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Satterlee AB, Dunn DE, Valdivia A, Malawsky D, Buckley A, Gershon T, Floyd S, Hingtgen S. Spatiotemporal analysis of induced neural stem cell therapy to overcome advanced glioblastoma recurrence. Mol Ther Oncolytics 2022; 26:49-62. [PMID: 35784402 PMCID: PMC9217992 DOI: 10.1016/j.omto.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/01/2022] [Indexed: 12/03/2022] Open
Abstract
Genetically engineered neural stem cells (NSCs) are a promising therapy for the highly aggressive brain cancer glioblastoma (GBM); however, treatment durability remains a major challenge. We sought to define the events that contribute to dynamic adaptation of GBM during treatment with human skin-derived induced NSCs releasing the pro-apoptotic agent TRAIL (iNSC-TRAIL) and develop strategies that convert initial tumor kill into sustained GBM suppression. In vivo and ex vivo analysis before, during, and after treatment revealed significant shifts in tumor transcriptome and spatial distribution as the tumors adapted to treatment. To address this, we designed iNSC delivery strategies that increased spatiotemporal TRAIL coverage and significantly decreased GBM volume throughout the brain, reducing tumor burden 100-fold as quantified in live ex vivo brain slices. The varying impact of different strategies on treatment durability and median survival of both solid and invasive tumors provides important guidance for optimizing iNSC therapy.
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Affiliation(s)
- Andrew B. Satterlee
- Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Denise E. Dunn
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27704, USA
| | - Alain Valdivia
- Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Daniel Malawsky
- Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
| | - Andrew Buckley
- Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Timothy Gershon
- Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
- UNC Neuroscience Center, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
| | - Scott Floyd
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27704, USA
| | - Shawn Hingtgen
- Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
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2
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Laucis AM, Selwa K, Sun Y, Kim MM, Cuneo KC, Lawrence TS, Wahl DR, Junck L, Umemura Y. Efficacy and toxicity with radiation field designs and concurrent temozolomide for CNS lymphoma. Neurooncol Pract 2022; 9:536-544. [DOI: 10.1093/nop/npac052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There is no consensus on the treatment of central nervous system (CNS) lymphoma refractory to first-line methotrexate-based chemotherapy. Whole brain radiotherapy (WBRT) is sometimes used but may result in unacceptable neurocognitive dysfunction. We examined the efficacy and toxicities of WBRT with or without concurrent temozolomide in CNS lymphoma treatment.
Methods
This single-institution IRB-approved retrospective study included adults with CNS lymphoma who received WBRT, either consolidative low-dose WBRT alone or low-dose WBRT with a focal boost to residual disease and were previously treated with high-dose methotrexate. The relationships between the WBRT regimen, concurrent temozolomide, and clinical outcomes and toxicities were assessed using proportional hazards and logistic regression models.
Results
A total of 45 patients with a median age of 64 years (range 24–74) treated from 2004 to 2019 were included. In total, 20 patients received concurrent temozolomide. In the WBRT + Boost cohort (n = 32), concurrent temozolomide resulted in better 2-year overall survival (OS) and progression free survival (PFS) (73% OS and 66% PFS) compared to patients treated without concurrent temozolomide (44% OS and 24% PFS). On multivariate analysis, concurrent temozolomide was associated with significantly better PFS (HR 0.28, P = .02). There were no significant differences between the two radiation groups or between those treated with or without concurrent temozolomide, with respect to significant acute hematologic, non-hematologic, and long-term neurocognitive toxicities (P > .05).
Conclusions
In this study, concurrent temozolomide with radiotherapy in CNS lymphoma was associated with better PFS and was well tolerated. Low-dose WBRT with a boost is a safe and reasonable treatment approach for focal refractory disease. Prospective research that includes rigorous neurocognitive assessments is now warranted.
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Affiliation(s)
- Anna M Laucis
- Department of Radiation Oncology, University of Michigan Rogel Cancer Center , Ann Arbor, MI , USA
| | - Katherine Selwa
- Department of Neurology, University of Michigan Hospital , Ann Arbor, MI , USA
| | - Yilun Sun
- Department of Radiation Oncology, University of Michigan Rogel Cancer Center , Ann Arbor, MI , USA
| | - Michelle M Kim
- Department of Radiation Oncology, University of Michigan Rogel Cancer Center , Ann Arbor, MI , USA
| | - Kyle C Cuneo
- Department of Radiation Oncology, University of Michigan Rogel Cancer Center , Ann Arbor, MI , USA
| | - Theodore S Lawrence
- Department of Radiation Oncology, University of Michigan Rogel Cancer Center , Ann Arbor, MI , USA
| | - Daniel R Wahl
- Department of Radiation Oncology, University of Michigan Rogel Cancer Center , Ann Arbor, MI , USA
| | - Larry Junck
- Department of Neurology, University of Michigan Hospital , Ann Arbor, MI , USA
| | - Yoshie Umemura
- Department of Neurology, University of Michigan Hospital , Ann Arbor, MI , USA
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3
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Primary intradural extramedullary spinal Burkitt's lymphoma mimicking a nerve sheath tumor: a case report. Spinal Cord Ser Cases 2022; 8:53. [PMID: 35568724 PMCID: PMC9107486 DOI: 10.1038/s41394-022-00520-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/23/2022] [Accepted: 04/26/2022] [Indexed: 11/08/2022] Open
Abstract
Spinal involvement in lymphomas is often associated with advanced disease. Primary spinal non-Hodgkin's lymphoma is a rare entity. A 47-year-old male presented with a history of neck pain followed by progressive quadriparesis and bowel bladder involvement over a 5-month period. The magnetic resonance imaging was suggestive of an intradural extramedullary lesion at the C1-C2 vertebra level. A surgical excision was done and the histopathology revealed atypical lymphoid cells, which are immunopositive for CD45, CD20, MUM-1, and BCL6, while negative for BCL2, EBV (LMP-1 and CISH), Cyclin D1 and confirmed the diagnosis of Burkitt's lymphoma. The patient received chemotherapy in the form of CODOX-M/IVAC (cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, high-dose cytarabine) regimen. Primary spinal intradural extramedullary Burkitt's lymphoma is a rare diagnosis that may often be difficult to differentiate radiologically from other causes of intradural extramedullary lesions. A thorough histological examination is warranted in such cases.
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4
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Wang W, Marín-Ramos NI, He H, Zeng S, Cho HY, Swenson SD, Zheng L, Epstein AL, Schönthal AH, Hofman FM, Chen L, Chen TC. NEO100 enables brain delivery of blood‒brain barrier impermeable therapeutics. Neuro Oncol 2021; 23:63-75. [PMID: 32877532 DOI: 10.1093/neuonc/noaa206] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Intracarotid injection of mannitol has been applied for decades to support brain entry of therapeutics that otherwise do not effectively cross the blood-brain barrier (BBB). However, the elaborate and high-risk nature of this procedure has kept its use restricted to well-equipped medical centers. We are developing a more straightforward approach to safely open the BBB, based on the intra-arterial (IA) injection of NEO100, a highly purified version of the natural monoterpene perillyl alcohol. METHODS In vitro barrier permeability with NEO100 was evaluated by transepithelial/transendothelial electrical resistance and antibody diffusion assays. Its mechanism of action was studied by western blot, microarray analysis, and electron microscopy. In mouse models, we performed ultrasound-guided intracardiac administration of NEO100, followed by intravenous application of Evan's blue, methotrexate, checkpoint-inhibitory antibodies, or chimeric antigen receptor (CAR) T cells. RESULTS NEO100 opened the BBB in a reversible and nontoxic fashion in vitro and in vivo. It enabled greatly increased brain entry of all tested therapeutics and was well tolerated by animals. Mechanistic studies revealed effects of NEO100 on different BBB transport pathways, along with translocation of tight junction proteins from the membrane to the cytoplasm in brain endothelial cells. CONCLUSION We envision that this procedure can be translated to patients in the form of transfemoral arterial catheterization and cannulation to the cerebral arteries, which represents a low-risk procedure commonly used in a variety of clinical settings. Combined with NEO100, it is expected to provide a safe, widely available approach to enhance brain entry of any therapeutic.
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Affiliation(s)
- Weijun Wang
- Department of Neurological Surgery, USC, Luzhou, China
| | | | - Haiping He
- Department of Neurological Surgery, USC, Luzhou, China.,Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Shan Zeng
- Department of Neurological Surgery, USC, Luzhou, China.,Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hee-Yeon Cho
- Department of Neurological Surgery, USC, Luzhou, China
| | | | - Long Zheng
- Department of Pathology, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | - Alan L Epstein
- Department of Pathology, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | - Axel H Schönthal
- Departments of Microbiology and Immunology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Florence M Hofman
- Department of Pathology, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | - Ligang Chen
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Thomas C Chen
- Department of Neurological Surgery, USC, Luzhou, China.,Departments of Microbiology and Immunology, Keck School of Medicine, USC, Los Angeles, California, USA
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Goitom Sereke S, Bongomin F, Muyinda Z. Primary Intradural Extramedullary Spinal Burkitt's Lymphoma: A Case Report. Int Med Case Rep J 2021; 13:701-705. [PMID: 33408533 PMCID: PMC7781032 DOI: 10.2147/imcrj.s291729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/15/2020] [Indexed: 12/22/2022] Open
Abstract
Background Non-Hodgkin's lymphoma (NHL) rarely involves the spine primarily, and if it does, is almost always associated with advanced disease. Case Presentation An 8-year-old male presented with a one month history of nuchal pain followed by stiffness and rapidly progressive upper and lower limb weakness. He was seronegative for HIV and EBV. Computed tomography myelogram and magnetic resonance imaging of the cervical and thoracic spine showed a long segment (C2 to T1) complete absence of cerebrospinal fluid signal and mildly enhancing intradural extramedullary lesion with an extradural and right paravertebral muscle extension, respectively. Post-excision biopsy histopathology and immunohistochemistry confirmed the diagnosis of a CD 10+, CD20+, CD45+, Bcl-2+, Ki67+, and EBER in situ hybridization for EBV negative, Burkitt's lymphoma (BL). Cytogenetic analysis showed chromosomal translocations of 8q24. CHOP plus intrathecal cytarabine, methotrexate was given as chemotherapy regimen. 1.8 grays (Gy) per fraction to the local area for an average total dose of 36 Gy was given with a resultant significant clinical improvement. Conclusion Though considered uncommon spinal canal tumors, BL should be in the differential diagnosis, if multilevel involvement is demonstrated on imaging.
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Affiliation(s)
- Senai Goitom Sereke
- Department of Radiology and Radiotherapy, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Felix Bongomin
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Zeridah Muyinda
- Department of Radiology, Mulago National Referral Hospital, Kampala, Uganda
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6
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Kim HO, Kim JS, Kim SO, Chae SY, Oh SJ, Seo M, Lee SH, Oh JS, Ryu JS, Huh JR, Kim JH. Clinicopathological characteristics of primary central nervous system lymphoma with low 18F-fludeoxyglucose uptake on brain positron emission tomography. Medicine (Baltimore) 2020; 99:e20140. [PMID: 32443328 PMCID: PMC7254841 DOI: 10.1097/md.0000000000020140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Primary central nervous system lymphoma (PCNSL) typically shows a strong uptake of F-fludeoxyglucose (FDG) imaged by positron emission tomography (PET). Uncommonly, PCNSL demonstrates a low uptake on FDG PET. We investigated the clinicopathological characteristics of the unusual cases of PCNSL with low FDG uptake.We retrospectively enrolled 104 consecutive patients with newly diagnosed PCNSL who underwent baseline brain FDG PET. The degree of FDG uptake of PCNSL was visually scored by 4 grades (0, ≤contralateral white matter; 1, >contralateral white matter and <contralateral gray matter; 2, = contralateral gray matter; 3, >contralateral gray matter). Grades 0-2 were considered as PCNSL with low uptake. We investigated association of low uptake of PCNSL with the following clinicopathological factors: age, sex, steroid treatment, lactate dehydrogenase level, cerebrospinal fluid protein level, condition of PET scanning, immunohistochemical markers (cluster of differentiation 10 [CD10], B-cell lymphoma 6 [BCL-6], B-cell lymphoma 2 [BCL-2], multiple myeloma oncogene 1 [MUM1], Epstein-Barr virus [EBV] protein, and Ki67), location of lesions, tumor size, multiplicity of lesions, involvement of deep brain structures, and cystic or necrotic appearance of lesions.Of the 104 patients with PCNSL, 14 patients (13.5%) showed PCNSL with low FDG uptake on PET. Among various clinicopathological factors, MUM1 negativity was the only factor associated with low FDG uptake PCNSL by univariate (P = .002) and multivariate analysis (P = .007).This study suggests that the different clinicopathological characteristics between patients with high uptake and low uptake of PCNSL on FDG PET is closely associated with lack of MUM1, a protein known to be a crucial regulator of B-cell development and tumorigenesis.
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Affiliation(s)
- Hye Ok Kim
- Department of Nuclear Medicine, College of Medicine, Ewha Womans University
| | | | - Seon-Ok Kim
- Department of Clinical Epidemiology and Biostatistics
| | | | | | - Minjung Seo
- Department of Nuclear Medicine, Ulsan University Hospital
| | - Suk Hyun Lee
- Division of Nuclear Medicine, Department of Radiology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine
| | | | | | | | - Jeong Hoon Kim
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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7
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Pal BP, Palosaari T, Kivelä T. MULTIMODAL IMAGING DURING THE EVOLUTION OF BLOOD-BRAIN BARRIER DISRUPTION MACULOPATHY. Retin Cases Brief Rep 2019; 13:67-71. [PMID: 28098709 DOI: 10.1097/icb.0000000000000535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE To highlight the course of blood-brain barrier disruption maculopathy in a patient with successfully managed relapsed central nervous system lymphoma. METHODS Case report with fundus autofluorescence and optical coherence tomography imaging, and literature review. RESULTS A 57-year-old patient diagnosed with central nervous system large B-cell lymphoma had a normal ophthalmic evaluation on his first visit. Subsequently, when his malignancy recurred locally, he was started on blood-brain barrier disruption therapy and intraarterial methotrexate. During the course of the therapy, he developed bilateral retinal pigment epithelial abnormalities located in the foveal and perifoveal zones. The changes were first mildly progressive and then marginally regressive in nature with minimal eventual loss of visual acuity to 20/32 and 20/25 in his right and left eye, respectively. CONCLUSION Maculopathy is a known complication in patients with central nervous system malignancies undergoing blood-brain barrier disruption. A detailed clinical evaluation using fundus autofluorescence and high-definition optical coherence tomography are informative in managing such patients.
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Affiliation(s)
- Bikramjit P Pal
- Ocular Oncology Service, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Tapani Palosaari
- Vitreoretinal Service, Department of Ophthalmology, Oulu University Hospital, Oulu, Finland
| | - Tero Kivelä
- Ocular Oncology Service, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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8
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Bairey O, Siegal T. The possible role of maintenance treatment for primary central nervous system lymphoma. Blood Rev 2018; 32:378-386. [PMID: 29551465 DOI: 10.1016/j.blre.2018.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 02/27/2018] [Accepted: 03/09/2018] [Indexed: 12/22/2022]
Abstract
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive brain tumor. The prognosis is poor, with high rates of relapse and disease progression after treatment. In addition, PCNSL affects a largely older population, so that a significant proportion of patients are ineligible for intensive therapies and high-dose chemotherapy. The elderly patients are also susceptible to the accelerated and detrimental cognitive side effects of whole-brain irradiation which is an alternative consolidation to high-dose chemotherapy. Maintenance therapy has been shown to be a promising strategy to prolong remission time in other hematopoietic malignancies. Herein, we discuss the place of maintenance treatment in PCNSL in view of perspective obtained from hematological malignancies and non-Hodgkin's lymphoma.
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Affiliation(s)
- Osnat Bairey
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Tali Siegal
- Neuro-Oncology Center, Davidoff Cancer Center, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.
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Abstract
Background. Primary spinal dural lymphomas (PSDL) are tumors with characteristic histopathology of a lymphoma, which are completely in the spinal epidural space without any other systemic involvement. Extranodal primary lymphoma involving nervous system prefers thalamus/basal ganglia, periventricular region, cerebellum, eyes, meninges/dura, and cranial nerves or spinal cord. Rare spinal localization with acute spinal cord compression is worth attention. Case Presentation. A 48-year-old male presented with a several-month-long history of upper back pain. Lately, he had numbness and weakness at both lower extremities and was unable to walk for one week. A spinal MRI showed a thoracic lesion with cord compression at T2-T4 levels. The patient underwent surgical decompression, with his final histopathology showing diffuse large B-cell lymphoma. Systemic work-up was negative for nodal disease. Following surgery, he received radiotherapy combined with chemotherapy. He experienced a good outcome after four years. Conclusion. The upper thoracic cord is a rare location for primary spinal lesions/metastases, both of which prefer the lower thoracic and upper lumbar regions. In cases of progressive paraparesis, there should be immediate surgical intervention in the case of denovo disease, followed by combined radiotherapy and chemotherapy procedures.
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Mohamed MS, Veeranarayanan S, Baliyan A, Poulose AC, Nagaoka Y, Minegishi H, Iwai S, Shimane Y, Yoshida Y, Maekawa T, Kumar DS. Structurally Distinct Hybrid Polymer/Lipid Nanoconstructs Harboring a Type-I Ribotoxin as Cellular Imaging and Glioblastoma-Directed Therapeutic Vectors. Macromol Biosci 2014; 14:1696-711. [DOI: 10.1002/mabi.201400248] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 07/26/2014] [Indexed: 11/06/2022]
Affiliation(s)
- M. Sheikh Mohamed
- Bio Nano Electronics Research Center; Graduate School of Interdisciplinary New Science Toyo University; Kawagoe Saitama 350-8585 Japan
| | - Srivani Veeranarayanan
- Bio Nano Electronics Research Center; Graduate School of Interdisciplinary New Science Toyo University; Kawagoe Saitama 350-8585 Japan
| | - Ankur Baliyan
- Bio Nano Electronics Research Center; Graduate School of Interdisciplinary New Science Toyo University; Kawagoe Saitama 350-8585 Japan
| | - Aby Cheruvathoor Poulose
- Bio Nano Electronics Research Center; Graduate School of Interdisciplinary New Science Toyo University; Kawagoe Saitama 350-8585 Japan
| | - Yutaka Nagaoka
- Bio Nano Electronics Research Center; Graduate School of Interdisciplinary New Science Toyo University; Kawagoe Saitama 350-8585 Japan
| | - Hiroaki Minegishi
- Bio Nano Electronics Research Center; Graduate School of Interdisciplinary New Science Toyo University; Kawagoe Saitama 350-8585 Japan
| | - Seiki Iwai
- Bio Nano Electronics Research Center; Graduate School of Interdisciplinary New Science Toyo University; Kawagoe Saitama 350-8585 Japan
| | - Yasuhiro Shimane
- Bio Nano Electronics Research Center; Graduate School of Interdisciplinary New Science Toyo University; Kawagoe Saitama 350-8585 Japan
| | - Yasuhiko Yoshida
- Bio Nano Electronics Research Center; Graduate School of Interdisciplinary New Science Toyo University; Kawagoe Saitama 350-8585 Japan
| | - Toru Maekawa
- Bio Nano Electronics Research Center; Graduate School of Interdisciplinary New Science Toyo University; Kawagoe Saitama 350-8585 Japan
| | - D. Sakthi Kumar
- Bio Nano Electronics Research Center; Graduate School of Interdisciplinary New Science Toyo University; Kawagoe Saitama 350-8585 Japan
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11
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1H-MRS is useful to reinforce the suspicion of primary central nervous system lymphoma prior to surgery. Eur Radiol 2014; 24:2895-905. [DOI: 10.1007/s00330-014-3308-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 06/04/2014] [Accepted: 07/02/2014] [Indexed: 10/25/2022]
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12
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Type 1 ribotoxin-curcin conjugated biogenic gold nanoparticles for a multimodal therapeutic approach towards brain cancer. Biochim Biophys Acta Gen Subj 2014; 1840:1657-69. [DOI: 10.1016/j.bbagen.2013.12.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 10/31/2013] [Accepted: 12/16/2013] [Indexed: 01/02/2023]
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13
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The combination of 13N-ammonia and 18F-FDG in predicting primary central nervous system lymphomas in immunocompetent patients. Clin Nucl Med 2013; 38:98-102. [PMID: 23334122 DOI: 10.1097/rlu.0b013e318279b6cc] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Accurate identification of primary central nervous system lymphoma (PCNSL) and its differentiation from other brain tumors remain difficult but are essential for treatment. In this study, we investigated whether (13)N-ammonia combined with (18)F-FDG could distinguish PCNSL from solid gliomas effectively. METHODS Ten consecutive patients with final diagnosis of PCNSL (5 female and 5 male patients; mean [SD] age, 59.10 [12.47] years; range, 43-74 years) and another fifteen consecutive patients with solid glioma lesions (5 female and 10 male patients; mean [SD] age, 46.73 [19.61] years; range, 14-72 years) were included in this study. PET/CT imaging was performed for all of them with both (18)F-FDG and (13)N-ammonia as tracers. Tumor-to-gray matter (T/G) ratios were calculated for the evaluation of tumor uptake. Both Student t test and discriminant analysis were recruited to assess the differential efficacy of these 2 tracers. RESULTS The T/G ratios of (18)F-FDG in PCNSL lesions were higher than in solid gliomas (3.26 [1.18] vs 1.56 [0.41], P < 0.001), whereas the T/G ratios of (13)N-ammonia in PCNSL lesions were lower than in solid gliomas significantly (1.38 [0.20] vs 2.11 [0.69], P < 0.001). All the lesions of PCNSL displayed higher T/G ratios of (18)F-FDG than (13)N-ammonia, whereas 14 (77.8%) of 18 glioma lesions showed contrary results. Tumor classification by means of canonical discriminant analysis yielded an overall accuracy of 96.9%, and only one glioma lesion was misclassified into the PCNSL group. CONCLUSIONS PCNSLs and solid gliomas have different metabolic profiles on N-ammonia and F-FDG imaging. The combination of these 2 tracers can distinguish these 2 clinical entities effectively and make an accurate prediction of PCNSL.
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