanced intraoperative image-guided techniques can allow a better understanding of the anatomo-functional relationships between the tumor and the surrounding brain, thus maximizing the EOR while preserving functional outcomes.
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Henssen D, Meijer F, Verburg FA, Smits M. Challenges and opportunities for advanced neuroimaging of glioblastoma. Br J Radiol 2023; 96:20211232. [PMID: 36062962 PMCID: PMC10997013 DOI: 10.1259/bjr.20211232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 08/10/2022] [Accepted: 08/25/2022] [Indexed: 11/05/2022] Open
Abstract
Glioblastoma is the most aggressive of glial tumours in adults. On conventional magnetic resonance (MR) imaging, these tumours are observed as irregular enhancing lesions with areas of infiltrating tumour and cortical expansion. More advanced imaging techniques including diffusion-weighted MRI, perfusion-weighted MRI, MR spectroscopy and positron emission tomography (PET) imaging have found widespread application to diagnostic challenges in the setting of first diagnosis, treatment planning and follow-up. This review aims to educate readers with regard to the strengths and weaknesses of the clinical application of these imaging techniques. For example, this review shows that the (semi)quantitative analysis of the mentioned advanced imaging tools was found useful for assessing tumour aggressiveness and tumour extent, and aids in the differentiation of tumour progression from treatment-related effects. Although these techniques may aid in the diagnostic work-up and (post-)treatment phase of glioblastoma, so far no unequivocal imaging strategy is available. Furthermore, the use and further development of artificial intelligence (AI)-based tools could greatly enhance neuroradiological practice by automating labour-intensive tasks such as tumour measurements, and by providing additional diagnostic information such as prediction of tumour genotype. Nevertheless, due to the fact that advanced imaging and AI-diagnostics is not part of response assessment criteria, there is no harmonised guidance on their use, while at the same time the lack of standardisation severely hampers the definition of uniform guidelines.
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Affiliation(s)
- Dylan Henssen
- Department of Medical Imaging, Radboud university medical
center, Nijmegen, The Netherlands
| | - Frederick Meijer
- Department of Medical Imaging, Radboud university medical
center, Nijmegen, The Netherlands
| | - Frederik A. Verburg
- Department of Medical Imaging, Radboud university medical
center, Nijmegen, The Netherlands
| | - Marion Smits
- Department of Medical Imaging, Radboud university medical
center, Nijmegen, The Netherlands
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7
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Senhaji N, Squalli Houssaini A, Lamrabet S, Louati S, Bennis S. Molecular and Circulating Biomarkers in Patients with Glioblastoma. Int J Mol Sci 2022; 23:ijms23137474. [PMID: 35806478 PMCID: PMC9267689 DOI: 10.3390/ijms23137474] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023] Open
Abstract
Glioblastoma is the most aggressive malignant tumor of the central nervous system with a low survival rate. The difficulty of obtaining this tumor material represents a major limitation, making the real-time monitoring of tumor progression difficult, especially in the events of recurrence or resistance to treatment. The identification of characteristic biomarkers is indispensable for an accurate diagnosis, the rigorous follow-up of patients, and the development of new personalized treatments. Liquid biopsy, as a minimally invasive procedure, holds promise in this regard. The purpose of this paper is to summarize the current literature regarding the identification of molecular and circulating glioblastoma biomarkers and the importance of their integration as a valuable tool to improve patient care.
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Affiliation(s)
- Nadia Senhaji
- Department of Biology, Faculty of Sciences, Moulay Ismail University, Meknes 50000, Morocco
- Laboratory of Biomedical and Translational Research, Faculty of Medicine, Pharmacy and Dental Medicine of Fez, Sidi Mohamed Ben Abdellah University, Fez 30070, Morocco; (A.S.H.); (S.L.); (S.B.)
- Correspondence: ; Tel.: +212-662600394
| | - Asmae Squalli Houssaini
- Laboratory of Biomedical and Translational Research, Faculty of Medicine, Pharmacy and Dental Medicine of Fez, Sidi Mohamed Ben Abdellah University, Fez 30070, Morocco; (A.S.H.); (S.L.); (S.B.)
| | - Salma Lamrabet
- Laboratory of Biomedical and Translational Research, Faculty of Medicine, Pharmacy and Dental Medicine of Fez, Sidi Mohamed Ben Abdellah University, Fez 30070, Morocco; (A.S.H.); (S.L.); (S.B.)
| | - Sara Louati
- Medical Biotechnology Laboratory, Faculty of Medicine and Pharmacy of Rabat, Mohammed Vth University, Rabat 10000, Morocco;
| | - Sanae Bennis
- Laboratory of Biomedical and Translational Research, Faculty of Medicine, Pharmacy and Dental Medicine of Fez, Sidi Mohamed Ben Abdellah University, Fez 30070, Morocco; (A.S.H.); (S.L.); (S.B.)
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8
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Abstract
Abstract
Purpose
Gliomas, the most common primary brain tumours, have recently been re-classified incorporating molecular aspects with important clinical, prognostic, and predictive implications. Concurrently, the reprogramming of metabolism, altering intracellular and extracellular metabolites affecting gene expression, differentiation, and the tumour microenvironment, is increasingly being studied, and alterations in metabolic pathways are becoming hallmarks of cancer. Magnetic resonance spectroscopy (MRS) is a complementary, non-invasive technique capable of quantifying multiple metabolites. The aim of this review focuses on the methodology and analysis techniques in proton MRS (1H MRS), including a brief look at X-nuclei MRS, and on its perspectives for diagnostic and prognostic biomarkers in gliomas in both clinical practice and preclinical research.
Methods
PubMed literature research was performed cross-linking the following key words: glioma, MRS, brain, in-vivo, human, animal model, clinical, pre-clinical, techniques, sequences, 1H, X-nuclei, Artificial Intelligence (AI), hyperpolarization.
Results
We selected clinical works (n = 51), preclinical studies (n = 35) and AI MRS application papers (n = 15) published within the last two decades. The methodological papers (n = 62) were taken into account since the technique first description.
Conclusions
Given the development of treatments targeting specific cancer metabolic pathways, MRS could play a key role in allowing non-invasive assessment for patient diagnosis and stratification, predicting and monitoring treatment responses and prognosis. The characterization of gliomas through MRS will benefit of a wide synergy among scientists and clinicians of different specialties within the context of new translational competences. Head coils, MRI hardware and post-processing analysis progress, advances in research, experts’ consensus recommendations and specific professionalizing programs will make the technique increasingly trustworthy, responsive, accessible.
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9
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Jian A, Jang K, Russo C, Liu S, Di Ieva A. Foundations of Multiparametric Brain Tumour Imaging Characterisation Using Machine Learning. ACTA NEUROCHIRURGICA. SUPPLEMENT 2021; 134:183-193. [PMID: 34862542 DOI: 10.1007/978-3-030-85292-4_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The heterogeneity of brain tumours at the molecular, metabolic and structural levels poses significant challenge for accurate tissue characterisation. Artificial intelligence and radiomics have emerged as valuable tools to analyse quantitative features extracted from medical images which capture the complex microenvironment of brain tumours. In particular, a number of computational tools including machine learning algorithms have been proposed for image preprocessing, tumour segmentation, feature extraction, classification, and prognostic stratifications as well. In this chapter, we explore the fundamentals of multiparametric brain tumour characterisation, as an understanding of the strengths, limitations and applications of these tools allows clinicians to better develop and evaluate models with improved diagnostic and prognostic value in brain tumour patients.
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Affiliation(s)
- Anne Jian
- Computational NeuroSurgery (CNS) Lab, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
- Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Kevin Jang
- Computational NeuroSurgery (CNS) Lab, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Carlo Russo
- Computational NeuroSurgery (CNS) Lab, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Sidong Liu
- Computational NeuroSurgery (CNS) Lab, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
- Centre for Health Informatics, Macquarie University, Sydney, NSW, Australia
| | - Antonio Di Ieva
- Computational NeuroSurgery (CNS) Lab, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
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Franco P, Huebschle I, Simon-Gabriel CP, Dacca K, Schnell O, Beck J, Mast H, Urbach H, Wuertemberger U, Prinz M, Hosp JA, Delev D, Mader I, Heiland DH. Mapping of Metabolic Heterogeneity of Glioma Using MR-Spectroscopy. Cancers (Basel) 2021; 13:cancers13102417. [PMID: 34067701 PMCID: PMC8155922 DOI: 10.3390/cancers13102417] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 01/04/2023] Open
Abstract
Simple Summary Radiomics is a research field that integrates radiological and genetic information, but the application of the techniques that have been developed to this purpose have not been widely established in daily clinical practice. The purpose of our study is the development of a straightforward tool that can easily be used to preoperatively predict and correlate the metabolic signature of different CNS-lesions. Particularly in gliomas, we hope to integrate the molecular profile of these tumors into our prediction model. Our goal is to deliver an open-software tool with the intention of advancing the diagnostic work-up of gliomas to the latest standards. Abstract Proton magnetic resonance spectroscopy (1H-MRS) delivers information about the non-invasive metabolic landscape of brain pathologies. 1H-MRS is used in clinical setting in addition to MRI for diagnostic, prognostic and treatment response assessments, but the use of this radiological tool is not entirely widespread. The importance of developing automated analysis tools for 1H-MRS lies in the possibility of a straightforward application and simplified interpretation of metabolic and genetic data that allow for incorporation into the daily practice of a broad audience. Here, we report a prospective clinical imaging trial (DRKS00019855) which aimed to develop a novel MR-spectroscopy-based algorithm for in-depth characterization of brain lesions and prediction of molecular traits. Dimensional reduction of metabolic profiles demonstrated distinct patterns throughout pathologies. We combined a deep autoencoder and multi-layer linear discriminant models for voxel-wise prediction of the molecular profile based on MRS imaging. Molecular subtypes were predicted by an overall accuracy of 91.2% using a classifier score. Our study indicates a first step into combining the metabolic and molecular traits of lesions for advancing the pre-operative diagnostic workup of brain tumors and improve personalized tumor treatment.
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Affiliation(s)
- Pamela Franco
- Department of Neurosurgery, Medical Center-University of Freiburg, 79106 Freiburg, Germany; (I.H.); (K.D.); (O.S.); (J.B.); (D.H.H.)
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
- Correspondence: ; Tel.: +49-(0)-761-270-50010; Fax: +49-(0)-761-270-51020
| | - Irene Huebschle
- Department of Neurosurgery, Medical Center-University of Freiburg, 79106 Freiburg, Germany; (I.H.); (K.D.); (O.S.); (J.B.); (D.H.H.)
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
| | - Carl Philipp Simon-Gabriel
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
- Department of Radiology, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - Karam Dacca
- Department of Neurosurgery, Medical Center-University of Freiburg, 79106 Freiburg, Germany; (I.H.); (K.D.); (O.S.); (J.B.); (D.H.H.)
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
| | - Oliver Schnell
- Department of Neurosurgery, Medical Center-University of Freiburg, 79106 Freiburg, Germany; (I.H.); (K.D.); (O.S.); (J.B.); (D.H.H.)
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
| | - Juergen Beck
- Department of Neurosurgery, Medical Center-University of Freiburg, 79106 Freiburg, Germany; (I.H.); (K.D.); (O.S.); (J.B.); (D.H.H.)
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
| | - Hansjoerg Mast
- Department of Neuroradiology, Medical Center-University of Freiburg, 79106 Freiburg, Germany;
| | - Horst Urbach
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
- Department of Neuroradiology, Medical Center-University of Freiburg, 79106 Freiburg, Germany;
| | - Urs Wuertemberger
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
- Department of Neuroradiology, Medical Center-University of Freiburg, 79106 Freiburg, Germany;
| | - Marco Prinz
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
- Institute of Neuropathology, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
- Signaling Research Centers BIOSS and CIBSS, University of Freiburg, 79106 Freiburg, Germany
- Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Jonas A. Hosp
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
- Department of Neurology and Neuroscience, Medical Center-University of Freiburg, 79106 Freiburg, Germany
| | - Daniel Delev
- Department of Neurosurgery, RWTH University of Aachen, 52074 Aachen, Germany;
| | - Irina Mader
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
- Department of Neuroradiology, Medical Center-University of Freiburg, 79106 Freiburg, Germany;
- Specialist Centre for Radiology, Schoen Clinic, 83569 Vogtareuth, Germany
| | - Dieter Henrik Heiland
- Department of Neurosurgery, Medical Center-University of Freiburg, 79106 Freiburg, Germany; (I.H.); (K.D.); (O.S.); (J.B.); (D.H.H.)
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.P.S.-G.); (H.U.); (U.W.); (M.P.); (J.A.H.); (I.M.)
- Microenvironment and Immunology Research Laboratory, Medical Center-University of Freiburg, 79106 Freiburg, Germany
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The role of 2-hydroxyglutarate magnetic resonance spectroscopy for the determination of isocitrate dehydrogenase status in lower grade gliomas versus glioblastoma: a systematic review and meta-analysis of diagnostic test accuracy. Neuroradiology 2021; 63:1823-1830. [PMID: 33811494 DOI: 10.1007/s00234-021-02702-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Magnetic resonance spectroscopy (MRS) provides a non-invasive means of determining isocitrate dehydrogenase (IDH) status. Determination of 2-hydroxyglutarate (2-HG) presence through MRS is a means of determining IDH status; however, differences may be seen by grade. The goal of this paper is to perform a diagnostic test accuracy (DTA) meta-analysis on 2-HG MRS for IDH status in both lower-grade glioma (LGG) and glioblastoma (GBM) in preoperative patients. METHODS A systematic review and meta-analysis were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Diagnostic Test Accuracy guidelines. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies 2. The search was up to date as of 09/02/2021. Nine English-language journal articles were included. RESULTS The meta-analysis found a pooled sensitivity of 93% (95% CI 58-99%) and specificity of 84% (95% CI 51-96%) for LGG (n= 181). For GBM (n= 77), the pooled sensitivity was 84% (95% CI 25.0-99%) and the specificity was 97% (95% CI 43-100%). CONCLUSION 2-HG MRS shows promise as a non-invasive means of determining IDH status, with specificity higher for GBM and sensitivity higher for LGG. The wide confidence intervals are notable, however, in particular related to the small number of IDH-mutant GBM studied. Diagnostic heterogeneity was particularly present for LGG, and the hierarchical summary receiver operator curves showed poor predictive accuracy in both groups. For more conclusive results, diagnostic test accuracy statistics need to be quantified with larger studies and more deliberate study design.
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Franco P, Würtemberger U, Dacca K, Hübschle I, Beck J, Schnell O, Mader I, Binder H, Urbach H, Heiland DH. SPectroscOpic prediction of bRain Tumours (SPORT): study protocol of a prospective imaging trial. BMC Med Imaging 2020; 20:123. [PMID: 33228567 PMCID: PMC7685595 DOI: 10.1186/s12880-020-00522-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/15/2020] [Indexed: 12/26/2022] Open
Abstract
Background The revised 2016 WHO-Classification of CNS-tumours now integrates molecular information of glial brain tumours for accurate diagnosis as well as for the development of targeted therapies. In this prospective study, our aim is to investigate the predictive value of MR-spectroscopy in order to establish a solid preoperative molecular stratification algorithm of these tumours. We will process a 1H MR-spectroscopy sequence within a radiomics analytics pipeline.
Methods Patients treated at our institution with WHO-Grade II, III and IV gliomas will receive preoperative anatomical (T2- and T1-weighted imaging with and without contrast enhancement) and proton MR spectroscopy (MRS) by using chemical shift imaging (MRS) (5 × 5 × 15 mm3 voxel size). Tumour regions will be segmented and co-registered to corresponding spectroscopic voxels.
Raw signals will be processed by a deep-learning approach for identifying patterns in metabolic data that provides information with respect to the histological diagnosis as well patient characteristics obtained and genomic data such as target sequencing and transcriptional data. Discussion By imaging the metabolic profile of a glioma using a customized chemical shift 1H MR spectroscopy sequence and by processing the metabolic profiles with a machine learning tool we intend to non-invasively uncover the genetic signature of gliomas. This work-up will support surgical and oncological decisions to improve personalized tumour treatment.
Trial registration This study was initially registered under another name and was later retrospectively registered under the current name at the German Clinical Trials Register (DRKS) under DRKS00019855.
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Affiliation(s)
- Pamela Franco
- Department of Neurosurgery, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany. .,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany.
| | - Urs Würtemberger
- Department of Neuroradiology, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Karam Dacca
- Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Irene Hübschle
- Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Jürgen Beck
- Department of Neurosurgery, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Oliver Schnell
- Department of Neurosurgery, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Irina Mader
- Specialist Centre for Radiology, Schoen Clinic, Vogtareuth, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Harald Binder
- Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany.,Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Centre, University of Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg im Breisgau, Germany
| | - Horst Urbach
- Department of Neuroradiology, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Dieter Henrik Heiland
- Department of Neurosurgery, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
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13
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Liu S, Shah Z, Sav A, Russo C, Berkovsky S, Qian Y, Coiera E, Di Ieva A. Isocitrate dehydrogenase (IDH) status prediction in histopathology images of gliomas using deep learning. Sci Rep 2020; 10:7733. [PMID: 32382048 PMCID: PMC7206037 DOI: 10.1038/s41598-020-64588-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 04/15/2020] [Indexed: 01/07/2023] Open
Abstract
Mutations in isocitrate dehydrogenase genes IDH1 and IDH2 are frequently found in diffuse and anaplastic astrocytic and oligodendroglial tumours as well as in secondary glioblastomas. As IDH is a very important prognostic, diagnostic and therapeutic biomarker for glioma, it is of paramount importance to determine its mutational status. The haematoxylin and eosin (H&E) staining is a valuable tool in precision oncology as it guides histopathology-based diagnosis and proceeding patient's treatment. However, H&E staining alone does not determine the IDH mutational status of a tumour. Deep learning methods applied to MRI data have been demonstrated to be a useful tool in IDH status prediction, however the effectiveness of deep learning on H&E slides in the clinical setting has not been investigated so far. Furthermore, the performance of deep learning methods in medical imaging has been practically limited by small sample sizes currently available. Here we propose a data augmentation method based on the Generative Adversarial Networks (GAN) deep learning methodology, to improve the prediction performance of IDH mutational status using H&E slides. The H&E slides were acquired from 266 grade II-IV glioma patients from a mixture of public and private databases, including 130 IDH-wildtype and 136 IDH-mutant patients. A baseline deep learning model without data augmentation achieved an accuracy of 0.794 (AUC = 0.920). With GAN-based data augmentation, the accuracy of the IDH mutational status prediction was improved to 0.853 (AUC = 0.927) when the 3,000 GAN generated training samples were added to the original training set (24,000 samples). By integrating also patients' age into the model, the accuracy improved further to 0.882 (AUC = 0.931). Our findings show that deep learning methodology, enhanced by GAN data augmentation, can support physicians in gliomas' IDH status prediction.
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Affiliation(s)
- Sidong Liu
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Computational NeuroSurgery (CNS) Lab, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Centre for Health Informatics, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Zubair Shah
- Computational NeuroSurgery (CNS) Lab, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Centre for Health Informatics, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Aydin Sav
- Department of Pathology, Yeditepe University, School of Medicine, Istanbul, Turkey
| | - Carlo Russo
- Computational NeuroSurgery (CNS) Lab, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Shlomo Berkovsky
- Centre for Health Informatics, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Yi Qian
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Enrico Coiera
- Centre for Health Informatics, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Antonio Di Ieva
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
- Computational NeuroSurgery (CNS) Lab, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
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Correlation between IDH, ATRX, and TERT promoter mutations in glioma. Brain Tumor Pathol 2020; 37:33-40. [PMID: 32227259 DOI: 10.1007/s10014-020-00360-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/11/2020] [Indexed: 12/12/2022]
Abstract
According to the 2016 World Health Organization (WHO) classification of central nervous system tumors, diffuse astrocytic and oligodendroglial tumors are differentiated by the presence of isocitrate dehydrogenase 1 or 2 (IDH1/2) mutation and the combined loss of the short arm of chromosome 1 and the long arm of chromosome 19 (1p/19q co-deletion). IDH-mutant astrocytoma often has p53 and alpha-thalassemia/mental retardation syndrome X-linked (ATRX) mutation, showing the alternative lengthening of telomeres (ALT) phenotype, while IDH-mutant and 1p/19q-co-deleted oligodendroglioma often have wild-type p53 and telomerase reverse transcriptase (TERT) promoter mutation, showing telomerase activation. This study analyzed IDH, ATRX, and TERT promoter mutations, and the correlation between them. Immortalized cells overcome the telomere-related crisis by activating telomerase or ALT. In glioma, telomerase is mainly activated by TERT promoter mutation, while ALT is usually associated with ATRX mutation. Although the mechanism of how ATRX mutation induces ALT remains unclear, ATRX loss alone is believed to be insufficient to induce ALT. Treatments targeting telomere maintenance are promising.
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Grasso G, Torregrossa F. Magnetic Resonance Spectrobiopsy for Prediction of Isocitrate Dehydrogenase Mutation in Glioma. World Neurosurg 2020; 134:187-189. [DOI: 10.1016/j.wneu.2019.10.181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 01/24/2023]
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