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Kalasauskas D, Kosterhon M, Keric N, Korczynski O, Kronfeld A, Ringel F, Othman A, Brockmann MA. Beyond Glioma: The Utility of Radiomic Analysis for Non-Glial Intracranial Tumors. Cancers (Basel) 2022; 14:cancers14030836. [PMID: 35159103 PMCID: PMC8834271 DOI: 10.3390/cancers14030836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/30/2022] [Accepted: 02/04/2022] [Indexed: 02/05/2023] Open
Abstract
Simple Summary Tumor qualities, such as growth rate, firmness, and intrusion into healthy tissue, can be very important for operation planning and further treatment. Radiomics is a promising new method that allows the determination of some of these qualities on images performed before surgery. In this article, we provide a review of the use of radiomics in various tumors of the central nervous system, such as metastases, lymphoma, meningioma, medulloblastoma, and pituitary tumors. Abstract The field of radiomics is rapidly expanding and gaining a valuable role in neuro-oncology. The possibilities related to the use of radiomic analysis, such as distinguishing types of malignancies, predicting tumor grade, determining the presence of particular molecular markers, consistency, therapy response, and prognosis, can considerably influence decision-making in medicine in the near future. Even though the main focus of radiomic analyses has been on glial CNS tumors, studies on other intracranial tumors have shown encouraging results. Therefore, as the main focus of this review, we performed an analysis of publications on PubMed and Web of Science databases, focusing on radiomics in CNS metastases, lymphoma, meningioma, medulloblastoma, and pituitary tumors.
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Affiliation(s)
- Darius Kalasauskas
- Department of Neurosurgery, University Medical Centre, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (D.K.); (M.K.); (N.K.); (F.R.)
| | - Michael Kosterhon
- Department of Neurosurgery, University Medical Centre, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (D.K.); (M.K.); (N.K.); (F.R.)
| | - Naureen Keric
- Department of Neurosurgery, University Medical Centre, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (D.K.); (M.K.); (N.K.); (F.R.)
| | - Oliver Korczynski
- Department of Neuroradiology, University Medical Centre, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (O.K.); (A.K.); (A.O.)
| | - Andrea Kronfeld
- Department of Neuroradiology, University Medical Centre, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (O.K.); (A.K.); (A.O.)
| | - Florian Ringel
- Department of Neurosurgery, University Medical Centre, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (D.K.); (M.K.); (N.K.); (F.R.)
| | - Ahmed Othman
- Department of Neuroradiology, University Medical Centre, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (O.K.); (A.K.); (A.O.)
| | - Marc A. Brockmann
- Department of Neuroradiology, University Medical Centre, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (O.K.); (A.K.); (A.O.)
- Correspondence:
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Neurosarcoïdose ou lymphome cérébral, un diagnostic difficile. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Bathla G, Freeman CW, Moritani T, Song JW, Srivastava S, Soni N, Derdeyn C, Mohan S. Retrospective, dual-centre review of imaging findings in neurosarcoidosis at presentation: prevalence and imaging sub-types. Clin Radiol 2020; 75:796.e1-796.e9. [PMID: 32703543 DOI: 10.1016/j.crad.2020.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 05/06/2020] [Indexed: 01/07/2023]
Abstract
AIM To assess the prevalence of various imaging manifestations in neurosarcoidosis (NS) patients at presentation and to explore if specific imaging findings may cluster in different sub-groups. MATERIALS AND METHODS A retrospective, dual-institution, systematic imaging review was undertaken of the magnetic resonance imaging (MRI) findings in 100 consecutive NS patients who presented over a 15-year period. Clustering analysis (k-mode) was performed to evaluate co-occurrence of imaging findings. RESULTS Non-enhancing white matter (NEWM) lesions were the most common imaging abnormality (56%), followed by leptomeningeal (47%) and pachymeningeal (32%) involvement. Other common manifestations included cranial nerve involvement (30%), parenchymal granulomas (27%), hypothalamic-pituitary-adrenal axis involvement (26%), and hydrocephalus (14%). Additionally, a higher prevalence of perivascular enhancement (23%), cerebrovascular events (including ischaemic and haemorrhagic events; 17%), and ependymal involvement (20%) were noted than recognised previously. Additional k-mode analysis was performed to explore underlying disease sub-clusters. This was evaluated for clusters varying between two though five (k=2-5). For k=4, the analysis revealed that the imaging findings may possibly be divided into disease sub-sets of four groups, each with varying distribution of imaging manifestations and clinical manifestations. CONCLUSION Overall, NEWM lesions and meningeal involvement are the most common imaging manifestations of NS. The prevalence of perivascular enhancement, cerebrovascular events, and ependymal involvement is likely higher than reported previously. Additionally, different imaging findings in NS may cluster together and imaging subtypes in NS possibly exist.
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Affiliation(s)
- G Bathla
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
| | - C W Freeman
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - T Moritani
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - J W Song
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - S Srivastava
- Department of Statistics and Actuarial Science, University of Iowa, Iowa, USA
| | - N Soni
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - C Derdeyn
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - S Mohan
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, PA, USA
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Sarioglu O, Sarioglu FC, Akdogan AI, Kucuk U, Arslan IB, Cukurova I, Pekcevik Y. MRI-based texture analysis to differentiate the most common parotid tumours. Clin Radiol 2020; 75:877.e15-877.e23. [PMID: 32703544 DOI: 10.1016/j.crad.2020.06.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/04/2020] [Indexed: 01/23/2023]
Abstract
AIM To evaluate magnetic resonance imaging (MRI) features and signal characteristics of parotid masses and investigate the added role of texture analysis (TA) in the differentiation of parotid tumours. MATERIALS AND METHODS Ninety-five patients (42 women, 53 men; mean age 51.67±14.15) were included in this study. The study group consisted of 40 pleomorphic adenoma, 45 Warthin's tumour, and 10 mucoepidermoid carcinomas. Two reviewers assessed the MRI sequences retrospectively. Fat-suppressed T2-weighted and contrast-enhanced T1-weighted axial images were used for TA. Receiver operating characteristic curve analyses were performed to evaluate the ability to make a diagnosis. Logistic regression analyses were conducted to explore the independent risk factors among the MRI features and to analyse the added value of TA to the qualitative analysis. RESULTS Significant differences were found in the tumour border (p<0.001), infiltration of the surrounding tissue (p=0.003), contrast-enhancement grading (p<0.001), perineural spread (p=0.013), and pathological lymph nodes (p<0.001) between the malignant and benign tumours. Kurtosis on contrast-enhanced T1-weighted images, and skewness and kurtosis on T2-weighted images were significantly different between the three groups (p=0.020, <0.001, 0.003; respectively). A kurtosis value on T2-weighted images <2.815 along with an ill-defined border had the highest specificity (98.8%) and positive predictive value (83.3%) in the differentiation of malignant tumours. CONCLUSION The addition of TA parameters to the MRI findings may contribute to distinguish benign from malignant parotid tumours.
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Affiliation(s)
- O Sarioglu
- Department of Radiology, Health Sciences University, Tepecik Educational and Research Hospital, Izmir, Turkey.
| | - F C Sarioglu
- Department of Radiology, Dokuz Eylul University, School of Medicine, Izmir, Turkey.
| | - A I Akdogan
- Department of Radiology, Health Sciences University, Tepecik Educational and Research Hospital, Izmir, Turkey
| | - U Kucuk
- Department of Pathology, Health Sciences University, Tepecik Educational and Research Hospital, Izmir, Turkey
| | - I B Arslan
- Department of Otorhinolaryngology, Health Sciences University, Tepecik Educational and Research Hospital, Izmir, Turkey
| | - I Cukurova
- Department of Otorhinolaryngology, Health Sciences University, Tepecik Educational and Research Hospital, Izmir, Turkey
| | - Y Pekcevik
- Department of Radiology, Health Sciences University, Tepecik Educational and Research Hospital, Izmir, Turkey
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Current status and quality of radiomics studies in lymphoma: a systematic review. Eur Radiol 2020; 30:6228-6240. [PMID: 32472274 DOI: 10.1007/s00330-020-06927-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/25/2020] [Accepted: 04/28/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To perform a systematic review regarding the developments in the field of radiomics in lymphoma. To evaluate the quality of included articles by the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2), the phases classification criteria for image mining studies, and the radiomics quality scoring (RQS) tool. METHODS We searched for eligible articles in the MEDLINE/PubMed and EMBASE databases using the terms "radiomics", "texture" and "lymphoma". The included studies were divided into two categories: diagnosis-, therapy response- and outcome-related studies. The diagnosis-related studies were evaluated using the QUADAS-2; all studies were evaluated using the phases classification criteria for image mining studies and the RQS tool by two reviewers. RESULTS Forty-five studies were included; thirteen papers (28.9%) focused on the differential diagnosis of primary central nervous system lymphoma (PCNSL) and glioblastoma (GBM). Thirty-two (71.1%) studies were classified as discovery science according to the phase classification criteria for image mining studies. The mean RQS score of all studies was 14.2% (ranging from 0.0 to 40.3%), and 23 studies (51.1%) were given a score of < 10%. CONCLUSION The radiomics features could serve as diagnostic and prognostic indicators in lymphoma. However, the current conclusions should be interpreted with caution due to the suboptimal quality of the studies. In order to introduce radiomics into lymphoma clinical settings, the lesion segmentation and selection, the influence of the pathological pattern and the extraction of multiple modalities and multiple time points features need to be further studied. KEY POINTS • The radiomics approach may provide useful information for diagnosis, prediction of the therapy response, and outcome of lymphoma. • The quality of published radiomics studies in lymphoma has been suboptimal to date. • More studies are needed to examine lesion selection and segmentation, the influence of pathological patterns, and the extraction of multiple modalities and multiple time point features.
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Nepal P, Batchala PP, Rehm PK, Fadul CE. Diffuse large B-cell lymphoma relapse presenting as extensive neurolymphomatosis. Neuroradiol J 2020; 33:230-235. [PMID: 32401669 DOI: 10.1177/1971400920924799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 56-year-old woman with a history of diffuse large B-cell non-Hodgkin lymphoma (DLBCL-NHL) in remission for two years presented with weight loss and multifocal sensory/motor symptoms. Magnetic resonance imaging (MRI) of the neuraxis and whole-body FDG PET/CT led to a diagnosis of secondary neurolymphomatosis (NL). MRI demonstrated extensive thickening and enhancement of multiple cranial nerves and peripheral nerve plexuses with corresponding elevated metabolism on FDG PET/CT. Treatment with chemotherapy resulted in complete response on FDG PET/CT and subsequently she underwent autologous stem cell transplantation. NL is a rare manifestation of lymphoma affecting the peripheral nervous system. Nonspecific neuropathic symptoms make clinical diagnosis difficult. Though nerve biopsy is considered the gold standard, MRI and FDG PET/CT are accepted alternatives for making the diagnosis. We review imaging findings in NL, describe the differential diagnosis, and discuss the limitations of the imaging modalities.
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Affiliation(s)
- Pankaj Nepal
- Department of Radiology and Medical Imaging, St. Vincent's Medical Center, Bridgeport, CT, USA
| | - Prem P Batchala
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA
| | - Patrice K Rehm
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA
| | - Camilo E Fadul
- Division of Neuro-oncology, Department of Neurology, University of Virginia Health System, Charlottesville, VA, USA
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Otto C, Wengert O, Unterwalder N, Meisel C, Ruprecht K. Analysis of soluble interleukin-2 receptor as CSF biomarker for neurosarcoidosis. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:7/4/e725. [PMID: 32393650 PMCID: PMC7238895 DOI: 10.1212/nxi.0000000000000725] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/26/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To systematically analyze soluble interleukin-2 receptor (sIL-2R) in CSF as a diagnostic and disease activity biomarker in patients with sarcoidosis involving the CNS (neurosarcoidosis). METHODS sIL-2R was determined by chemiluminescent immunoassays in CSF/serum samples from patients with neurosarcoidosis (n = 23), MS (n = 19), neurotuberculosis (n = 8), viral (n = 18) and bacterial (n = 9) meningitis, cerebral lymphoma (n = 15), Guillain-Barré syndrome (n = 8), and 115 patients with noninflammatory neurologic diseases (NINDs) as controls. The sIL-2R index was calculated by dividing the CSF/serum sIL-2R quotient (QsIL-2R) through the CSF/serum albumin quotient (QAlb). sIL-2R quotient diagrams were established by plotting QsIL-2R against QAlb. sIL-2R levels were correlated with clinical, MRI, and CSF disease activity markers of neurosarcoidosis. RESULTS Patients with neurosarcoidosis had higher CSF sIL-2R, QsIL-2R, and sIL-2R index values than patients with NINDs (p < 0.0001 for all pairwise group comparisons). sIL-2R quotient diagrams demonstrated an intrathecal sIL-2R synthesis in >50% of neurosarcoidosis samples. Similar findings were observed in viral/bacterial meningitis, CNS lymphoma, and, most pronounced, in neurotuberculosis, but not in patients with MS. CSF sIL-2R parameters were associated with clinical disease activity, leptomeningeal gadolinium enhancement, and the CSF white cell count in patients with neurosarcoidosis. CONCLUSIONS CSF sIL-2R parameters are elevated in patients with neurosarcoidosis, but this finding is not specific for neurosarcoidosis. Nevertheless, CSF sIL-2R parameters may help distinguishing neurosarcoidosis from MS and are associated with clinical, radiologic, and CSF disease activity markers of neurosarcoidosis. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that CSF sIL-2R parameters distinguish neurosarcoidosis from NINDs and MS.
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Affiliation(s)
- Carolin Otto
- From the Department of Neurology (C.O., O.W., K.R.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Labor Berlin Charité-Vivantes GmbH (N.U., C.M.); and Institute for Medical Immunology (C.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - Oliver Wengert
- From the Department of Neurology (C.O., O.W., K.R.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Labor Berlin Charité-Vivantes GmbH (N.U., C.M.); and Institute for Medical Immunology (C.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nadine Unterwalder
- From the Department of Neurology (C.O., O.W., K.R.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Labor Berlin Charité-Vivantes GmbH (N.U., C.M.); and Institute for Medical Immunology (C.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christian Meisel
- From the Department of Neurology (C.O., O.W., K.R.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Labor Berlin Charité-Vivantes GmbH (N.U., C.M.); and Institute for Medical Immunology (C.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Klemens Ruprecht
- From the Department of Neurology (C.O., O.W., K.R.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Labor Berlin Charité-Vivantes GmbH (N.U., C.M.); and Institute for Medical Immunology (C.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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Szychot E, Youssef A, Ganeshan B, Endozo R, Hyare H, Gains J, Mankad K, Shankar A. Predicting outcome in childhood diffuse midline gliomas using magnetic resonance imaging based texture analysis. J Neuroradiol 2020; 48:243-247. [PMID: 32184119 DOI: 10.1016/j.neurad.2020.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 02/23/2020] [Accepted: 02/27/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Diffuse midline gliomas (DMG) are aggressive brain tumours, previously known as diffuse intrinsic pontine gliomas (DIPG), with 10% overall survival (OS) at 18 months. Predicting OS will help refine treatment strategy in this patient group. MRI based texture analysis (MRTA) is novel image analysis technique that provides objective information about spatial arrangement of MRI signal intensity (heterogeneity) and has potential to be imaging biomarker. OBJECTIVES To investigate MRTA in predicting OS in childhood DMG. METHODS Retrospective study of patients diagnosed with DMG, based on radiological features, treated at our institution 2007-2017. MRIs were acquired at diagnosis and 6 weeks after radiotherapy (54Gy in 30 fractions). MRTA was performed using commercial available TexRAD research software on T2W sequence and Apparent Diffusion Coefficient (ADC) maps encapsulating tumour in the largest single axial plane. MRTA comprised filtration-histogram technique using statistical and histogram metrics for quantification of texture. Kaplan-Meier survival analysis determined association of MRI texture parameters with OS. RESULTS In all, 32 children 2-14 years (median 7 years) were included. MRTA was undertaken on T2W (n=32) and ADC (n=22). T2W-MRTA parameters were better at prognosticating than ADC-MRTA. Children with homogenous tumour texture, at medium scale on diagnostic T2W MRI, had worse prognosis (Mean of Positive Pixels (MPP): P=0.005, mean: P=0.009, SD: P=0.011, kurtosis: P=0.037, entropy: P=0.042). Best predictor MPP was able to stratify patients into poor and good prognostic groups with median survival of 7.5 months versus 17.5 months, respectively. CONCLUSIONS DMG with more homogeneous texture on diagnostic MRI is associated with worse prognosis. Texture parameter MPP is the most predictive marker of OS in childhood DMG.
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Affiliation(s)
- Elwira Szychot
- The Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, UK.
| | - Adam Youssef
- Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.
| | - Balaji Ganeshan
- University College London Hospital, 235 Euston Road, Bloomsbury, London NW1 2BU, UK
| | - Raymond Endozo
- University College London Hospital, 235 Euston Road, Bloomsbury, London NW1 2BU, UK.
| | - Harpreet Hyare
- University College London Hospital, 235 Euston Road, Bloomsbury, London NW1 2BU, UK.
| | - Jenny Gains
- University College London Hospital, 235 Euston Road, Bloomsbury, London NW1 2BU, UK.
| | - Kshitij Mankad
- Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.
| | - Ananth Shankar
- University College London Hospital, 235 Euston Road, Bloomsbury, London NW1 2BU, UK.
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