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Zhong J, Huang V, Gurbani SS, Ramesh K, Scott Cordova J, Schreibmann E, Shu HKG, Olson J, Han H, Giuffrida A, Shim H, Weinberg BD. 3D whole-brain metabolite imaging to improve characterization of low-to-intermediate grade gliomas. J Neurooncol 2021; 153:303-311. [PMID: 33983570 PMCID: PMC8237861 DOI: 10.1007/s11060-021-03770-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/03/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE MRI is the standard imaging modality used for diagnosis, treatment planning, and post-treatment management of gliomas. Contrast-enhanced T1-weighted (CE-T1w) MRI is used to plan biopsy and radiation for grade IV gliomas but is less effective for grade II and III gliomas (i.e., low-to-intermediate grade gliomas) which may have minimal or no enhancement. Magnetic resonance spectroscopic imaging (MRSI) is an advanced MRI technique that has been shown, to improve diagnostic yield of biopsy and target delineation for grade IV glioma. The purpose of this study is to determine if MRSI can improve characterization and tissue sampling of low-to-intermediate grade gliomas. METHODS Prospective grade II and grade III glioma patients were enrolled to undergo whole brain high-resolution MRSI prior to tissue sampling. Choline/N-acetyl-aspartate (Cho/NAA) maps were overlaid on anatomic imaging and imported into stereotactic biopsy software. Patients were treated with standard-of-care surgery and radiation. Volumes of spectroscopically abnormal tissue were generated and compared with anatomic imaging and areas of enhancing recurrence on follow-up imaging. RESULTS Ten patients had pathologic diagnosis of grade II (n = 4) or grade III (n = 6) with a median follow-up of 27.3 months. Five patients had recurrence, and regions of recurrence were found to overlap with metabolically abnormal regions on MRSI at the time of diagnosis. CONCLUSION MRSI in low-to-intermediate grade glioma patients is predictive of areas of subsequent recurrence. Larger studies are needed to determine if MRSI can be used to guide surgical and radiation treatment planning in these patients.
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Affiliation(s)
- Jim Zhong
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Emory University School of Medicine, 1701 Uppergate Drive, C5018, Atlanta, GA, 30322, USA
| | - Vicki Huang
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Emory University School of Medicine, 1701 Uppergate Drive, C5018, Atlanta, GA, 30322, USA
| | - Saumya S Gurbani
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Emory University School of Medicine, 1701 Uppergate Drive, C5018, Atlanta, GA, 30322, USA
| | - Karthik Ramesh
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Emory University School of Medicine, 1701 Uppergate Drive, C5018, Atlanta, GA, 30322, USA
| | - J Scott Cordova
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Emory University School of Medicine, 1701 Uppergate Drive, C5018, Atlanta, GA, 30322, USA
| | - Eduard Schreibmann
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Emory University School of Medicine, 1701 Uppergate Drive, C5018, Atlanta, GA, 30322, USA
| | - Hui-Kuo G Shu
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Emory University School of Medicine, 1701 Uppergate Drive, C5018, Atlanta, GA, 30322, USA
| | - Jeffrey Olson
- Department of Neurosurgery, Winship Cancer Institute of Emory University, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Hui Han
- Biomedical Sciences and Biomedical Imaging Research Institute, Cedars Sinai, Los Angeles, CA, 90048, USA
| | - Alexander Giuffrida
- Department of Biomedical Engineering, Winship Cancer Institute of Emory University, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Hyunsuk Shim
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Emory University School of Medicine, 1701 Uppergate Drive, C5018, Atlanta, GA, 30322, USA.
| | - Brent D Weinberg
- Department of Radiology and Imaging Sciences, Winship Cancer Institute of Emory University, Emory University School of Medicine, 1701 Uppergate Drive, C5018, Atlanta, GA, 30322, USA.
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Quitt PR, Brühschwein A, Matiasek K, Wielaender F, Karkamo V, Hytönen MK, Meyer-Lindenberg A, Dengler B, Leeb T, Lohi H, Fischer A. A hypomyelinating leukodystrophy in German Shepherd dogs. J Vet Intern Med 2021; 35:1455-1465. [PMID: 33734486 PMCID: PMC8163122 DOI: 10.1111/jvim.16085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/07/2021] [Accepted: 02/17/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Shaking puppy syndrome is commonly attributed to abnormal myelination of the central nervous system. HYPOTHESIS/OBJECTIVES To report the long-term clinical course and the imaging characteristics of hypomyelinating leukodystrophy in German Shepherd dogs. ANIMALS AND METHODS Three related litters with 11 affected dogs. RESULTS The 11 affected dogs experienced coarse, side-to-side tremors of the head and trunk, which interfered with normal goal-oriented movements and disappeared at rest. Signs were noticed shortly after birth. Nine dogs were euthanized, 3 dogs underwent pathological examination, and 2 littermates were raised by their breeder. Tremors improved gradually until 6 to 7 months of age. Adult dogs walked with severe residual pelvic limb ataxia. One dog developed epilepsy with tonic-clonic seizures at 15 months of age. Conventional magnetic resonance imaging (MRI) disclosed homogenous hyperintense signal of the entire subcortical white matter in 3 affected 7-week-old dogs and a hypointense signal in a presumably unaffected littermate. Subcortical white matter appeared isointense to gray matter at 15 and 27 weeks of age on repeated MRI. Abnormal white matter signal with failure to display normal gray-white matter contrast persisted into adulthood. Cerebellar arbor vitae was not visible at any time point. Clinical signs, MRI findings, and pathological examinations were indicative of a hypomyelinating leukodystrophy. All parents of the affected litters shared a common ancestor and relatedness of the puppies suggested an autosomal recessive mode of inheritance. CONCLUSION We describe a novel hypomyelinating leukodystrophy in German Shepherd dogs with a suspected inherited origin.
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Affiliation(s)
- Pia R Quitt
- Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany
| | - Andreas Brühschwein
- Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany
| | - Kaspar Matiasek
- Section of Clinical and Comparative Pathology, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany
| | - Franziska Wielaender
- Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany
| | - Veera Karkamo
- Production and Companion Animal Pathology Section, Finnish Food Authority, Helsinki, Finland
| | - Marjo K Hytönen
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland.,Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Andrea Meyer-Lindenberg
- Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany
| | - Berett Dengler
- Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany
| | - Tosso Leeb
- Institute of Genetics, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Hannes Lohi
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland.,Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Andrea Fischer
- Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany
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Jang M, Hwang J, Nam J, Kim D, Son W, Lee I, Choi M, Yoon J. Proper fraction of inspired oxygen for reduction of oxygen-induced canine cerebrospinal fluid hyperintensity on fluid attenuation inversion recovery sequence using low-field magnetic resonance imaging. J Vet Med Sci 2020; 82:1321-1328. [PMID: 32684615 PMCID: PMC7538315 DOI: 10.1292/jvms.20-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Oxygen-induced cerebrospinal fluid (CSF) hyperintensity artifact is inevitable in fluid attenuation inversion recovery (FLAIR) magnetic resonance (MR) images
of anesthetized animals. This experimental study aimed to confirm the occurrence of this artifact on low-field magnetic resonance imaging (MRI), and to
determine the fraction of inspired oxygen (FiO2) that is safe and does not induce this artifact in canine brain MRI. Six healthy dogs underwent brain
FLAIR MR scans under general anesthesia with 21%, 30%, 50%, 70%, and 100% FiO2. The signal intensity (SI) ratio was calculated as the SI of CSF
spaces divided by that of normalizing regions. The SI ratios of 21% FiO2 images were significantly different from those of 100% FiO2
images, indicating the presence of artifacts on 100% FiO2 images. The SI ratios of 30% FiO2 images were not significantly different from
those of 21% FiO2 images for any of CSF spaces. However, they were significantly different from those of 100% FiO2 images in the cerebral
sulci, third ventricle, interpeduncular cistern, mesencephalic aqueduct, and subarachnoid space at the level of the first cervical vertebra
(P<0.05). All dogs had normal partial pressure of arterial oxygen (PaO2) during inhalation of 30% FiO2, while two dogs
had low PaO2 during inhalation of 21% FiO2. Our findings support the hypothesis that high FiO2 induces CSF hyperintensity
artifact on low-field FLAIR MR images in dogs. FiO2 of 30% is appropriate for obtaining brain FLAIR MR images with fewer artifacts in dogs.
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Affiliation(s)
- Moonjung Jang
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Jaewoo Hwang
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Jihye Nam
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Dalhae Kim
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Wongyun Son
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Inhyung Lee
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Mincheol Choi
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Junghee Yoon
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea
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