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Hasner MC, van Opijnen MP, de Vos FYF, Cuppen E, Broekman MLD. Whole genome sequencing in (recurrent) glioblastoma: challenges related to informed consent procedures and data sharing. Acta Neurochir (Wien) 2024; 166:266. [PMID: 38874628 PMCID: PMC11178618 DOI: 10.1007/s00701-024-06158-z] [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: 03/18/2024] [Accepted: 06/04/2024] [Indexed: 06/15/2024]
Abstract
Increased use of whole genome sequencing (WGS) in neuro-oncology for diagnostics and research purposes necessitates a renewed conversation about informed consent procedures and governance structures for sharing personal health data. There is currently no consensus on how to obtain informed consent for WGS in this population. In this narrative review, we analyze the formats and contents of frameworks suggested in literature for WGS in oncology and assess their benefits and limitations. We discuss applicability, specific challenges, and legal context for patients with (recurrent) glioblastoma. This population is characterized by the rarity of the disease, extremely limited prognosis, and the correlation of the stage of the disease with cognitive abilities. Since this has implications for the informed consent procedure for WGS, we suggest that the content of informed consent should be tailor-made for (recurrent) glioblastoma patients.
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Affiliation(s)
- Mira C Hasner
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Mark P van Opijnen
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands.
- Department of Cell and Chemical Biology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands.
| | - Filip Y F de Vos
- Department of Medical Oncology, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Edwin Cuppen
- Hartwig Medical Foundation, Amsterdam, The Netherlands
- Center for Molecular Medicine and Oncode Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marike L D Broekman
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands
- Department of Cell and Chemical Biology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands
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Todeschi J, Dannhoff G, Chibbaro S, Segbedji F, Spatola G, Mallereau CH, Noel G, Schott R, Lhermitte B, Cebula H, Ganau M. Second Cancer Affecting the Central Nervous System: Systematic Literature Review Exploring the Link Between Malignant Melanoma and Glioblastoma. World Neurosurg 2023; 179:178-184. [PMID: 37625631 DOI: 10.1016/j.wneu.2023.08.073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Glioblastoma (GBM) is a malignant primary brain cancer, among the most devastating and lethal diseases of the central nervous system. Similarly, malignant melanoma (MM) is responsible for most skin cancer-related deaths. A link between those 2 aggressive cancers has not yet been established. We present here a systematic review of the literature and an exemplificative case. METHODS A systematic review of the literature was conducted to assess possible commonalities between MM and GBM. An exemplificative surgical vignette of a 73-year-old patient with the occurrence of a frontobasal GBM after surgical removal of a metastasis of MM in the same location was then detailed. RESULTS Fifteen studies published in the English international literature support a link between MM and GBM, both based on epidemiologic and pathophysiologic/genetic aspects. This theory is reinforced by our surgical vignette of a collision tumor with the occurrence of both tumors in the same location several years apart. CONCLUSIONS The evidence reported in the literature, as well as our surgical vignette, support a likely link between the pathogenesis of GBM and MM.
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Affiliation(s)
- Julien Todeschi
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - Guillaume Dannhoff
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France.
| | - Salvatore Chibbaro
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - Felix Segbedji
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - Giorgio Spatola
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | | | - Georges Noel
- Department of Radiotherapy, Strasbourg University Hospital, Strasbourg, France
| | - Roland Schott
- Department of Neuro-oncology, Strasbourg University Hospital, Strasbourg, France
| | - Benoit Lhermitte
- Histopathology Unit, Strasbourg University Hospital, Strasbourg, France
| | - Hélène Cebula
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - Mario Ganau
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
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Kumar M, Moiyadi A, Rangaraj N, Noronha S, Shetty P, Singh VK, Choudhari AK. Implications of use of different intraoperative ultrasound modalities during glioma surgery - A comparative study of factors affecting outcomes. Int J Med Inform 2023; 177:105154. [PMID: 37506442 DOI: 10.1016/j.ijmedinf.2023.105154] [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: 04/26/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND The main goal of glioma surgery is to remove the maximum amount of tumor without worsening the patient's neurological condition. Intraoperative ultrasound (US) imaging technologies (2D and 3D) are available to assist surgeons, providing real-time updates. Considering additional time, personnel, and cost, we investigate if comparable outcomes can be achieved using basic (2D) and advanced (3D) technology. OBJECTIVE We propose predictive models for (i) glioma tumor resectability (ii) surgical outcome, and (iii) a model to predict the outcome of surgery aided with a particular ultrasound and compare outcomes between 2D and 3D US. METHODOLOGY We used real-world surgery data from a tertiary cancer centre. Three groups of cases were analyzed (2D US used, 3D US used, and no US used during resection). The data analysis uses hypothesis testing, bootstrap sampling, and logistic regression. RESULTS The preoperatively anticipated extent of tumor removal correlated with the postoperative MRI measurement of tumor removal for US-supported surgery (p=0.01) but not for no US-supported surgeries (p = 0.13). A combination of delineation, eloquence, and the multifocal/multicentric nature of the tumor effectively predicted resectability. The eventual outcome of surgery (actual extent of resection achieved) can be predicted by prior treatment status, delineation, eloquence, and satellite nodules. Based on our prediction model (training set of 350 cases and test of 40 cases of US-guided surgeries), we identify some cases where 3D US seems to offer superior EORs. CONCLUSION The resectability of glioma tumors is crucial in determining surgical objectives, and the type of ultrasound used as support impacts tumor removal. The findings in this study aid informed decision-making and optimize imaging technology usage, providing a decision flow for selecting ultrasound based on tumor characteristics.
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Affiliation(s)
- Manoj Kumar
- Industrial Engineering & Operations Research, IIT Bombay, India.
| | - Aliasgar Moiyadi
- Department of Neurosurgery, Tata Memorial Centre Mumbai, India; Dept. of Health Sciences, Homi Bhabha National Institute, Mumbai, India
| | | | | | - Prakash Shetty
- Department of Neurosurgery, Tata Memorial Centre Mumbai, India; Dept. of Health Sciences, Homi Bhabha National Institute, Mumbai, India
| | - Vikas Kumar Singh
- Department of Neurosurgery, Tata Memorial Centre Mumbai, India; Dept. of Health Sciences, Homi Bhabha National Institute, Mumbai, India
| | - Amit Kumar Choudhari
- Department of Neurosurgery, Tata Memorial Centre Mumbai, India; Department of Radiology, Tata Memorial Centre Mumbai, India
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Sheng Y, Dang X, Zhang H, Rui W, Wang J, Cheng H, Qiu T, Zhang Y, Ding Y, Yao Z, Pang H, Ren Y. Correlations between intravoxel incoherent motion-derived fast diffusion and perfusion fraction parameters and VEGF- and MIB-1-positive rates in brain gliomas: an intraoperative MR-navigated, biopsy-based histopathologic study. Eur Radiol 2023; 33:5236-5246. [PMID: 36941492 DOI: 10.1007/s00330-023-09506-2] [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: 05/18/2022] [Revised: 12/23/2022] [Accepted: 01/30/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES To explore the correlations between histopathologic findings and intravoxel incoherent motion (IVIM)-derived perfusion and diffusion parameters in brain gliomas. METHODS Thirty-two biopsy samples from twenty-one patients with newly diagnosed gliomas from a previous prospective cohort study were retrospectively analyzed. All patients underwent diffusion-weighted MRI with 22 b values (0-5000 s/mm2), followed by intraoperative MR-guided biopsy surgery and surgical resection. All 32 biopsy samples underwent immunohistochemical staining followed by quantitative analysis of cell density (cellularity), percent of MIB-1 (Ki67)-positive expression (pMIB-1), number of CD34-stained vessels (CD34-MVD), and percent of VEGF-positive expressing cells (pVEGF) using a multispectral phenotyping microscope. Based on the co-registered localized biopsy, correlation analysis was performed between the IVIM-derived biexponential model-based parameters (Dfast1500 and Dfast5000, Dslow1500 and Dslow5000, PF1500 and PF5000) and the above four pathological biomarkers and glioma grades. RESULTS Significant positive correlations were revealed between Dfast5000 and pVEGF (rho (r) = 0.466, p = 0.007), and Dfast1500 and pVEGF (r = 0.371, p = 0.037). A significant negative correlation was revealed between PF5000 with pMIB-1 (r = - 0.456, p = 0.01). Moderate to good positive correlations were shown between Dfast5000 and glioma grades (r = 0.509, p = 0.003) and Dfast1500 and glioma grades (r = 0.476, p = 0.006). CONCLUSIONS IVIM-DWI-derived Dfast and PF correlate, respectively, with intratumor pVEGF and pMIB-1. When using the wide-high b value scheme, IVIM-derived Dfast and PF tend to demonstrate better efficacy in evaluating malignancy-related characteristics such as angiogenesis and cellular proliferation in gliomas. KEY POINTS • Intravoxel incoherent motion-diffusion-weighted imaging (IVIM-DWI)-derived fast diffusion (Dfast) and perfusion fraction (PF) can quantitatively reflect intratumor pVEGF and pMIB-1. • IVIM-DWI-derived Dfast and PF tend to demonstrate better efficacy in evaluating glioma malignancy when an optimized scheme is used. • IVIM-DWI-derived Dfast5000 and PF5000 are promising non-invasive parameters correlating with pVEGF and pMIB-1 in gliomas.
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Affiliation(s)
- Yaru Sheng
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xuefei Dang
- Department of Oncology, Minhang Branch of Fudan University Shanghai Cancer Center, Shanghai, 200240, China
| | - Hua Zhang
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, 266000, China
| | - Wenting Rui
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Jing Wang
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Haixia Cheng
- Neuropathology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Tianming Qiu
- Neurosurgery Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yong Zhang
- MR Research, GE Healthcare, 1 Huatuo Road, Shanghai, 201203, China
| | - Yueyue Ding
- Department of Echocardiology, Children's Hospital, Suzhou University, Suzhou, 215000, China
| | - Zhenwei Yao
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Haopeng Pang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, #197 Rui Jin Er Road, Shanghai, 200025, China.
- Department of Integrative Oncology, Minimally Invasive Therapy Center, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Radiology Department of Huashan Hospital, Fudan University, Mid 12 Wulumuqi Road, Shanghai, 200040, China.
| | - Yan Ren
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China.
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Kumar M, Noronha S, Rangaraj N, Moiyadi A, Shetty P, Singh VK. Choice of intraoperative ultrasound adjuncts for brain tumor surgery. BMC Med Inform Decis Mak 2022; 22:307. [DOI: 10.1186/s12911-022-02046-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Gliomas are among the most typical brain tumors tackled by neurosurgeons. During navigation for surgery of glioma brain tumors, preoperatively acquired static images may not be accurate due to shifts. Surgeons use intraoperative imaging technologies (2-Dimensional and navigated 3-Dimensional ultrasound) to assess and guide resections. This paper aims to precisely capture the importance of preoperative parameters to decide which type of ultrasound to be used for a particular surgery.
Methods
This paper proposes two bagging algorithms considering base classifier logistic regression and random forest. These algorithms are trained on different subsets of the original data set. The goodness of fit of Logistic regression-based bagging algorithms is established using hypothesis testing. Furthermore, the performance measures for random-forest-based bagging algorithms used are AUC under ROC and AUC under the precision-recall curve. We also present a composite model without compromising the explainability of the models.
Results
These models were trained on the data of 350 patients who have undergone brain surgery from 2015 to 2020. The hypothesis test shows that a single parameter is sufficient instead of all three dimensions related to the tumor ($$p < 0.05$$
p
<
0.05
). We observed that the choice of intraoperative ultrasound depends on the surgeon making a choice, and years of experience of the surgeon could be a surrogate for this dependence.
Conclusion
This study suggests that neurosurgeons may not need to focus on a large set of preoperative parameters in order to decide on ultrasound. Moreover, it personalizes the use of a particular ultrasound option in surgery. This approach could potentially lead to better resource management and help healthcare institutions improve their decisions to make the surgery more effective.
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Endoscopic-enhanced supra-cerebellar trans-tentorial (SCTT) approach to temporo-mesial region: a multicenter study. Neurosurg Rev 2022; 45:3749-3758. [PMID: 36220960 DOI: 10.1007/s10143-022-01881-6] [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: 06/15/2022] [Revised: 09/03/2022] [Accepted: 09/30/2022] [Indexed: 10/17/2022]
Abstract
Surgical access to the temporo-mesial area may be achieved by several routes such as the sub-temporal, the temporal trans-ventricular, the pterional/trans-sylvian, and the occipital interhemispheric approaches; nonetheless, none of them has shown to be superior to the others. The supra-cerebellar trans-tentorial approach allows a great exposure of the middle and posterior temporo-mesial region, while avoiding temporal lobe retraction. A prospective multicenter study was designed to collect data on patients undergoing endoscopic-enhanced SCTT approach to excise left temporo-mesial lesions. The study involved 5 different neurosurgical European centers and ran from 2015 to 2020. All patients had preoperative as well as postoperative brain MRI and ophthalmology evaluation. A total of 30 patients were included in this study, the mean follow-up was 44 months (range 18 to 84 months), male/female ratio was 16/14, and mean age was 39 years. A gross total resection was achieved in 29/30 (96.7%) cases. All surgical procedures were uneventful, without transient or permanent neurological deficits thanks to the preservation of the posterior cerebral artery. The endoscopic-enhanced SCTT approach provides satisfactory exposure to the left temporo-mesial region. Its minimally invasive nature helps minimize the surgical risks related to vascular and white tract manipulation, which represent known limitations of open microsurgical as well as other approaches.
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Yan Z, Wang J, Dong Q, Zhu L, Lin W, Jiang X. Predictors of tumor progression of low-grade glioma in adult patients within 5 years follow-up after surgery. Front Surg 2022; 9:937556. [PMID: 36277286 PMCID: PMC9581165 DOI: 10.3389/fsurg.2022.937556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/08/2022] [Indexed: 11/11/2022] Open
Abstract
Background Glioma originates from glial cells in the brain and is the most common primary intracranial tumor. This study intends to use a retrospective analysis to explore the factors that can predict tumor progression in adult low-grade gliomas, namely WHO II grade patients, within 5 years after surgery. Methods Patients with WHO grade II glioma who were surgically treated in our hospital from February 2011 to May 2017 were included. According to the inclusion and exclusion criteria, 252 patients were included in the final analysis. According to the results of the 5-year follow-up (including survival and imaging review results), patients were divided into progression-free group and progression group. Univariate and multivariate analysis were conducted to investigate the related factors of tumor progression during the 5-year follow-up. Results The results of the 5-year follow-up showed that 111 (44.0%) cases had no progress (progression free group, PFG), 141 (56.0%) cases had progress (progression group, PG), of which 43 (30.5%) cases were operated again, 37 cases (26.2%) received non-surgical treatments. There were 26 (10.3%) all-cause deaths, and 21 (8.3%) tumor-related deaths. Univariate and multivariate analysis showed that age >45 years old (OR = 1.35, 95% CI, 1.07-3.19, P = 0.027), partial tumor resection (OR = 1.66, 95% CI, 1.15-3.64, P = 0.031), tumor diameter >3 cm (OR = 1.52, 95% CI, 1.14-4.06, P = 0.017) and no radiotherapy (OR = 1.37, 95% CI, 1.12-2.44, P = 0.039) were independent predictors of the progression of tumor during the 5-year follow-up period. Conclusion Age >45 years old, partial tumor resection, tumor diameter >3 cm, no radiotherapy are predictors for tumor progression for glioma patients after surgery.
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Affiliation(s)
| | | | | | | | - Wei Lin
- Correspondence: Xiaofan Jiang Wei Lin
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Letter to the Editor Regarding "Burnout Among Neurosurgeons and Residents in Neurosurgery: A Systematic Review and Meta-Analysis of the Literature". World Neurosurg 2022; 165:205. [PMID: 36123826 PMCID: PMC9472586 DOI: 10.1016/j.wneu.2022.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/23/2022]
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Zaed I, Chibbaro S. In Reply to the Letter to the Editor Regarding “Burnout Among Neurosurgeons and Residents in Neurosurgery: A Systematic Review and Meta-Analysis of the Literature”. World Neurosurg 2022; 164:479. [DOI: 10.1016/j.wneu.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 10/16/2022]
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Bo L, Zhang Z, Jiang Z, Yang C, Huang P, Chen T, Wang Y, Yu G, Tan X, Cheng Q, Li D, Liu Z. Differentiation of Brain Abscess From Cystic Glioma Using Conventional MRI Based on Deep Transfer Learning Features and Hand-Crafted Radiomics Features. Front Med (Lausanne) 2021; 8:748144. [PMID: 34869438 PMCID: PMC8636043 DOI: 10.3389/fmed.2021.748144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/06/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives: To develop and validate the model for distinguishing brain abscess from cystic glioma by combining deep transfer learning (DTL) features and hand-crafted radiomics (HCR) features in conventional T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI). Methods: This single-center retrospective analysis involved 188 patients with pathologically proven brain abscess (102) or cystic glioma (86). One thousand DTL and 105 HCR features were extracted from the T1WI and T2WI of the patients. Three feature selection methods and four classifiers, such as k-nearest neighbors (KNN), random forest classifier (RFC), logistic regression (LR), and support vector machine (SVM), for distinguishing brain abscess from cystic glioma were compared. The best feature combination and classifier were chosen according to the quantitative metrics including area under the curve (AUC), Youden Index, and accuracy. Results: In most cases, deep learning-based radiomics (DLR) features, i.e., DTL features combined with HCR features, contributed to a higher accuracy than HCR and DTL features alone for distinguishing brain abscesses from cystic gliomas. The AUC values of the model established, based on the DLR features in T2WI, were 0.86 (95% CI: 0.81, 0.91) in the training cohort and 0.85 (95% CI: 0.75, 0.95) in the test cohort, respectively. Conclusions: The model established with the DLR features can distinguish brain abscess from cystic glioma efficiently, providing a useful, inexpensive, convenient, and non-invasive method for differential diagnosis. This is the first time that conventional MRI radiomics is applied to identify these diseases. Also, the combination of HCR and DTL features can lead to get impressive performance.
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Affiliation(s)
- Linlin Bo
- Shandong Key Laboratory of Medical Physics and Image Processing, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - Zijian Zhang
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
| | - Zekun Jiang
- Shandong Key Laboratory of Medical Physics and Image Processing, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - Chao Yang
- Shandong Key Laboratory of Medical Physics and Image Processing, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - Pu Huang
- Shandong Key Laboratory of Medical Physics and Image Processing, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - Tingyin Chen
- Department of Network Information Center, Xiangya Hospital, Centra South University, Changsha, China
| | - Yifan Wang
- Department of Network Information Center, Xiangya Hospital, Centra South University, Changsha, China
| | - Gang Yu
- Shandong Key Laboratory of Medical Physics and Image Processing, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - Xiao Tan
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
| | - Quan Cheng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Dengwang Li
- Shandong Key Laboratory of Medical Physics and Image Processing, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - Zhixiong Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Chaudhary N, Zhang G, Li S, Zhu W. Monoexponential, biexponential and stretched exponential models of diffusion weighted magnetic resonance imaging in glioma in relation to histopathologic grade and Ki-67 labeling index using high B values. Am J Transl Res 2021; 13:12480-12494. [PMID: 34956467 PMCID: PMC8661204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/12/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE To explore the performance of various parameters obtained from monoexponential (Gaussian), biexponential and stretched exponential (non-Gaussian) models of Diffusion Weighted Magnetic Resonance Imaging in differentiating gliomas with correlation to histopathology and Ki-67 labeling index (LI). MATERIALS AND METHODS This Institute Review Board approved retrospective study included 51 pathologically proven glioma patients (WHO Grade I, n = 1; Grade II, n = 19, Grade III, n = 12; Grade IV, n = 19), and immunohistochemistry for Ki-67 LI was obtained. The conventional Magnetic Resonance (MR) images and Diffusion Weighted (DW) images with 19 non-zero b values (0-4500 s/mm2) followed by contrast-enhanced MR images were obtained at 3T preoperatively. All images were processed with Advantage Workstation 4.5 (GE Medical Systems). Region of interest (ROI) in the solid part of the tumor was manually drawn along the border meticulously excluding areas of edema, cyst, hemorrhage, necrosis, and/or calcification, and the parameters: Apparent Diffusion Coefficient (ADC) of monoexponential; pure molecular diffusion coefficient (Dslow), pseudo-diffusion coefficient (Dfast), and perfusion fraction (f) of biexponential; Distributed Diffusion Coefficient (DDC), and heterogeneity index (α) of stretched exponential models were obtained. ROI of 50 mm2 in the contralateral normal appearing white matter (NAWM) was drawn for the internal control either on centrum semiovale or white matter of the frontal lobe. Analysis of reliability by Intra-class Correlation Coefficient (ICC); correlation with Ki-67 LI by Spearman's rank correlation; comparison between high grade glioma (HGG) and low grade glioma (LGG) by either Mann Whitney U test or Independent t-Test; comparison among Grade II, III and IV gliomas by one-way ANOVA with Bonferroni; and diagnostic performance by analysis of Area Under Receiver Operating Characteristic (ROC) Curve (AUC) were conducted. RESULTS Highly significant differences were found between HGG and LGG for all the parameters (P < 0.001 for all). In differentiating HGG from LGG, AUC values were 0.955 for Ki-67 LI; 0.926 for α; 0.903 for Dslow; 0.897 for f; 0.863 for DDC; 0.852 for ADC; 0.820 for Dfast (P < 0.001 for all). The parameters ADC, Dslow, Dfast, f, DDC, and α showed moderate to good negative correlation with Ki-67 LI (P < 0.001 for all). The ICCs of all the parameters were found greater than 0.75 (P < 0.05 for all) suggesting good reliability of measurements. CONCLUSION In comparison to ADC derived from monoexponential model, the parameters α and Dslow derived from stretched exponential, and biexponential models respectively can efficiently differentiate HGG from LGG with high diagnostic accuracy. Additionally, f and DDC derived from biexponential, and stretched exponential models respectively are also more useful in differentiating HGG from LGG in comparison to ADC.
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Affiliation(s)
- Nabin Chaudhary
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology No. 1095 Jiefang Avenue, Wuhan 430030, Hubei, China
| | - Guiling Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology No. 1095 Jiefang Avenue, Wuhan 430030, Hubei, China
| | - Shihui Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology No. 1095 Jiefang Avenue, Wuhan 430030, Hubei, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology No. 1095 Jiefang Avenue, Wuhan 430030, Hubei, China
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Ali S, Li J, Pei Y, Khurram R, Rehman KU, Rasool AB. State-of-the-Art Challenges and Perspectives in Multi-Organ Cancer Diagnosis via Deep Learning-Based Methods. Cancers (Basel) 2021; 13:5546. [PMID: 34771708 PMCID: PMC8583666 DOI: 10.3390/cancers13215546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
Thus far, the most common cause of death in the world is cancer. It consists of abnormally expanding areas that are threatening to human survival. Hence, the timely detection of cancer is important to expanding the survival rate of patients. In this survey, we analyze the state-of-the-art approaches for multi-organ cancer detection, segmentation, and classification. This article promptly reviews the present-day works in the breast, brain, lung, and skin cancer domain. Afterwards, we analytically compared the existing approaches to provide insight into the ongoing trends and future challenges. This review also provides an objective description of widely employed imaging techniques, imaging modality, gold standard database, and related literature on each cancer in 2016-2021. The main goal is to systematically examine the cancer diagnosis systems for multi-organs of the human body as mentioned. Our critical survey analysis reveals that greater than 70% of deep learning researchers attain promising results with CNN-based approaches for the early diagnosis of multi-organ cancer. This survey includes the extensive discussion part along with current research challenges, possible solutions, and prospects. This research will endow novice researchers with valuable information to deepen their knowledge and also provide the room to develop new robust computer-aid diagnosis systems, which assist health professionals in bridging the gap between rapid diagnosis and treatment planning for cancer patients.
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Affiliation(s)
- Saqib Ali
- Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China; (S.A.); (J.L.); (K.u.R.)
| | - Jianqiang Li
- Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China; (S.A.); (J.L.); (K.u.R.)
| | - Yan Pei
- Computer Science Division, University of Aizu, Aizuwakamatsu 965-8580, Japan
| | - Rooha Khurram
- Beijing Key Laboratory for Green Catalysis and Separation, Department of Chemistry and Chemical Engineering, Beijing University of Technology, Beijing 100124, China;
| | - Khalil ur Rehman
- Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China; (S.A.); (J.L.); (K.u.R.)
| | - Abdul Basit Rasool
- Research Institute for Microwave and Millimeter-Wave (RIMMS), National University of Sciences and Technology (NUST), Islamabad 44000, Pakistan;
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Wang ZH, Xiao XL, Zhang ZT, He K, Hu F. A Radiomics Model for Predicting Early Recurrence in Grade II Gliomas Based on Preoperative Multiparametric Magnetic Resonance Imaging. Front Oncol 2021; 11:684996. [PMID: 34540662 PMCID: PMC8443788 DOI: 10.3389/fonc.2021.684996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/12/2021] [Indexed: 12/23/2022] Open
Abstract
Objective This study aimed to develop a radiomics model to predict early recurrence (<1 year) in grade II glioma after the first resection. Methods The pathological, clinical, and magnetic resonance imaging (MRI) data of patients diagnosed with grade II glioma who underwent surgery and had a recurrence between 2017 and 2020 in our hospital were retrospectively analyzed. After a rigorous selection, 64 patients were eligible and enrolled in the study. Twenty-two cases had a pathologically confirmed recurrent glioma. The cases were randomly assigned using a ratio of 7:3 to either the training set or validation set. T1-weighted image (T1WI), T2-weighted image (T2WI), and contrast-enhanced T1-weighted image (T1CE) were acquired. The minimum-redundancy-maximum-relevancy (mRMR) method alone or in combination with univariate logistic analysis were used to identify the most optimal predictive feature from the three image sequences. Multivariate logistic regression analysis was then used to develop a predictive model using the screened features. The performance of each model in both training and validation datasets was assessed using a receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). Results A total of 396 radiomics features were initially extracted from each image sequence. After running the mRMR and univariate logistic analysis, nine predictive features were identified and used to build the multiparametric radiomics model. The model had a higher AUC when compared with the univariate models in both training and validation data sets with an AUC of 0.966 (95% confidence interval: 0.949–0.99) and 0.930 (95% confidence interval: 0.905–0.973), respectively. The calibration curves indicated a good agreement between the predictable and the actual probability of developing recurrence. The DCA demonstrated that the predictive value of the model improved when combining the three MRI sequences. Conclusion Our multiparametric radiomics model could be used as an efficient and accurate tool for predicting the recurrence of grade II glioma.
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Affiliation(s)
- Zhen-Hua Wang
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xin-Lan Xiao
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhao-Tao Zhang
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Keng He
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Hu
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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Yin L, Cheng L, Wang F, Zhu X, Hua Y, He W. Application of intraoperative B-mode ultrasound and shear wave elastography for glioma grading. Quant Imaging Med Surg 2021; 11:2733-2743. [PMID: 34079737 DOI: 10.21037/qims-20-1368] [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] [Indexed: 12/12/2022]
Abstract
Background To evaluate the value of intraoperative B-mode ultrasound and shear wave elastography (SWE) in differentiating low-grade and high-grade gliomas. Methods A total of 172 patients with glioma were examined by B-mode ultrasound to obtain a tumor sonogram. Intraoperative SWE was performed on 52 patients to obtain Young's modulus values of peritumor tissue and tumor tissue, and the differences in conventional B-mode signs and Young's modulus values of gliomas of different grades were then compared. The diagnostic performance of SWE in glioma grading was assessed by receiver operating characteristic (ROC) curve analysis, and the intra- and interobserver reliability of SWE was analyzed by the intraclass correlation coefficient (ICC). Results For B-mode ultrasound, patient age, cystic degeneration, and peritumor edema were independent risk factors for high-grade glioma (P<0.05, OR >1). For SWE, Young's modulus values of peritumor tissue, low-grade glioma, and high-grade glioma tissues were 8.20 (7.50, 9.70) kPa, 19.65 (15.30, 24.75) kPa, and 9.55 (8.50, 13.80) kPa, respectively. The area under the ROC curve for the diagnosis of high-grade glioma by SWE was 0.859 (95% CI: 0.758-0.961, P<0.05), and the optimal cutoff value was 12.1 kPa, with 89.3% sensitivity and 75.0% specificity. The intra- and interobserver reliability of SWE in grading gliomas was excellent, with ICCs ranging from 0.921 to 0.965. Conclusions High-grade glioma is associated with significantly more severe necrotic cystic degeneration and peritumoral edema on B-mode ultrasound and lower stiffness on SWE. Further, SWE exhibits excellent intra- and interobserver reliability. Intraoperative B-mode ultrasound combined with SWE helps differentiate different grades of gliomas.
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Affiliation(s)
- Lu Yin
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Linggang Cheng
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fumin Wang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Ultrasound, Peking University First Hospital, Beijing, China
| | - Xueli Zhu
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yue Hua
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wen He
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Loss of 5'-Methylthioadenosine Phosphorylase (MTAP) is Frequent in High-Grade Gliomas; Nevertheless, it is Not Associated with Higher Tumor Aggressiveness. Cells 2020; 9:cells9020492. [PMID: 32093414 PMCID: PMC7072758 DOI: 10.3390/cells9020492] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/04/2020] [Accepted: 02/10/2020] [Indexed: 12/12/2022] Open
Abstract
The 5’-methylthioadenosine phosphorylase (MTAP) gene is located in the chromosomal region 9p21. MTAP deletion is a frequent event in a wide variety of human cancers; however, its biological role in tumorigenesis remains unclear. The purpose of this study was to characterize the MTAP expression profile in a series of gliomas and to associate it with patients’ clinicopathological features. Moreover, we sought to evaluate, through glioma gene-edited cell lines, the biological impact of MTAP in gliomas. MTAP expression was evaluated in 507 glioma patients by immunohistochemistry (IHC), and the expression levels were associated with patients’ clinicopathological features. Furthermore, an in silico study was undertaken using genomic databases totalizing 350 samples. In glioma cell lines, MTAP was edited, and following MTAP overexpression and knockout (KO), a transcriptome analysis was performed by NanoString Pan-Cancer Pathways panel. Moreover, MTAP’s role in glioma cell proliferation, migration, and invasion was evaluated. Homozygous deletion of 9p21 locus was associated with a reduction of MTAP mRNA expression in the TCGA (The Cancer Genome Atlas) - glioblastoma dataset (p < 0.01). In addition, the loss of MTAP expression was markedly high in high-grade gliomas (46.6% of cases) determined by IHC and Western blotting (40% of evaluated cell lines). Reduced MTAP expression was associated with a better prognostic in the adult glioblastoma dataset (p < 0.001). Nine genes associated with five pathways were differentially expressed in MTAP-knockout (KO) cells, with six upregulated and three downregulated in MTAP. Analysis of cell proliferation, migration, and invasion did not show any significant differences between MTAP gene-edited and control cells. Our results integrating data from patients as well as in silico and in vitro models provide evidence towards the lack of strong biological importance of MTAP in gliomas. Despite the frequent loss of MTAP, it seems not to have a clinical impact in survival and does not act as a canonic tumor suppressor gene in gliomas.
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Primary Gliosarcoma of the Cerebellum in a Young Pregnant Woman: Management Challenges and Immunohistochemical Features. Case Rep Surg 2019; 2019:7105361. [PMID: 31396432 PMCID: PMC6664503 DOI: 10.1155/2019/7105361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/17/2019] [Accepted: 05/25/2019] [Indexed: 11/24/2022] Open
Abstract
Background Gliosarcoma (GS) represents a rare, high-grade (WHO Grade IV), central nervous system neoplasm, characterized by a very poor prognosis. Similar to other high-grade gliomas, GS affects mainly adults in the 5th-7th decade of life and presents a higher incidence in males. The most reported locations of GS are the temporal lobe and the frontal lobe, while only eight cases of GS originating from the posterior cranial fossa are reported in the literature. Case Description We report the first case occurring during pregnancy in a 33-year-old patient. Diagnosis was obtained on the 15th week of gestation when patient presented with signs and symptoms of life-threatening raised intracranial pressure. Surgical excision was followed by early recurrence and eventually disease progression because the patient refused adjuvant treatment to save her fetus. Conclusions GS should be considered in the differential diagnosis of posterior cranial fossa tumors with radiological features of meningioma or glioblastoma, even in young patients. To this regard, sarcomas, solitary fibrous tumors, and even metastases should be considered, especially in light of the tendency of GS to give rise to extracranial localizations. Whenever an aggressive management with radical excision and adjuvant treatment is not safely achievable, disease progression is likely to be unavoidable.
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Li J, Niu X, Gan Y, Yang Y, Wang T, Zhang H, Liu Y, Mao Q. Clinical and Pathologic Features and Prognostic Factors for Recurrent Gliomas. World Neurosurg 2019; 128:e21-e30. [PMID: 30880199 DOI: 10.1016/j.wneu.2019.02.210] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/22/2019] [Accepted: 02/23/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To explore related factors that influence time to recurrence and prognosis of gliomas. METHODS A retrospective analysis of pathologic and clinical data of patients with glioma who underwent surgery for the first time and had a recurrence between 2009 and 2018 in West China Hospital was performed. Clinical characteristics of patients were reviewed, and survival analysis was performed to identify prognostic factors for the recurrent time. Molecules with differential changes in the paired samples were included in the survival analysis. RESULTS A total of 84 patients met our inclusion requirements and were included in the study; other related factors were also considered in detail in the integrated analysis. Significant differences among O6-methylguanine-DNA methyltransferase (positive/negative), isocitrate dehydrogenase 1 (positive/negative), and Ki-67 were determined by statistical analysis of paired samples (P = 0.013, P = 0.014, P = 0.017). Univariate analysis demonstrated that Ki-67 (low expression, medium expression, high expression), initial World Health Organization grade (low or high), tumor side (left, right, middle), age (≥50 years, <50 years), and extent of resection were significantly correlated with time to recurrence (log-rank P = 0.008, P < 0.001, P = 0.015, P < 0.001, P = 0.001). Multivariate analysis results showed that Ki-67 lower expression (hazard ratio [HR] = 0.585, 95% confidence interval [CI] = 0.146-2.336, P = 0.448), medium expression (HR = 0.256, 95% CI = 0.084-0.784, P = 0.017), and high expression (HR = 1 as a reference) together with the initial World Health Organization grade (HR = 0.148, 95% CI = 0.029-0.749, P = 0.021) were independent predictive factors for glioma recurrence. CONCLUSIONS This comprehensive analysis revealed that initial World Health Organization grade and Ki-67 proliferative index were independent prognostic factors that predict the time to recurrence of glioma in patients after first surgery.
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Affiliation(s)
- Jiaoming Li
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaodong Niu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Youjun Gan
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Yang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Tianwei Wang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Haodongfang Zhang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yanhui Liu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qing Mao
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
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Ganau M, Ligarotti GK, Apostolopoulos V. Real-time intraoperative ultrasound in brain surgery: neuronavigation and use of contrast-enhanced image fusion. Quant Imaging Med Surg 2019; 9:350-358. [PMID: 31032183 DOI: 10.21037/qims.2019.03.06] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Mario Ganau
- Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Gianfranco K Ligarotti
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Tong J, Li J, Zhang QS, Yang JK, Zhang L, Liu HY, Liu YZ, Yuan JW, Su XM, Zhang XX, Jiao BH. Delayed cognitive deficits can be alleviated by calcium antagonist nimodipine by downregulation of apoptosis following whole brain radiotherapy. Oncol Lett 2018; 16:2525-2532. [PMID: 30013647 PMCID: PMC6036595 DOI: 10.3892/ol.2018.8968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 01/29/2018] [Indexed: 01/30/2023] Open
Abstract
Radiation therapy is important for the comprehensive treatment of intracranial tumors. However, the molecular mechanisms underlying the pathogenesis of delayed cognitive dysfunction are not well-defined and effective treatments or prevention measures remain insufficient. In the present study, 60 adult male Wistar rats were randomly divided into three groups, which included a control, whole brain radiotherapy (WBRT) (single dose of 30 Gy of WBRT) and nimodipine (single dose of 30 Gy of WBRT followed by nimodipine injection intraperitoneally) groups. The rats were sacrificed 7 days or 3 months following irradiation. At 3 months, the Morris water maze test was used to assess spatial learning and memory function in rats. The results demonstrated that the WBRT group demonstrated a significantly impaired cognitive performance, decreased numbers of hippocampal Cornu Ammonis (CA)1 neurons and upregulated expression of caspase-3 in the dentate gyrus compared with those in the control and nimodipine groups. Reverse transcription-quantitative polymerase chain reaction analysis demonstrated that the WBRT group exhibited increased ratio of B-cell lymphoma 2 (Bcl-2)-associated X protein (Bax)/Bcl-2 compared with that in control and nimodipine groups on day 7 following irradiation. However, the WBRT group exhibited decreased levels of brain-derived neurotrophic factor (BDNF) compared with that in control and nimodipine groups at 3 months following brain irradiation. The levels of growth-associated protein 43 and amyloid precursor protein between the nimodipine group and WBRT group were not statistically significant. The present study demonstrated that neuron apoptosis may lead to delayed cognitive deficits in the hippocampus, in response to radiotherapy. The cognitive impairment may be alleviated in response to a calcium antagonist nimodipine. The molecular mechanisms involved in nimodipine-mediated protection against cognitive decline may involve the regulation of Bax/Bcl-2 and BDNF in the hippocampus.
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Affiliation(s)
- Jing Tong
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Juan Li
- Department of Radiotherapy, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Qiu-Shi Zhang
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Jian-Kai Yang
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Lei Zhang
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Hai-Ying Liu
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Ying-Zi Liu
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Jiang-Wei Yuan
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Xu-Ming Su
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Xue-Xin Zhang
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Bao-Hua Jiao
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
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Ganau M, Mankad K, Srirambhatla UR, Tahir Z, D'Arco F. Ring-enhancing lesions in neonatal meningitis: an analysis of neuroradiology pitfalls through exemplificative cases and a review of the literature. Quant Imaging Med Surg 2018; 8:333-341. [PMID: 29774186 DOI: 10.21037/qims.2018.01.04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Very often the clinical course of neonatal meningitis (NM) is characterized by sudden worsening, at times associated with cerebrovascular complications and strokes or the formation of cerebral abscesses. The immediate recognition of these pathological patterns is pivotal in providing clinicians with useful information to differentiate between those different pathological entities, which may both present as ring-enhancing lesions on neuroradiology investigations. Understanding their natural history and diagnostic features is of paramount importance to timely adopt the most appropriate medical and surgical management.
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Affiliation(s)
- Mario Ganau
- Department of Neurosurgery, Great Ormond Street Hospital for Children, London, UK
| | - Kshitij Mankad
- Department of Paediatric Neuroradiology, Great Ormond Street Hospital for Children, London, UK
| | - Uma Rami Srirambhatla
- Department of Paediatric Neuroradiology, Great Ormond Street Hospital for Children, London, UK
| | - Zubair Tahir
- Department of Neurosurgery, Great Ormond Street Hospital for Children, London, UK
| | - Felice D'Arco
- Department of Paediatric Neuroradiology, Great Ormond Street Hospital for Children, London, UK
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Differentiation of brain infection from necrotic glioblastoma using combined analysis of diffusion and perfusion MRI. J Magn Reson Imaging 2018; 49:184-194. [DOI: 10.1002/jmri.26053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/28/2018] [Indexed: 12/13/2022] Open
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How Nanotechnology and Biomedical Engineering Are Supporting the Identification of Predictive Biomarkers in Neuro-Oncology. MEDICINES 2018; 5:medicines5010023. [PMID: 29495368 PMCID: PMC5874588 DOI: 10.3390/medicines5010023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 02/12/2018] [Accepted: 02/22/2018] [Indexed: 01/26/2023]
Abstract
The field of neuro-oncology is rapidly progressing and internalizing many of the recent discoveries coming from research conducted in basic science laboratories worldwide. This systematic review aims to summarize the impact of nanotechnology and biomedical engineering in defining clinically meaningful predictive biomarkers with a potential application in the management of patients with brain tumors. Data were collected through a review of the existing English literature performed on Scopus, MEDLINE, MEDLINE in Process, EMBASE, and/or Cochrane Central Register of Controlled Trials: all available basic science and clinical papers relevant to address the above-stated research question were included and analyzed in this study. Based on the results of this systematic review we can conclude that: (1) the advances in nanotechnology and bioengineering are supporting tremendous efforts in optimizing the methods for genomic, epigenomic and proteomic profiling; (2) a successful translational approach is attempting to identify a growing number of biomarkers, some of which appear to be promising candidates in many areas of neuro-oncology; (3) the designing of Randomized Controlled Trials will be warranted to better define the prognostic value of those biomarkers and biosignatures.
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Understanding the Pathological Basis of Neurological Diseases Through Diagnostic Platforms Based on Innovations in Biomedical Engineering: New Concepts and Theranostics Perspectives. MEDICINES 2018; 5:medicines5010022. [PMID: 29495320 PMCID: PMC5874587 DOI: 10.3390/medicines5010022] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 02/14/2018] [Accepted: 02/20/2018] [Indexed: 02/07/2023]
Abstract
The pace of advancement of genomics and proteomics together with the recent understanding of the molecular basis behind rare diseases could lead in the near future to significant advances in the diagnosing and treating of many pathological conditions. Innovative diagnostic platforms based on biomedical engineering (microdialysis and proteomics, biochip analysis, non-invasive impedance spectroscopy, etc.) are introduced at a rapid speed in clinical practice: this article primarily aims to highlight how such platforms will advance our understanding of the pathological basis of neurological diseases. An overview of the clinical challenges and regulatory hurdles facing the introduction of such platforms in clinical practice, as well as their potential impact on patient management, will complement the discussion on foreseeable theranostic perspectives. Indeed, the techniques outlined in this article are revolutionizing how we (1) identify biomarkers that better define the diagnostic criteria of any given disease, (2) develop research models, and (3) exploit the externalities coming from innovative pharmacological protocols (i.e., those based on monoclonal antibodies, nanodrugs, etc.) meant to tackle the molecular cascade so far identified.
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Ganau L, Ligarotti GKI, Ganau M. Predicting complexity of tumor removal and postoperative outcome in patients with high-grade gliomas. Neurosurg Rev 2017; 41:371-373. [PMID: 29046996 DOI: 10.1007/s10143-017-0921-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 10/10/2017] [Indexed: 12/30/2022]
Affiliation(s)
- Laura Ganau
- School of Medicine, University of Cagliari, Cagliari, Italy
| | | | - Mario Ganau
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
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Morrone FB, Gehring MP, Nicoletti NF. Calcium Channels and Associated Receptors in Malignant Brain Tumor Therapy. Mol Pharmacol 2016; 90:403-9. [PMID: 27418672 DOI: 10.1124/mol.116.103770] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 07/11/2016] [Indexed: 12/25/2022] Open
Abstract
Malignant brain tumors are highly lethal and aggressive. Despite recent advances in the current therapies, which include the combination of surgery and radio/chemotherapy, the average survival rate remains poor. Altered regulation of ion channels is part of the neoplastic transformation, which suggests that ion channels are involved in cancer. Distinct classes of calcium-permeable channels are abnormally expressed in cancer and are likely involved in the alterations underlying malignant growth. Specifically, cytosolic Ca(2+) activity plays an important role in the regulation of cell proliferation, and Ca(2+) signaling is altered in proliferating tumor cells. A series of previous studies emphasized the importance of the T-type low-voltage-gated calcium channels (VGCC) in different cancer types, including gliomas, and remarkably, pharmacologic inhibition of T-type VGCC caused antiproliferative effects and triggered apoptosis of human glioma cells. Other calcium permeable channels, such as transient receptor potential (TRP) channels, contribute to changes in Ca(2+) by modulating the driving force for Ca(2+) entry, and some TRP channels are required for proliferation and migration in gliomas. Furthermore, recent evidence shows that TRP channels contribute to the progression and survival of the glioblastoma patients. Likewise, the purinergic P2X7 receptor acts as a direct conduit for Ca(2+)-influx and an indirect activator of voltage-gated Ca(2+)-channel. Evidence also shows that P2X7 receptor activation is linked to elevated expression of inflammation promoting factors, tumor cell migration, an increase in intracellular mobilization of Ca(2+), and membrane depolarization in gliomas. Therefore, this review summarizes the recent findings on calcium channels and associated receptors as potential targets to treat malignant gliomas.
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Affiliation(s)
- Fernanda B Morrone
- Programa de Pós-graduação em Biologia Celular e Molecular (F.B.M., M.P.G., N.F.N), Programa de Pós-graduação em Medicina e Ciências da Saúde, Faculdade de Farmácia, Pontifícia Universidade Católica do RS, Porto Alegre (F.B.M.); Laboratório de Terapia Celular, Centro de Ciências Biológicas e da Saúde, Universidade de Caxias do Sul, Caxias do Sul (N.F.N.), Brasil
| | - Marina P Gehring
- Programa de Pós-graduação em Biologia Celular e Molecular (F.B.M., M.P.G., N.F.N), Programa de Pós-graduação em Medicina e Ciências da Saúde, Faculdade de Farmácia, Pontifícia Universidade Católica do RS, Porto Alegre (F.B.M.); Laboratório de Terapia Celular, Centro de Ciências Biológicas e da Saúde, Universidade de Caxias do Sul, Caxias do Sul (N.F.N.), Brasil
| | - Natália F Nicoletti
- Programa de Pós-graduação em Biologia Celular e Molecular (F.B.M., M.P.G., N.F.N), Programa de Pós-graduação em Medicina e Ciências da Saúde, Faculdade de Farmácia, Pontifícia Universidade Católica do RS, Porto Alegre (F.B.M.); Laboratório de Terapia Celular, Centro de Ciências Biológicas e da Saúde, Universidade de Caxias do Sul, Caxias do Sul (N.F.N.), Brasil
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