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Asai K, Nakamura H, Watanabe Y, Nishida T, Sakai M, Arisawa A, Takagaki M, Arita H, Ozaki T, Kagawa N, Fujimoto Y, Nakanishi K, Kinoshita M, Kishima H. Efficacy of endovascular intratumoral embolization for meningioma: assessment using dynamic susceptibility contrast-enhanced perfusion-weighted imaging. J Neurointerv Surg 2021; 13:1167-1171. [PMID: 33722964 DOI: 10.1136/neurintsurg-2020-017116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/29/2021] [Accepted: 02/04/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND In preoperative embolization for intracranial meningioma, endovascular intratumoral embolization is considered to be more effective for the reduction of tumorous vascularity than proximal feeder occlusion. In this study, we aimed to reveal different efficacies for reducing tumor blood flow in meningiomas by comparing endovascular intratumoral embolization and proximal feeder occlusion using dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI). METHODS 28 consecutive patients were included. DSC-PWI was performed before and after embolization for intracranial meningiomas. Normalized tumor blood volume (nTBV) of voxels of interest of whole tumors were measured from the DSC-PWI data before and after embolization. ΔnTBV% was compared between the cases that received intratumoral embolization and proximal feeder occlusion. RESULTS ΔnTBV% in the intratumoral embolization group (42.4±29.8%) was higher than that of the proximal feeder occlusion group (15.3±14.3%, p=0.0039). We used three types of embolic materials and ΔnTBV% did not differ between treatments with or without the use of each material: 42.8±42.4% vs 28.7±20.1% for microspheres (p=0.12), 36.1±20.6% vs 28.1±41.1% for n-butyl cyanoacrylate (p=0.33), and 32.3±37.3% vs 34.1±19.0% for bare platinum coils (p=0.77). CONCLUSIONS The flow reduction effect of intratumoral embolization was superior to that of proximal feeder occlusion in preoperative embolization for intracranial meningioma in an assessment using DSC-PWI.
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Affiliation(s)
- Katsunori Asai
- Neurosurgery, Osaka International Cancer Institute, Osaka, Japan .,Neurosurgery, Osaka Neurological Institute, Toyonaka, Japan
| | - Hajime Nakamura
- Neurosurgery, Osaka University School of Medicine Graduate School of Medicine, Suita, Japan
| | | | - Takeo Nishida
- Neurosurgery, Osaka University School of Medicine Graduate School of Medicine, Suita, Japan
| | - Mio Sakai
- Diagnostic and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan
| | - Atsuko Arisawa
- Diagnostic and Interventional Radiology, Osaka University School of Medicine Graduate School of Medicine, Suita, Japan
| | - Masatoshi Takagaki
- Neurosurgery, Osaka University School of Medicine Graduate School of Medicine, Suita, Japan
| | - Hideyuki Arita
- Neurosurgery, Osaka University School of Medicine Graduate School of Medicine, Suita, Japan
| | - Tomohiko Ozaki
- Neurosurgery, Osaka University School of Medicine Graduate School of Medicine, Suita, Japan
| | - Naoki Kagawa
- Neurosurgery, Osaka University School of Medicine Graduate School of Medicine, Suita, Japan
| | - Yasunori Fujimoto
- Neurosurgery, Osaka University School of Medicine Graduate School of Medicine, Suita, Japan
| | - Katsuyuki Nakanishi
- Diagnostic and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan
| | - Manabu Kinoshita
- Neurosurgery, Osaka International Cancer Institute, Osaka, Japan.,Neurosurgery, Osaka University School of Medicine Graduate School of Medicine, Suita, Japan
| | - Haruhiko Kishima
- Neurosurgery, Osaka University School of Medicine Graduate School of Medicine, Suita, Japan
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Bao S, Watanabe Y, Takahashi H, Tanaka H, Arisawa A, Matsuo C, Wu R, Fujimoto Y, Tomiyama N. Differentiating between Glioblastoma and Primary CNS Lymphoma Using Combined Whole-tumor Histogram Analysis of the Normalized Cerebral Blood Volume and the Apparent Diffusion Coefficient. Magn Reson Med Sci 2018; 18:53-61. [PMID: 29848919 PMCID: PMC6326759 DOI: 10.2463/mrms.mp.2017-0135] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose: This study aimed to determine whether whole-tumor histogram analysis of normalized cerebral blood volume (nCBV) and apparent diffusion coefficient (ADC) for contrast-enhancing lesions can be used to differentiate between glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL). Methods: From 20 patients, 9 with PCNSL and 11 with GBM without any hemorrhagic lesions, underwent MRI, including diffusion-weighted imaging and dynamic susceptibility contrast perfusion-weighted imaging before surgery. Histogram analysis of nCBV and ADC from whole-tumor voxels in contrast-enhancing lesions was performed. An unpaired t-test was used to compare the mean values for each type of tumor. A multivariate logistic regression model (LRM) was performed to classify GBM and PCNSL using the best parameters of ADC and nCBV. Results: All nCBV histogram parameters of GBMs were larger than those of PCNSLs, but only average nCBV was statistically significant after Bonferroni correction. Meanwhile, ADC histogram parameters were also larger in GBM compared to those in PCNSL, but these differences were not statistically significant. According to receiver operating characteristic curve analysis, the nCBV average and ADC 25th percentile demonstrated the largest area under the curve with values of 0.869 and 0.838, respectively. The LRM combining these two parameters differentiated between GBM and PCNSL with a higher area under the curve value (Logit (P) = −21.12 + 10.00 × ADC 25th percentile (10−3 mm2/s) + 5.420 × nCBV mean, P < 0.001). Conclusion: Our results suggest that whole-tumor histogram analysis of nCBV and ADC combined can be a valuable objective diagnostic method for differentiating between GBM and PCNSL.
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Affiliation(s)
- Shixing Bao
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine
| | - Yoshiyuki Watanabe
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine
| | - Hiroto Takahashi
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine
| | - Hisashi Tanaka
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine
| | - Atsuko Arisawa
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine
| | - Chisato Matsuo
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine
| | - Rongli Wu
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine
| | - Yasunori Fujimoto
- Department of Neurosurgery, Osaka University Graduate School of Medicine
| | - Noriyuki Tomiyama
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine
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Arisawa A, Watanabe Y, Tanaka H, Takahashi H, Matsuo C, Fujiwara T, Fujiwara M, Fujimoto Y, Tomiyama N. Comparative study of pulsed-continuous arterial spin labeling and dynamic susceptibility contrast imaging by histogram analysis in evaluation of glial tumors. Neuroradiology 2018; 60:599-608. [DOI: 10.1007/s00234-018-2024-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
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