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Thomas-Joulié A, Tran S, El Houari L, Seyve A, Bielle F, Birzu C, Lozano-Sanchez F, Mokhtari K, Giry M, Marie Y, Laigle-Donadey F, Dehais C, Houillier C, Psimaras D, Alentorn A, Laurenge A, Touat M, Sanson M, Hoang-Xuan K, Kas A, Rozenblum L, Habert MO, Nichelli L, Leclercq D, Galanaud D, Jacob J, Karachi C, Capelle L, Carpentier A, Mathon B, Belin L, Idbaih A. Prognosis of glioblastoma patients improves significantly over time interrogating historical controls. Eur J Cancer 2024; 202:114004. [PMID: 38493668 DOI: 10.1016/j.ejca.2024.114004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Glioblastoma (GBM) is the most common devastating primary brain cancer in adults. In our clinical practice, median overall survival (mOS) of GBM patients seems increasing over time. METHODS To address this observation, we have retrospectively analyzed the prognosis of 722 newly diagnosed GBM patients, aged below 70, in good clinical conditions (i.e. Karnofsky Performance Status -KPS- above 70%) and treated in our department according to the standard of care (SOC) between 2005 and 2018. Patients were divided into two groups according to the year of diagnosis (group 1: from 2005 to 2012; group 2: from 2013 to 2018). RESULTS Characteristics of patients and tumors of both groups were very similar regarding confounding factors (age, KPS, MGMT promoter methylation status and treatments). Follow-up time was fixed at 24 months to ensure comparable survival times between both groups. Group 1 patients had a mOS of 19 months ([17.3-21.3]) while mOS of group 2 patients was not reached. The recent period of diagnosis was significantly associated with a longer mOS in univariate analysis (HR=0.64, 95% CI [0.51 - 0.81]), p < 0.001). Multivariate Cox analysis showed that the period of diagnosis remained significantly prognostic after adjustment on confounding factors (adjusted Hazard Ratio (aHR) 0.49, 95% CI [0.36-0.67], p < 0.001). CONCLUSION This increase of mOS over time in newly diagnosed GBM patients could be explained by better management of potentially associated non-neurological diseases, optimization of validated SOC, better management of treatments side effects, supportive care and participation in clinical trials.
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Affiliation(s)
- A Thomas-Joulié
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France; AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service d'Oncologie-Radiothérapie, F-75013 Paris, France
| | - S Tran
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuropathologie-Escourolle, F-75013 Paris, France
| | - L El Houari
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Unité de Recherche Clinique, F-75013 Paris, France
| | - A Seyve
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - F Bielle
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuropathologie-Escourolle, F-75013 Paris, France
| | - C Birzu
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - F Lozano-Sanchez
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - K Mokhtari
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuropathologie-Escourolle, F-75013 Paris, France
| | - M Giry
- Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, F-75013 Paris, France
| | - Y Marie
- Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, F-75013 Paris, France
| | - F Laigle-Donadey
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - C Dehais
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - C Houillier
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - D Psimaras
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - A Alentorn
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - A Laurenge
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - M Touat
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - M Sanson
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - K Hoang-Xuan
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France
| | - A Kas
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Médecine Nucléaire, F-75013 Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, 75006 Paris, France
| | - L Rozenblum
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Médecine Nucléaire, F-75013 Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, 75006 Paris, France
| | - M-O Habert
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Médecine Nucléaire, F-75013 Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, CNRS, INSERM, 75006 Paris, France
| | - L Nichelli
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuroradiologie, F-75013 Paris, France
| | - D Leclercq
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuroradiologie, F-75013 Paris, France
| | - D Galanaud
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuroradiologie, F-75013 Paris, France
| | - J Jacob
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service d'Oncologie-Radiothérapie, F-75013 Paris, France
| | - C Karachi
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - L Capelle
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - A Carpentier
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - B Mathon
- Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, F-75013 Paris, France
| | - L Belin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Département de Santé Publique, Unité de Recherche Clinique Pitié-Salpêtrière-Charles Foix, Paris, France
| | - A Idbaih
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie-Oncologie, F-75013 Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Département de Santé Publique, Unité de Recherche Clinique Pitié-Salpêtrière-Charles Foix, Paris, France.
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Fan B, Abou-Alfa GK, Zhu AX, Pandya SS, Jia H, Yin F, Gliser C, Hua Z, Hossain M, Yang H. Pharmacokinetics/pharmacodynamics of ivosidenib in advanced IDH1-mutant cholangiocarcinoma: findings from the phase III ClarIDHy study. Cancer Chemother Pharmacol 2024; 93:471-479. [PMID: 38278871 PMCID: PMC11043204 DOI: 10.1007/s00280-023-04633-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/18/2023] [Indexed: 01/28/2024]
Abstract
PURPOSE Report pharmacokinetic (PK)/pharmacodynamic (PD) findings from the phase III ClarIDHy study and any association between PK/PD parameters and treatment outcomes in this population. METHODS Patients with mutant isocitrate dehydrogenase 1 (mIDH1) advanced cholangiocarcinoma were randomized at a 2:1 ratio to receive ivosidenib or matched placebo. Crossover from placebo to ivosidenib was permitted at radiographic disease progression. Blood samples for PK/PD analyses, a secondary endpoint, were collected pre-dose and up to 4 h post-dose on day (D) 1 of cycles (C) 1 - 2, pre-dose and 2 h post-dose on D15 of C1 - 2, and pre-dose on D1 from C3 onwards. Plasma ivosidenib and D-2-hydroxyglutarate (2-HG) were measured using liquid chromatography-tandem mass spectrometry. All clinical responses were centrally reviewed previously. RESULTS PK/PD analysis was available for samples from 156 ivosidenib-treated patients. Ivosidenib was absorbed rapidly following single and multiple oral doses (time of maximum observed plasma concentration [Tmax] of 2.63 and 2.07 h, respectively). Ivosidenib exposure was higher at C2D1 than after a single dose, with low accumulation. In ivosidenib-treated patients, mean plasma 2-HG concentration was reduced from 1108 ng/mL at baseline to 97.7 ng/mL at C2D1, close to levels previously observed in healthy individuals. An average 2-HG inhibition of 75.0% was observed at steady state. No plasma 2-HG decreases were seen with placebo. Plasma 2-HG reductions were observed in ivosidenib-treated patients irrespective of best overall response (progressive disease, or partial response and stable disease). CONCLUSION Once-daily ivosidenib 500 mg has a favorable PK/PD profile, attesting the 2-HG reduction mechanism of action and, thus, positive outcomes in treated patients with advanced mIDH1 cholangiocarcinoma. CLINICAL TRIAL REGISTRATION NCT02989857 Registered February 20, 2017.
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Affiliation(s)
- Bin Fan
- Agios Pharmaceuticals Inc., Cambridge, MA, USA
- Jacobio (US) Pharmaceuticals, Inc., Lexington, MA, USA
| | - Ghassan K Abou-Alfa
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine - Cornell University, New York, NY, USA
- Trinity College Dublin School of Medicine, Dublin, Ireland
| | - Andrew X Zhu
- Massachusetts General Cancer Center, Harvard Medical School, Boston, MA, USA
- I-Mab Biophrma, 555 W Haiyang Road New Bund Ctr Fl 55-56, Shanghai, China
| | - Shuchi S Pandya
- Agios Pharmaceuticals Inc., Cambridge, MA, USA
- Servier Pharmaceuticals LLC, 200 Pier Four Boulevard, Boston, MA, 02210, USA
| | - Hongxia Jia
- Agios Pharmaceuticals Inc., Cambridge, MA, USA
- Takeda Pharmaceutical Company Limited, Cambridge, MA, USA
| | - Feng Yin
- Agios Pharmaceuticals Inc., Cambridge, MA, USA
- Pyxis Oncology, Boston, MA, USA
| | - Camelia Gliser
- Agios Pharmaceuticals Inc., Cambridge, MA, USA
- Servier Pharmaceuticals LLC, 200 Pier Four Boulevard, Boston, MA, 02210, USA
| | - Zhaowei Hua
- Servier Pharmaceuticals LLC, 200 Pier Four Boulevard, Boston, MA, 02210, USA
| | | | - Hua Yang
- Agios Pharmaceuticals Inc., Cambridge, MA, USA
- Disc Medicine, Cambridge, MA, USA
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Chen M, Zhang M, Yin L, Ma L, Ding R, Zheng T, Yue Q, Lui S, Sun H. Medical image foundation models in assisting diagnosis of brain tumors: a pilot study. Eur Radiol 2024:10.1007/s00330-024-10728-1. [PMID: 38627290 DOI: 10.1007/s00330-024-10728-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/08/2024] [Accepted: 03/04/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES To build self-supervised foundation models for multicontrast MRI of the whole brain and evaluate their efficacy in assisting diagnosis of brain tumors. METHODS In this retrospective study, foundation models were developed using 57,621 enhanced head MRI scans through self-supervised learning with a pretext task of cross-contrast context restoration with two different content dropout schemes. Downstream classifiers were constructed based on the pretrained foundation models and fine-tuned for brain tumor detection, discrimination, and molecular status prediction. Metrics including accuracy, sensitivity, specificity, and area under the ROC curve (AUC) were used to evaluate the performance. Convolutional neural networks trained exclusively on downstream task data were employed for comparative analysis. RESULTS The pretrained foundation models demonstrated their ability to extract effective representations from multicontrast whole-brain volumes. The best classifiers, endowed with pretrained weights, showed remarkable performance with accuracies of 94.9, 92.3, and 80.4%, and corresponding AUC values of 0.981, 0.972, and 0.852 on independent test datasets in brain tumor detection, discrimination, and molecular status prediction, respectively. The classifiers with pretrained weights outperformed the convolutional classifiers trained from scratch by approximately 10% in terms of accuracy and AUC across all tasks. The saliency regions in the correctly predicted cases are mainly clustered around the tumors. Classifiers derived from the two dropout schemes differed significantly only in the detection of brain tumors. CONCLUSIONS Foundation models obtained from self-supervised learning have demonstrated encouraging potential for scalability and interpretability in downstream brain tumor-related tasks and hold promise for extension to neurological diseases with diffusely distributed lesions. CLINICAL RELEVANCE STATEMENT The application of our proposed method to the prediction of key molecular status in gliomas is expected to improve treatment planning and patient outcomes. Additionally, the foundation model we developed could serve as a cornerstone for advancing AI applications in the diagnosis of brain-related diseases.
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Affiliation(s)
- Mengyao Chen
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | | | - Lijuan Yin
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
| | - Lu Ma
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
| | - Renxing Ding
- IT center, West China Hospital of Sichuan University, Chengdu, China
| | - Tao Zheng
- IT center, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Yue
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Huaiqiang Sun
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China.
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Malik P, Soliman R, Chen YA, Munoz DG, Das S, Bharatha A, Mathur S. Patterns of T2-FLAIR discordance across a cohort of adult-type diffuse gliomas and deviations from the classic T2-FLAIR mismatch sign. Neuroradiology 2024; 66:521-530. [PMID: 38347151 DOI: 10.1007/s00234-024-03297-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/25/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE T2-FLAIR mismatch serves as a highly specific but insensitive marker for IDH-mutant (IDHm) astrocytoma with potential limitations in real-world application. We aimed to assess the utility of a broader definition of T2-FLAIR discordance across a cohort of adult-type diffuse lower-grade gliomas (LrGG) to see if specific patterns emerge and additionally examine factors determining deviation from the classic T2-FLAIR mismatch sign. METHODS Preoperative MRIs of non-enhancing adult-type diffuse LrGGs were reviewed. Relevant demographic, molecular, and MRI data were compared across tumor subgroups. RESULTS Eighty cases satisfied the inclusion criteria. Highest discordance prevalence and > 50% T2-FLAIR discordance volume were noted with IDHm astrocytomas (P < 0.001), while < 25% discordance volume was associated with oligodendrogliomas (P = 0.03) and IDH-wildtype (IDHw) LrGG (P = 0.004). "T2-FLAIR matched pattern" was associated with IDHw LrGG (P < 0.001) and small or minimal areas of discordance with oligodendrogliomas (P = 0.03). Sensitivity and specificity of classic mismatch sign for IDHm astrocytoma were 25.7% and 100%, respectively (P = 0.06). Retained ATRX expression and/or non-canonical IDH mutation (n = 10) emerged as a significant factor associated with absence of classic T2-FLAIR mismatch sign in IDHm astrocytomas (100%, P = 0.02) and instead had minimal discordance or matched pattern (40%, P = 0.04). CONCLUSION T2-FLAIR discordance patterns in adult-type diffuse LrGGs exist on a diverging but distinct spectrum of classic mismatch to T2-FLAIR matched patterns. Specific molecular markers may play a role in deviations from classic mismatch sign.
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Affiliation(s)
- Prateek Malik
- Division of Neuroradiology, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, 30 Bond St., Toronto, ON, M5B 1W8, Canada
| | - Radwa Soliman
- Diagnostic and Interventional Radiology Department, Assiut University, Asyut, Egypt
| | - Yingming Amy Chen
- Division of Neuroradiology, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, 30 Bond St., Toronto, ON, M5B 1W8, Canada
| | - David G Munoz
- Department of Pathology, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Sunit Das
- Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Aditya Bharatha
- Division of Neuroradiology, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, 30 Bond St., Toronto, ON, M5B 1W8, Canada
| | - Shobhit Mathur
- Division of Neuroradiology, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, 30 Bond St., Toronto, ON, M5B 1W8, Canada.
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Zhou W, Wen J, Huang Q, Zeng Y, Zhou Z, Zhu Y, Chen L, Guan Y, Xie F, Zhuang D, Hua T. Development and validation of clinical-radiomics analysis for preoperative prediction of IDH mutation status and WHO grade in diffuse gliomas: a consecutive L-[methyl-11C] methionine cohort study with two PET scanners. Eur J Nucl Med Mol Imaging 2024; 51:1423-1435. [PMID: 38110710 DOI: 10.1007/s00259-023-06562-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023]
Abstract
PURPOSE Determination of isocitrate dehydrogenase (IDH) genotype is crucial in the stratification of diagnosis and prognostication in diffuse gliomas. We sought to build and validate radiomics models and clinical features incorporated nomogram for preoperative prediction of IDH mutation status and WHO grade of diffuse gliomas with L-[methyl-11C] methionine ([11C]MET) PET/CT imaging according to the 2016 WHO classification of tumors of the central nervous system. METHODS Consecutive 178 preoperative [11C]MET PET/CT images were retrospectively studied for radiomics analysis. One hundred six patients from PET scanner 1 were used as training dataset, and 72 patients from PET scanner 2 were used for validation dataset. [11C]MET PET and integrated CT radiomics features were extracted, respectively; three independent predictive models were built based on PET features, CT features, and combined PET/CT features, respectively. The SelectKBest method, Spearman correlation analysis, Least Absolute Shrinkage and Selection Operator (LASSO) regression, and machine learning algorithms were applied for feature selection and model building. After filtering the satisfactory predictive model, key clinical features were incorporated for the nomogram establishment. RESULTS The combined [11C]MET PET/CT radiomics model, which consisted of four PET features and eight integrated CT features, was significantly associated with IDH genotype (p < 0.0001 for both training and validation datasets). Nomogram based on the [11C]MET PET/CT radiomics score, patients' age, and dichotomous tumor location status showed satisfactory discrimination capacity, and the AUC was 0.880 (95% CI, 0.726-0.998) in the training dataset and 0.866 (95% CI, 0.777-0.956) in the validation dataset. In IDH stratified WHO grade prediction, the final radiomics model consists of four PET features and two CT features had reasonable and stable differential efficacy of WHO grade II and III patients from grade IV patients in IDH-wildtype patients, and the AUC was 0.820 (95% CI, 0.541-1.000) in the training dataset and 0.766 (95% CI, 0.612-0.921) in the validation dataset. CONCLUSION [11C]MET PET radiomics features could benefit non-invasive IDH genotype prediction, and integrated CT radiomics features could enhance the efficacy. Radiomics and clinical features incorporation could establish satisfactory nomogram for clinical application. This non-invasive predictive investigation based on our consecutive cohort from two PET scanners could provide the perspective to observe the differential efficacy and the stability of radiomics-based investigation in untreated diffuse gliomas.
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Affiliation(s)
- Weiyan Zhou
- Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianbo Wen
- Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qi Huang
- Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Zeng
- Department of Research Center, Shanghai United Imaging Intelligence Co., Ltd., Shanghai, China
| | - Zhirui Zhou
- Radiation Oncology Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuhua Zhu
- Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Lei Chen
- Department of Research Center, Shanghai United Imaging Intelligence Co., Ltd., Shanghai, China
| | - Yihui Guan
- Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Fang Xie
- Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Shanghai, China.
| | - Dongxiao Zhuang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
- National Center for Neurological Disorders, Shanghai, China.
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China.
- Neurosurgical Institute of Fudan University, Shanghai, China.
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China.
| | - Tao Hua
- Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Shanghai, China.
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Foltyn-Dumitru M, Schell M, Rastogi A, Sahm F, Kessler T, Wick W, Bendszus M, Brugnara G, Vollmuth P. Impact of signal intensity normalization of MRI on the generalizability of radiomic-based prediction of molecular glioma subtypes. Eur Radiol 2024; 34:2782-2790. [PMID: 37672053 PMCID: PMC10957611 DOI: 10.1007/s00330-023-10034-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/09/2023] [Accepted: 06/16/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVES Radiomic features have demonstrated encouraging results for non-invasive detection of molecular biomarkers, but the lack of guidelines for pre-processing MRI-data has led to poor generalizability. Here, we assessed the influence of different MRI-intensity normalization techniques on the performance of radiomics-based models for predicting molecular glioma subtypes. METHODS Preoperative MRI-data from n = 615 patients with newly diagnosed glioma and known isocitrate dehydrogenase (IDH) and 1p/19q status were pre-processed using four different methods: no normalization (naive), N4 bias field correction (N4), N4 followed by either WhiteStripe (N4/WS), or z-score normalization (N4/z-score). A total of 377 Image-Biomarker-Standardisation-Initiative-compliant radiomic features were extracted from each normalized data, and 9 different machine-learning algorithms were trained for multiclass prediction of molecular glioma subtypes (IDH-mutant 1p/19q codeleted vs. IDH-mutant 1p/19q non-codeleted vs. IDH wild type). External testing was performed in public glioma datasets from UCSF (n = 410) and TCGA (n = 160). RESULTS Support vector machine yielded the best performance with macro-average AUCs of 0.84 (naive), 0.84 (N4), 0.87 (N4/WS), and 0.87 (N4/z-score) in the internal test set. Both N4/WS and z-score outperformed the other approaches in the external UCSF and TCGA test sets with macro-average AUCs ranging from 0.85 to 0.87, replicating the performance of the internal test set, in contrast to macro-average AUCs ranging from 0.19 to 0.45 for naive and 0.26 to 0.52 for N4 alone. CONCLUSION Intensity normalization of MRI data is essential for the generalizability of radiomic-based machine-learning models. Specifically, both N4/WS and N4/z-score approaches allow to preserve the high model performance, yielding generalizable performance when applying the developed radiomic-based machine-learning model in an external heterogeneous, multi-institutional setting. CLINICAL RELEVANCE STATEMENT Intensity normalization such as N4/WS or N4/z-score can be used to develop reliable radiomics-based machine learning models from heterogeneous multicentre MRI datasets and provide non-invasive prediction of glioma subtypes. KEY POINTS • MRI-intensity normalization increases the stability of radiomics-based models and leads to better generalizability. • Intensity normalization did not appear relevant when the developed model was applied to homogeneous data from the same institution. • Radiomic-based machine learning algorithms are a promising approach for simultaneous classification of IDH and 1p/19q status of glioma.
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Affiliation(s)
- Martha Foltyn-Dumitru
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, DE, Germany
- Section for Computational Neuroimaging, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, DE, Germany
| | - Marianne Schell
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, DE, Germany
- Section for Computational Neuroimaging, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, DE, Germany
| | - Aditya Rastogi
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, DE, Germany
- Section for Computational Neuroimaging, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, DE, Germany
| | - Felix Sahm
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, DE, Germany
| | - Tobias Kessler
- Department of Neurology, Heidelberg University Hospital, Heidelberg, DE, Germany
| | - Wolfgang Wick
- Department of Neurology, Heidelberg University Hospital, Heidelberg, DE, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, DE, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, DE, Germany
| | - Gianluca Brugnara
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, DE, Germany
- Section for Computational Neuroimaging, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, DE, Germany
| | - Philipp Vollmuth
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, DE, Germany.
- Section for Computational Neuroimaging, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, DE, Germany.
- Division of Medical Image Computing (MIC), German Cancer Research Center (DFKZ), Heidelberg, Germany.
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Wang X, Shu X, He P, Cai Y, Geng Y, Hu X, Sun Y, Xiao H, Zheng W, Song Y, Xue Y, Jiang R. Ultra-high b-value DWI accurately identifies isocitrate dehydrogenase genotypes and tumor subtypes of adult-type diffuse gliomas. Eur Radiol 2024:10.1007/s00330-024-10708-5. [PMID: 38528135 DOI: 10.1007/s00330-024-10708-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/08/2024] [Accepted: 02/23/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVES To distinguish isocitrate dehydrogenase (IDH) genotypes and tumor subtypes of adult-type diffuse gliomas based on the fifth edition of the World Health Organization classification of central nervous system tumors (WHO CNS5) in 2021 using standard, high, and ultra-high b-value diffusion-weighted imaging (DWI). MATERIALS AND METHODS This prospective study enrolled 70 patients with adult-type diffuse gliomas who underwent multiple b-value DWI. Apparent diffusion coefficient (ADC) values including ADCb500/b1000, ADCb500/b2000, ADCb500/b3000, ADCb500/b4000, ADCb500/b6000, ADCb500/b8000, and ADCb500/b10000 in tumor parenchyma (TP) and contralateral normal-appearing white matter (NAWM) were calculated. The ADC ratios of TP/NAWM were assessed for correlations with IDH genotypes, tumor subtypes, and Ki-67 status; diagnostic performances were compared. RESULTS All ADCs were significantly higher in IDH mutant gliomas than in IDH wild-type gliomas (p < 0.01 for all); ADCb500/b8000 had the highest area under the curve (AUC) of 0.866. All ADCs were significantly lower in glioblastoma than in astrocytoma (p < 0.01 for all). ADCs other than ADCb500/b1000 were significantly lower in glioblastoma than in oligodendroglioma (p < 0.05 for all). ADCb500/b8000 and ADCb500/b10000 were significantly higher in oligodendroglioma than in astrocytoma (p = 0.034 and 0.023). The highest AUCs were 0.818 for ADCb500/b6000 when distinguishing glioblastoma from astrocytoma, 0.979 for ADCb500/b8000 and ADCb500/b10000 when distinguishing glioblastoma from oligodendroglioma, and 0.773 for ADCb500/b10000 when distinguishing astrocytoma from oligodendroglioma. Additionally, all ADCs were negatively correlated with Ki-67 status (p < 0.05 for all). CONCLUSION Ultra-high b-value DWI can reliably separate IDH genotypes and tumor subtypes of adult-type diffuse gliomas using WHO CNS5 criteria. CLINICAL RELEVANCE STATEMENT Ultra-high b-value diffusion-weighted imaging can accurately distinguish isocitrate dehydrogenase genotypes and tumor subtypes of adult-type diffuse gliomas, which may facilitate personalized treatment and prognostic assessment for patients with glioma. KEY POINTS • Ultra-high b-value diffusion-weighted imaging can accurately distinguish subtle differences in water diffusion among biological tissues. • Ultra-high b-value diffusion-weighted imaging can reliably separate isocitrate dehydrogenase genotypes and tumor subtypes of adult-type diffuse gliomas. • Compared with standard b-value diffusion-weighted imaging, high and ultra-high b-value diffusion-weighted imaging demonstrate better diagnostic performances.
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Affiliation(s)
- Xueqin Wang
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
- School of Medical Imaging, Fujian Medical University, Fuzhou, 350004, China
| | - Xinru Shu
- School of Basic Medical Sciences, Fujian Medical University, Fuzhou, 350004, China
| | - Pingping He
- School of Medical Imaging, Fujian Medical University, Fuzhou, 350004, China
| | - Yiting Cai
- School of Medical Imaging, Fujian Medical University, Fuzhou, 350004, China
| | - Yingqian Geng
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Xiaomei Hu
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Yifan Sun
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Huinan Xiao
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Wanyi Zheng
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Yang Song
- MR Scientific Marketing, Siemens Healthcare, Shanghai, China
| | - Yunjing Xue
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Rifeng Jiang
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China.
- School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, 350004, China.
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Lee JO, Ahn SS, Choi KS, Lee J, Jang J, Park JH, Hwang I, Park CK, Park SH, Chung JW, Choi SH. Added prognostic value of 3D deep learning-derived features from preoperative MRI for adult-type diffuse gliomas. Neuro Oncol 2024; 26:571-580. [PMID: 37855826 PMCID: PMC10912011 DOI: 10.1093/neuonc/noad202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND To investigate the prognostic value of spatial features from whole-brain MRI using a three-dimensional (3D) convolutional neural network for adult-type diffuse gliomas. METHODS In a retrospective, multicenter study, 1925 diffuse glioma patients were enrolled from 5 datasets: SNUH (n = 708), UPenn (n = 425), UCSF (n = 500), TCGA (n = 160), and Severance (n = 132). The SNUH and Severance datasets served as external test sets. Precontrast and postcontrast 3D T1-weighted, T2-weighted, and T2-FLAIR images were processed as multichannel 3D images. A 3D-adapted SE-ResNeXt model was trained to predict overall survival. The prognostic value of the deep learning-based prognostic index (DPI), a spatial feature-derived quantitative score, and established prognostic markers were evaluated using Cox regression. Model evaluation was performed using the concordance index (C-index) and Brier score. RESULTS The MRI-only median DPI survival prediction model achieved C-indices of 0.709 and 0.677 (BS = 0.142 and 0.215) and survival differences (P < 0.001 and P = 0.002; log-rank test) for the SNUH and Severance datasets, respectively. Multivariate Cox analysis revealed DPI as a significant prognostic factor, independent of clinical and molecular genetic variables: hazard ratio = 0.032 and 0.036 (P < 0.001 and P = 0.004) for the SNUH and Severance datasets, respectively. Multimodal prediction models achieved higher C-indices than models using only clinical and molecular genetic variables: 0.783 vs. 0.774, P = 0.001, SNUH; 0.766 vs. 0.748, P = 0.023, Severance. CONCLUSIONS The global morphologic feature derived from 3D CNN models using whole-brain MRI has independent prognostic value for diffuse gliomas. Combining clinical, molecular genetic, and imaging data yields the best performance.
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Affiliation(s)
- Jung Oh Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Artificial Intelligence Collaborative Network, Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sung Soo Ahn
- Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyu Sung Choi
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Artificial Intelligence Collaborative Network, Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Junhyeok Lee
- Interdisciplinary Programs in Cancer Biology Major, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Joon Jang
- Department of Biomedical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Jung Hyun Park
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Inpyeong Hwang
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Artificial Intelligence Collaborative Network, Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sung Hye Park
- Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Wook Chung
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Artificial Intelligence Collaborative Network, Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Innovate Biomedical Technology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Artificial Intelligence Collaborative Network, Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
- Center for Nanoparticle Research, Institute for Basic Science, Seoul, Republic of Korea
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Li J, Wang W, Li B, Xue Y, Wang X, Liu S, Hu S, Tang J, Yan B, Li T, Xue J. NADP +-dependent isocitrate dehydrogenase as a novel target for altering carbon flux to lipid accumulation and enhancing antioxidant capacity in Tetradesmus obliquus. Bioresour Technol 2024; 395:130365. [PMID: 38266784 DOI: 10.1016/j.biortech.2024.130365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/18/2024] [Accepted: 01/20/2024] [Indexed: 01/26/2024]
Abstract
Regulatory complexities in lipogenesis hinder the harmonization of metabolic carbon precursors towards lipid synthesis. Exploring regulatory complexities in lipogenesis, this study identifies NADP+-dependent isocitrate dehydrogenase (IDH) in Tetradesmus obliquus as a key factor. Overexpression IDH in strains ToIDH-1 and ToIDH-2 resulted in a 1.69 and 1.64-fold increase in neutral lipids, respectively, compared to the wild type, with lipid yield reaching 234.56 and 227.17 mg/L. Notably, despite slower growth, the cellular biomass augmented to 790.67 mg/L. Metabolite analysis indicated a shift in carbon precursors from protein to lipid and carbohydrate synthesis. Morphological observations revealed increases in the volume and number of lipid droplets, alongside a change in the fatty acid profile favoring monounsaturated and saturated fatty acids. Furthermore, IDH overexpression enhanced NADPH production and antioxidant activity, thereby further boosting lipid accumulation when combined with salt stress. This study suggests a pathway for improved lipogenesis and algal growth via metabolic engineering.
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Affiliation(s)
- Jing Li
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi'an, Shaanxi 710069, China; Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an 710069, China; Shaanxi Key Laboratory for Carbon Neutral Technology, China
| | - Wei Wang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi'an, Shaanxi 710069, China; Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an 710069, China
| | - Bingze Li
- Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an 710069, China; Shaanxi Key Laboratory for Carbon Neutral Technology, China
| | - Yunzhuan Xue
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi'an, Shaanxi 710069, China; Shaanxi Key Laboratory for Carbon Neutral Technology, China
| | - Xinxin Wang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi'an, Shaanxi 710069, China; Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an 710069, China
| | - Shihui Liu
- Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an 710069, China; Shaanxi Key Laboratory for Carbon Neutral Technology, China
| | - Shuwei Hu
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi'an, Shaanxi 710069, China; Shaanxi Key Laboratory for Carbon Neutral Technology, China
| | - Jiaxuan Tang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi'an, Shaanxi 710069, China; Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an 710069, China
| | - Bo Yan
- Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an 710069, China; Shaanxi Key Laboratory for Carbon Neutral Technology, China
| | - Tong Li
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi'an, Shaanxi 710069, China; Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an 710069, China; Shaanxi Key Laboratory for Carbon Neutral Technology, China
| | - Jiao Xue
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Northwest University, Xi'an, Shaanxi 710069, China; Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an 710069, China; Shaanxi Key Laboratory for Carbon Neutral Technology, China.
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10
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Tang T, Wang Y, Dai Y, Liu Q, Fan X, Cheng Y, Tang J, Xiao X, Shan Y, Wei P, Zhao G. IDH1 mutation predicts seizure occurrence and prognosis in lower-grade glioma adults. Pathol Res Pract 2024; 254:155165. [PMID: 38286053 DOI: 10.1016/j.prp.2024.155165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/21/2024] [Accepted: 01/21/2024] [Indexed: 01/31/2024]
Abstract
Epileptic seizures are frequently the first symptom in glioma patients. However, the causal relationship between glioma and epilepsy is not yet fully understood, as it cannot be explained solely by tumor mass effect or peritumoral factors. In this study, we retrospectively enrolled 320 patients with grade 2-4 glioma who received treatment between January 2019 and July 2022, and explored the biomarkers of seizure occurrence and seizure outcome prediction using univariate and multivariate logistic regression analyses. Our results showed that IDH1 R132H mutation was an independent risk factor for seizure occurrence in lower-grade glioma (LGG) patients (OR = 4.915, 95%CI = 1.713 - 14.103, P = 0.003). Additionally, IDH1 R132H mutation predicted higher seizure-free ratios in LGG patients with intact ATRX expression (OR = 6.793, 95%CI = 1.217 - 37.923, P = 0.029) one year after diagnosis. Therefore, our findings suggest that IDH1 mutation can predict seizure occurrence and control in LGG patients, providing further insights into the relationship between glioma and epilepsy.
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Affiliation(s)
- Ting Tang
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Yihe Wang
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Yang Dai
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Quanlei Liu
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Xiaotong Fan
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China; Clinical Research Center for Epilepsy, Capital Medical University, Beijing 100053, China
| | - Ye Cheng
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Jie Tang
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Xinru Xiao
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Yongzhi Shan
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China; Clinical Research Center for Epilepsy, Capital Medical University, Beijing 100053, China
| | - Penghu Wei
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China; Clinical Research Center for Epilepsy, Capital Medical University, Beijing 100053, China.
| | - Guoguang Zhao
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China; Clinical Research Center for Epilepsy, Capital Medical University, Beijing 100053, China; Beijing Municipal Geriatric Medical Research Center, Beijing 100053, China.
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Cai M, Zhao J, Ding Q, Wei J. Oncometabolite 2-hydroxyglutarate regulates anti-tumor immunity. Heliyon 2024; 10:e24454. [PMID: 38293535 PMCID: PMC10826830 DOI: 10.1016/j.heliyon.2024.e24454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 02/01/2024] Open
Abstract
"Oncometabolite" 2-hydroxyglutarate (2-HG) is an aberrant metabolite found in tumor cells, exerting a pivotal influence on tumor progression. Recent studies have unveiled its impact on the proliferation, activation, and differentiation of anti-tumor T cells. Moreover, 2-HG regulates the function of innate immune components, including macrophages, dendritic cells, natural killer cells, and the complement system. Elevated levels of 2-HG hinder α-KG-dependent dioxygenases (α-KGDDs), contributing to tumorigenesis by disrupting epigenetic regulation, genome integrity, hypoxia-inducible factors (HIF) signaling, and cellular metabolism. The chiral molecular structure of 2-HG produces two enantiomers: D-2-HG and L-2-HG, each with distinct origins and biological functions. Efforts to inhibit D-2-HG and leverage the potential of L-2-HG have demonstrated efficacy in cancer immunotherapy. This review delves into the metabolism, biological functions, and impacts on the tumor immune microenvironment (TIME) of 2-HG, providing a comprehensive exploration of the intricate relationship between 2-HG and antitumor immunity. Additionally, we examine the potential clinical applications of targeted therapy for 2-HG, highlighting recent breakthroughs as well as the existing challenges.
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Affiliation(s)
- Mengyuan Cai
- Department of Pharmacy, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, China
- Jiangsu Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Jianyi Zhao
- Jiangsu Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Qiang Ding
- Jiangsu Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Jifu Wei
- Department of Pharmacy, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, China
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Alimohamadi M, Larijani A, Pour-Rashidi A, Farzin M, Ebrahimi H, Rahmani M, Hendi K, Yarandi KK, Aghajanian S, Shirani M. Comparative Analysis of the Prognostic Significance of IDH,TERT, EGFR and MGMT Status in Patients with Adult Non-H3-Altered Grade 4 Gliomas: A Prospective Cohort Study. World Neurosurg 2024; 181:e628-e639. [PMID: 37914076 DOI: 10.1016/j.wneu.2023.10.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 10/21/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Gliomas continue to have a dismal prognosis. A myriad of genetic alterations has been described in this subset of tumors over the last decades. The integrative interpretation of the biomarker constellation for individual patients remains unclear. This study aims to evaluate the impact of some known genetic factors as prognostic biomarkers in grade 4 gliomas. METHODS Adult non-H3-altered grade 4 gliomas who underwent maximal safe resection accompanied by adjuvant therapy were successively enrolled since January 2019 till January 2021. Patient data were documented preoperatively and during the follow-up visits. The genetic profiling of the tumors included Isocitrate Dehydrogenase (IDH)-1 and IDH-2 mutation, MGMT promoter methylation rate, EGFR gene amplification and telomerase reverse transcriptase gene promoter (TERTp) mutation. RESULTS Mean Overall survival (OS) and Progression-free survival (PFS) were 14.45 ± 5.13 months (3-24 months) and 10.66 ± 4.87 months respectively. TERTp-mutant group had a significantly lower OS (10.9 vs. 15.9) and PFS (6.9 vs. 12.3) than TERTp wildtype group. In the TERT-mutant group, those with concomitant IDH wildtype tumor had higher OS and PFS, comparable to those with both TERTp and IDH wildtype tumors. In multivariate analysis, IDH mutation and TERTp wildtype status were predictive of longer OS and PFS. While IDH and absence of TERTp mutation were associated with KPS > 80 across the follow-ups, their predictive values were inferior to preoperative KPS scores. CONCLUSIONS TERTp mutation and IDH-wildtype status were associated with worse OS and PFS and lower follow-up KPS score in surgically resected gliomas, while MGMT and EGFR status did not have considerable prognostic value in this study.
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Affiliation(s)
- Maysam Alimohamadi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Larijani
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Alborz University of Medical Sciences, Tehran, Iran.
| | - Ahmad Pour-Rashidi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Farzin
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Radio-Oncology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hannan Ebrahimi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamad Rahmani
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Hendi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kourosh Karimi Yarandi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepehr Aghajanian
- Department of Neurosurgery, Alborz University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirani
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Buz-Yalug B, Turhan G, Cetin AI, Dindar SS, Danyeli AE, Yakicier C, Pamir MN, Özduman K, Dincer A, Ozturk-Isik E. Identification of IDH and TERTp mutations using dynamic susceptibility contrast MRI with deep learning in 162 gliomas. Eur J Radiol 2024; 170:111257. [PMID: 38134710 DOI: 10.1016/j.ejrad.2023.111257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/21/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE Isocitrate dehydrogenase (IDH) and telomerase reverse transcriptase gene promoter (TERTp) mutations play crucial roles in glioma biology. Such genetic information is typically obtained invasively from excised tumor tissue; however, these mutations need to be identified preoperatively for better treatment planning. The relative cerebral blood volume (rCBV) information derived from dynamic susceptibility contrast MRI (DSC-MRI) has been demonstrated to correlate with tumor vascularity, functionality, and biology, and might provide some information about the genetic alterations in gliomas before surgery. Therefore, this study aims to predict IDH and TERTp mutational subgroups in gliomas using deep learning applied to rCBV images. METHOD After the generation of rCBV images from DSC-MRI data, classical machine learning algorithms were applied to the features obtained from the segmented tumor volumes to classify IDH and TERTp mutation subgroups. Furthermore, pre-trained convolutional neural networks (CNNs) and CNNs enhanced with attention gates were trained using rCBV images or a combination of rCBV and anatomical images to classify the mutational subgroups. RESULTS The best accuracies obtained with classical machine learning algorithms were 83 %, 68 %, and 76 % for the identification of IDH mutational, TERTp mutational, and TERTp-only subgroups, respectively. On the other hand, the best-performing CNN model achieved 88 % accuracy (86 % sensitivity, 91 % specificity) for the IDH-mutational subgroups, 70 % accuracy (73 % sensitivity and 67 % specificity) for the TERTp-mutational subgroups, and 84 % accuracy (86 % sensitivity, 81 % specificity) for the TERTp-only subgroup using attention gates. CONCLUSIONS DSC-MRI can be utilized to noninvasively classify IDH- and TERTp-based molecular subgroups of gliomas, facilitating preoperative identification of these genetic alterations.
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Affiliation(s)
- Buse Buz-Yalug
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Gulce Turhan
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Ayse Irem Cetin
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Sukru Samet Dindar
- Electrical and Electronics Engineering Department, Bogazici University, Istanbul, Turkey
| | - Ayca Ersen Danyeli
- Department of Medical Pathology, Acibadem University, Istanbul, Turkey; Center for Neuroradiological Applications and Research, Acibadem University, Istanbul, Turkey
| | - Cengiz Yakicier
- Department of Molecular Biology and Genetics, Acibadem University, Istanbul, Turkey
| | - M Necmettin Pamir
- Center for Neuroradiological Applications and Research, Acibadem University, Istanbul, Turkey; Department of Neurosurgery, Acibadem University, Istanbul, Turkey
| | - Koray Özduman
- Center for Neuroradiological Applications and Research, Acibadem University, Istanbul, Turkey; Department of Neurosurgery, Acibadem University, Istanbul, Turkey
| | - Alp Dincer
- Center for Neuroradiological Applications and Research, Acibadem University, Istanbul, Turkey; Department of Radiology, Acıbadem University, Istanbul, Turkey
| | - Esin Ozturk-Isik
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey; Center for Neuroradiological Applications and Research, Acibadem University, Istanbul, Turkey.
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Piao S, Kim S, Seo Y, Lee J, Jeon S, Vu GH, Yeo MK, Kim CS. The relative isoform expression levels of isocitrate dehydrogenase in breast cancer: IDH2 is a potential target in MDA-MB-231 cells. Korean J Clin Oncol 2023; 19:60-68. [PMID: 38229490 DOI: 10.14216/kjco.23011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/05/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE The isocitrate dehydrogenase (IDH) family plays an essential role in metabolism and energy production. The relative expression levels of IDH isoforms (IDH1, IDH2, and IDH3) have prognostic significance in several malignancies, including breast carcinoma. However, the IDH isozyme expression levels in different cancer stages and types have not been determined in breast carcinoma tissues. METHODS We analyzed the messenger RNA (mRNA) and protein levels of IDH (IDH1, IDH2, and IDH3A) and α-ketoglutarate (α-KG) in 59 breast carcinoma tissues. RESULTS The mRNA level of IDH2 was significantly increased at stages 2 and 3 in triple-negative and (ER-/PR-/HER+) breast cancers. However, the elevated α-KG level was only observed in stages 2 and 3, with no differences in the various breast carcinoma types. Western blotting analysis showed that IDH2 protein expression increased in the patient tissues and cell lines. An in vitro study showed IDH2 downregulation in the triple-negative breast cancer cell line MDA-MB-231 that inhibited cell proliferation and migration and induced cell cycle arrest in the G0/G1 phase. CONCLUSION These findings suggest that different from IDH1 and IDH3, IDH2 is more highly expressed in stages 2 and 3 breast cancer tissues, especially in triple-negative breast cancer. IDH2 potentially serves as a target to detect unknown mechanisms in breast cancer.
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Affiliation(s)
- Shuyu Piao
- Department of Physiology and Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
| | - Seonhee Kim
- Department of Physiology and Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
| | - Youngduk Seo
- Department of Nuclear Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Jinsun Lee
- Department of Surgery and Research Institute for Medical Sciences, Chungnam National University College of Medicine, Daejeon, Korea
| | - Sunhee Jeon
- Department of Physiology and Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
| | - Giang-Huong Vu
- Department of Physiology and Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
| | - Min-Kyung Yeo
- Department of Pathology, Chungnam National University College of Medicine, Daejeon, Korea
| | - Cuk-Seong Kim
- Department of Physiology and Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
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15
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Liu X, Zhang Q, Li J, Xu Q, Zhuo Z, Li J, Zhou X, Lu M, Zhou Q, Pan H, Wu N, Zhou Q, Shi F, Lu G, Liu Y, Zhang Z. Coordinatized lesion location analysis empowering ROI-based radiomics diagnosis on brain gliomas. Eur Radiol 2023; 33:8776-8787. [PMID: 37382614 DOI: 10.1007/s00330-023-09871-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 05/09/2023] [Accepted: 05/16/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES To assess the value of coordinatized lesion location analysis (CLLA), in empowering ROI-based imaging diagnosis of gliomas by improving accuracy and generalization performances. METHODS In this retrospective study, pre-operative contrasted T1-weighted and T2-weighted MR images were obtained from patients with gliomas from three centers: Jinling Hospital, Tiantan Hospital, and the Cancer Genome Atlas Program. Based on CLLA and ROI-based radiomic analyses, a fusion location-radiomics model was constructed to predict tumor grades, isocitrate dehydrogenase (IDH) status, and overall survival (OS). An inter-site cross-validation strategy was used for assessing the performances of the fusion model on accuracy and generalization with the value of area under the curve (AUC) and delta accuracy (ACC) (ACCtesting-ACCtraining). Comparisons of diagnostic performances were performed between the fusion model and the other two models constructed with location and radiomics analysis using DeLong's test and Wilcoxon signed ranks test. RESULTS A total of 679 patients (mean age, 50 years ± 14 [standard deviation]; 388 men) were enrolled. Based on tumor location probabilistic maps, fusion location-radiomics models (averaged AUC values of grade/IDH/OS: 0.756/0.748/0.768) showed the highest accuracy in contrast to radiomics models (0.731/0.686/0.716) and location models (0.706/0.712/0.740). Notably, fusion models ([median Delta ACC: - 0.125, interquartile range: 0.130]) demonstrated improved generalization than that of radiomics model ([- 0.200, 0.195], p = 0.018). CONCLUSIONS CLLA could empower ROI-based radiomics diagnosis of gliomas by improving the accuracy and generalization of the models. CLINICAL RELEVANCE STATEMENT This study proposed a coordinatized lesion location analysis for glioma diagnosis, which could improve the performances of the conventional ROI-based radiomics model in accuracy and generalization. KEY POINTS • Using coordinatized lesion location analysis, we mapped anatomic distribution patterns of gliomas with specific pathological and clinical features and constructed glioma prediction models. • We integrated coordinatized lesion location analysis into ROI-based analysis of radiomics to propose new fusion location-radiomics models. • Fusion location-radiomics models, with the advantages of being less influenced by variabilities, improved accuracy, and generalization performances of ROI-based radiomics models on predicting the diagnosis of gliomas.
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Affiliation(s)
- Xiaoxue Liu
- Department of Diagnostic Radiology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China
| | - Qirui Zhang
- Department of Diagnostic Radiology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China
| | - Jianrui Li
- Department of Diagnostic Radiology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China
| | - Qiang Xu
- Department of Diagnostic Radiology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China
| | - Zhizheng Zhuo
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Junjie Li
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xian Zhou
- Department of Diagnostic Radiology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China
| | - Mengjie Lu
- School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, 200240, China
| | - Qingqing Zhou
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, 211100, China
| | - Hao Pan
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, China
| | - Nan Wu
- Department of Pathology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, China
| | - Qing Zhou
- Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd., Shanghai, 200232, China
| | - Feng Shi
- Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd., Shanghai, 200232, China
| | - Guangming Lu
- Department of Diagnostic Radiology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China
- State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, 210093, China
| | - Yaou Liu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Zhiqiang Zhang
- Department of Diagnostic Radiology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China.
- State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, 210093, China.
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Emori M, Nakahashi N, Takasawa A, Murata K, Murahashi Y, Shimizu J, Tsukahara T, Sugita S, Takada K, Hasegawa T, Osanai M, Iba K. Establishment and characterization of a novel dedifferentiated chondrosarcoma cell line, SMU-DDCS, harboring an IDH1 mutation. Hum Cell 2023; 36:2195-2203. [PMID: 37454032 DOI: 10.1007/s13577-023-00944-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023]
Abstract
Dedifferentiated chondrosarcoma (DDCS) is a high-grade subtype with a bi-morphic histological appearance of a conventional chondrosarcoma component and it can abruptly transition to a high-grade non-cartilaginous sarcoma. To better understand the biological features of DDCSs and to help develop new therapies, a novel DDCS cell line, SMU-DDCS, was established. Tissue from an open biopsy of a tumor resected from a 75-year-old patient was subjected to primary culture. The cell line was established and authenticated by assessing DNA microsatellite short tandem repeats. The cells maintained in monolayer cultures exhibited constant growth, spheroid formation, and high invasive capacity. Out of the four mice inoculated with SMU-DDCS cells, tumors developed in three mice after 2 weeks. R132C mutation was found in the IDH1 but not the IDH2 genomic DNA sequence of SMU-DDCS cells. SMU-DDCS cells exhibited low chemosensitivity to doxorubicin, methotrexate, and cisplatin. This SMU-DDCS cell line harboring an IDH1 mutation will be a useful tool for investigating DDCS development and for evaluating novel therapeutic agents against it.
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Affiliation(s)
- Makoto Emori
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan.
| | - Naoya Nakahashi
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
- Departments of Pathology, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
| | - Akira Takasawa
- Departments of Pathology, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
| | - Kenji Murata
- Departments of Pathology, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
| | - Yasutaka Murahashi
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
| | - Junya Shimizu
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
| | - Tomohide Tsukahara
- Departments of Pathology, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
| | - Kohichi Takada
- Department of Medical Oncology, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
| | - Makoto Osanai
- Departments of Pathology, Sapporo Medical University School of Medicine, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
| | - Kosuke Iba
- Department of Musculoskeletal Anti-Aging Medicine, Sapporo Medical University, West 16, South 1, Chuo- Ku, Sapporo, 060-8543, Japan
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Lin HT, Lin CM, Wu YY, Chang WH, Wei KC, Chen YC, Chen PY, Liu FC, Chen KT. Predictors for delayed awakening in adult glioma patients receiving awake craniotomy under monitored anesthesia care. J Neurooncol 2023; 165:361-372. [PMID: 37917280 PMCID: PMC10689299 DOI: 10.1007/s11060-023-04494-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE Delayed awakening after anesthetic discontinuation during awake craniotomy is associated with somnolence during functional brain mapping. However, predictors of delayed awakening in patients receiving monitored anesthesia care for awake craniotomy are unknown. METHODS This retrospective cohort study analyzed 117 adult patients with supratentorial glioma in or near eloquent areas who received monitored anesthesia care for awake craniotomy between July 2020 and January 2023 at Linkou Chang Gung Memorial Hospital. These patients were divided into two groups according to their time to awakening (ability to speak their names) after propofol cessation: longer or shorter than 20 min (median duration). Because propofol was solely used anesthetic from skin incision to dural opening, parameters in Schnider model for propofol target-controlled infusion, such as age, sex, and BMI, were adjusted or propensity-matched to compare their anesthetic, surgical, and histopathological profiles. RESULTS After propensity-matched comparisons of age and BMI, significant predictors of delayed awakening included IDH1 wild-type tumors and repeated craniotomies. Subgroup analysis revealed that older age and larger T2 volume were predictors in patients undergoing the first craniotomy, while lower preoperative Karnofsky performance scale scores and depression were predictors in repeated craniotomy cases. Delayed awakening was also associated with somnolence and a lower gross total resection rate. CONCLUSION Our retrospective analysis of patients receiving monitored anesthesia care for awake craniotomy revealed that delayed awakening after propofol discontinuation occurred more often in patients with IDH1 wild-type tumors and repeated craniotomies. Also, delayed awakening was associated with somnolence during functional mapping and a lower gross total resection rate.
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Affiliation(s)
- Huan-Tang Lin
- Department of Anesthesiology, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Chun-Ming Lin
- Department of Anesthesiology, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, 333, Taiwan
| | - Yah-Yuan Wu
- Department of Neurology, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, 333, Taiwan
| | - Wei-Han Chang
- Department of Physical Medicine & Rehabilitation, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, 333, Taiwan
| | - Kuo-Chen Wei
- Department of Neurosurgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, Taoyuan, 333, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan
| | - Yi-Chun Chen
- Department of Neurology, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, 333, Taiwan
| | - Pin-Yuan Chen
- Department of Neurosurgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, Taoyuan, 333, Taiwan
| | - Fu-Chao Liu
- Department of Anesthesiology, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, 333, Taiwan
| | - Ko-Ting Chen
- Department of Neurosurgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, Taoyuan, 333, Taiwan.
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan.
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Kim M, Ong KTI, Choi S, Yeo J, Kim S, Han K, Park JE, Kim HS, Choi YS, Ahn SS, Kim J, Lee SK, Sohn B. Natural language processing to predict isocitrate dehydrogenase genotype in diffuse glioma using MR radiology reports. Eur Radiol 2023; 33:8017-8025. [PMID: 37566271 DOI: 10.1007/s00330-023-10061-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/18/2023] [Accepted: 06/22/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVES To evaluate the performance of natural language processing (NLP) models to predict isocitrate dehydrogenase (IDH) mutation status in diffuse glioma using routine MR radiology reports. MATERIALS AND METHODS This retrospective, multi-center study included consecutive patients with diffuse glioma with known IDH mutation status from May 2009 to November 2021 whose initial MR radiology report was available prior to pathologic diagnosis. Five NLP models (long short-term memory [LSTM], bidirectional LSTM, bidirectional encoder representations from transformers [BERT], BERT graph convolutional network [GCN], BioBERT) were trained, and area under the receiver operating characteristic curve (AUC) was assessed to validate prediction of IDH mutation status in the internal and external validation sets. The performance of the best performing NLP model was compared with that of the human readers. RESULTS A total of 1427 patients (mean age ± standard deviation, 54 ± 15; 779 men, 54.6%) with 720 patients in the training set, 180 patients in the internal validation set, and 527 patients in the external validation set were included. In the external validation set, BERT GCN showed the highest performance (AUC 0.85, 95% CI 0.81-0.89) in predicting IDH mutation status, which was higher than LSTM (AUC 0.77, 95% CI 0.72-0.81; p = .003) and BioBERT (AUC 0.81, 95% CI 0.76-0.85; p = .03). This was higher than that of a neuroradiologist (AUC 0.80, 95% CI 0.76-0.84; p = .005) and a neurosurgeon (AUC 0.79, 95% CI 0.76-0.84; p = .04). CONCLUSION BERT GCN was externally validated to predict IDH mutation status in patients with diffuse glioma using routine MR radiology reports with superior or at least comparable performance to human reader. CLINICAL RELEVANCE STATEMENT Natural language processing may be used to extract relevant information from routine radiology reports to predict cancer genotype and provide prognostic information that may aid in guiding treatment strategy and enabling personalized medicine. KEY POINTS • A transformer-based natural language processing (NLP) model predicted isocitrate dehydrogenase mutation status in diffuse glioma with an AUC of 0.85 in the external validation set. • The best NLP models were superior or at least comparable to human readers in both internal and external validation sets. • Transformer-based models showed higher performance than conventional NLP model such as long short-term memory.
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Affiliation(s)
- Minjae Kim
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kai Tzu-Iunn Ong
- Department of Artificial Intelligence, College of Computing, Yonsei University, Seoul, Korea
| | - Seonah Choi
- Department of Neurosurgery, Brain Tumor Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jinyoung Yeo
- Department of Artificial Intelligence, College of Computing, Yonsei University, Seoul, Korea
| | - Sooyon Kim
- Department of Statistics and Data Science, Yonsei University, Seoul, Korea
| | - Kyunghwa Han
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ho Sung Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Yoon Seong Choi
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jinna Kim
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Koo Lee
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Beomseok Sohn
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea.
- Department of Radiology and Center for Imaging Sciences, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Yang X, Hu C, Xing Z, Lin Y, Su Y, Wang X, Cao D. Prediction of Ki-67 labeling index, ATRX mutation, and MGMT promoter methylation status in IDH-mutant astrocytoma by morphological MRI, SWI, DWI, and DSC-PWI. Eur Radiol 2023; 33:7003-7014. [PMID: 37133522 DOI: 10.1007/s00330-023-09695-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 02/19/2023] [Accepted: 03/09/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVE Noninvasive detection of molecular status of astrocytoma is of great clinical significance for predicting therapeutic response and prognosis. We aimed to evaluate whether morphological MRI (mMRI), SWI, DWI, and DSC-PWI could predict Ki-67 labeling index (LI), ATRX mutation, and MGMT promoter methylation status in IDH mutant (IDH-mut) astrocytoma. METHODS We retrospectively analyzed mMRI, SWI, DWI, and DSC-PWI in 136 patients with IDH-mut astrocytoma.The features of mMRI and intratumoral susceptibility signals (ITSS) were compared using Fisher exact test or chi-square tests. Wilcoxon rank sum test was used to compare the minimum ADC (ADCmin), and minimum relative ADC (rADCmin) of IDH-mut astrocytoma in different molecular markers status. Mann-Whitney U test was used to compare the rCBVmax of IDH-mut astrocytoma with different molecular markers status. Receiver operating characteristic curves was performed to evaluate their diagnostic performances. RESULTS ITSS, ADCmin, rADCmin, and rCBVmax were significantly different between high and low Ki-67 LI groups. ITSS, ADCmin, and rADCmin were significantly different between ATRX mutant and wild-type groups. Necrosis, edema, enhancement, and margin pattern were significantly different between low and high Ki-67 LI groups. Peritumoral edema was significantly different between ATRX mutant and wild-type groups. Grade 3 IDH-mut astrocytoma with unmethylated MGMT promoter was more likely to show enhancement compared to the methylated group. CONCLUSIONS mMRI, SWI, DWI, and DSC-PWI were shown to have the potential to predict Ki-67 LI and ATRX mutation status in IDH-mut astrocytoma. A combination of mMRI and SWI may improve diagnostic performance for predicting Ki-67 LI and ATRX mutation status. CLINICAL RELEVANCE STATEMENT Conventional MRI and functional MRI (SWI, DWI, and DSC-PWI) can predict Ki-67 expression and ATRX mutation status of IDH mutant astrocytoma, which may help clinicians determine personalized treatment plans and predict patient outcomes. KEY POINTS • A combination of multimodal MRI may improve the diagnostic performance to predict Ki-67 LI and ATRX mutation status. • Compared with IDH-mutant astrocytoma with low Ki-67 LI, IDH-mutant astrocytoma with high Ki-67 LI was more likely to show necrosis, edema, enhancement, poorly defined margin, higher ITSS levels, lower ADC, and higher rCBV. • ATRX wild-type IDH-mutant astrocytoma was more likely to show edema, higher ITSS levels, and lower ADC compared to ATRX mutant IDH-mutant astrocytoma.
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Affiliation(s)
- Xiefeng Yang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Chengcong Hu
- Department of Pathology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, 350005, People's Republic of China
| | - Zhen Xing
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Yu Lin
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Yan Su
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Xingfu Wang
- Department of Pathology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, 350005, People's Republic of China.
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China.
- Fujian Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China.
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China.
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20
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Zhang X, Shi Z, Xie Y, Wang Y, Shen C, Qi Z, Zhang L, Yang B, Yu J, Ding H. Quantitative analysis using intraoperative contrast-enhanced ultrasound in adult-type diffuse gliomas with isocitrate dehydrogenase mutations: association between hemodynamics and molecular features. Ultrasonography 2023; 42:561-571. [PMID: 37710388 PMCID: PMC10555694 DOI: 10.14366/usg.23031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 09/16/2023] Open
Abstract
PURPOSE The relationship between contrast-enhanced ultrasound (CEUS) hemodynamics and the molecular biomarkers of adult-type diffuse gliomas, particularly isocitrate dehydrogenase (IDH), remains unclear. This study was conducted to provide a comprehensive description of the vascularization of adult-type diffuse gliomas using quantitative indicators. Additionally, it was designed to identify any variables with the potential to intraoperatively predict IDH mutation status. METHODS This prospective study enrolled patients with adult-type diffuse gliomas between November 2021 and September 2022. Intraoperative CEUS was performed, and CEUS videos were recorded for 90-second periods. Hemodynamic parameters, including the peak enhancement (PE) difference, were calculated based on the time-intensity curve of the region of interest. A differential analysis was performed on the CEUS parameters with respect to molecular biomarkers and grades. Receiver operating characteristic curves for various parameters were analyzed to evaluate the ability of those parameters to predict IDH mutation status. RESULTS Sixty patients with adult-type diffuse gliomas were evaluated. All hemodynamic parameters, apart from rising time, demonstrated significant differences between IDH-mutant and IDH-wildtype adult-type diffuse gliomas. The PE difference emerged as the optimal indicator for differentiating between IDH-wildtype and IDH-mutant gliomas, with an area under the curve of 0.958 (95% confidence interval, 0.406 to 0.785). Additionally, the hemodynamic parameters revealed significant differences across both grades and types of adult-type diffuse gliomas. CONCLUSION Hemodynamic parameters can be used intraoperatively to effectively distinguish between IDHwildtype and IDH-mutant adult-type diffuse gliomas. Additionally, quantitative CEUS equips neurosurgeons with dynamic perfusion information for various types and grades of adult-type diffuse gliomas.
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Affiliation(s)
- Xiandi Zhang
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhifeng Shi
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuanxin Xie
- School of Information Science and Technology, Fudan University, Shanghai, China
| | - Yong Wang
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Chao Shen
- Institute of Neurosurgery, Fudan University, Shanghai, China
| | - Zengxin Qi
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Liqiong Zhang
- School of Information Science and Technology, Fudan University, Shanghai, China
| | - Bojie Yang
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Jinhua Yu
- School of Information Science and Technology, Fudan University, Shanghai, China
| | - Hong Ding
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
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21
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Lee MD, Patel SH, Mohan S, Akbari H, Bakas S, Nasrallah MP, Calabrese E, Rudie J, Villanueva-Meyer J, LaMontagne P, Marcus DS, Colen RR, Balana C, Choi YS, Badve C, Barnholtz-Sloan JS, Sloan AE, Booth TC, Palmer JD, Dicker AP, Flanders AE, Shi W, Griffith B, Poisson LM, Chakravarti A, Mahajan A, Chang S, Orringer D, Davatzikos C, Jain R. Association of partial T2-FLAIR mismatch sign and isocitrate dehydrogenase mutation in WHO grade 4 gliomas: results from the ReSPOND consortium. Neuroradiology 2023; 65:1343-1352. [PMID: 37468750 DOI: 10.1007/s00234-023-03196-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE While the T2-FLAIR mismatch sign is highly specific for isocitrate dehydrogenase (IDH)-mutant, 1p/19q-noncodeleted astrocytomas among lower-grade gliomas, its utility in WHO grade 4 gliomas is not well-studied. We derived the partial T2-FLAIR mismatch sign as an imaging biomarker for IDH mutation in WHO grade 4 gliomas. METHODS Preoperative MRI scans of adult WHO grade 4 glioma patients (n = 2165) from the multi-institutional ReSPOND (Radiomics Signatures for PrecisiON Diagnostics) consortium were analyzed. Diagnostic performance of the partial T2-FLAIR mismatch sign was evaluated. Subset analyses were performed to assess associations of imaging markers with overall survival (OS). RESULTS One hundred twenty-one (5.6%) of 2165 grade 4 gliomas were IDH-mutant. Partial T2-FLAIR mismatch was present in 40 (1.8%) cases, 32 of which were IDH-mutant, yielding 26.4% sensitivity, 99.6% specificity, 80.0% positive predictive value, and 95.8% negative predictive value. Multivariate logistic regression demonstrated IDH mutation was significantly associated with partial T2-FLAIR mismatch (odds ratio [OR] 5.715, 95% CI [1.896, 17.221], p = 0.002), younger age (OR 0.911 [0.895, 0.927], p < 0.001), tumor centered in frontal lobe (OR 3.842, [2.361, 6.251], p < 0.001), absence of multicentricity (OR 0.173, [0.049, 0.612], p = 0.007), and presence of cystic (OR 6.596, [3.023, 14.391], p < 0.001) or non-enhancing solid components (OR 6.069, [3.371, 10.928], p < 0.001). Multivariate Cox analysis demonstrated cystic components (p = 0.024) and non-enhancing solid components (p = 0.003) were associated with longer OS, while older age (p < 0.001), frontal lobe center (p = 0.008), multifocality (p < 0.001), and multicentricity (p < 0.001) were associated with shorter OS. CONCLUSION Partial T2-FLAIR mismatch sign is highly specific for IDH mutation in WHO grade 4 gliomas.
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Affiliation(s)
- Matthew D Lee
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA.
| | - Sohil H Patel
- Department of Radiology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Suyash Mohan
- Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Hamed Akbari
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - MacLean P Nasrallah
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Glioblastoma Multiforme Translational Center of Excellence, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Evan Calabrese
- Department of Radiology, Division of Neuroradiology, Duke University, Durham, NC, USA
| | - Jeffrey Rudie
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Javier Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Pamela LaMontagne
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel S Marcus
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Rivka R Colen
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
- Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Carmen Balana
- Medical Oncology Department, Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Yoon Seong Choi
- Department of Radiology, Section of Neuroradiology, Yonsei University Health System, Seoul, South Korea
| | - Chaitra Badve
- Department of Radiology, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, OH, USA
| | - Jill S Barnholtz-Sloan
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, MD, USA
- Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Andrew E Sloan
- Department of Neurosurgery, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, OH, USA
- Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Thomas C Booth
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Neuroradiology, King's College Hospital NHS Foundation Trust, Ruskin WingLondon, UK
| | - Joshua D Palmer
- Department of Radiation Oncology and Neurosurgery, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Adam P Dicker
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Adam E Flanders
- Department of Radiology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Wenyin Shi
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Brent Griffith
- Department of Radiology, Henry Ford Health, Detroit, MI, USA
| | - Laila M Poisson
- Department of Public Health Sciences, Center for Bioinformatics, Henry Ford Health, Detroit, MI, USA
| | - Arnab Chakravarti
- Department of Radiation Oncology and Neurosurgery, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Abhishek Mahajan
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - Susan Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Daniel Orringer
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Department of Pathology, NYU Grossman School of Medicine, New York, NY, USA
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Center for AI and Data Science for Integrated Diagnostics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Rajan Jain
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
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Atef M, Shafik NF, Hassan NH, Allam RM, EL-Meligui YM, Abdelaziz H. Genetic Polymorphism Study of IDH 1/2 and TET2 Genes in Acute Myeloid leukemia Patients. Asian Pac J Cancer Prev 2023; 24:3169-3182. [PMID: 37774069 PMCID: PMC10762743 DOI: 10.31557/apjcp.2023.24.9.3169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 09/12/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Isocitrate dehydrogenase genes (IDH1 and IDH2) encode important enzymes that play pivotal role in cellular metabolism. Mutations in TET2 have been demonstrated to contribute to DNA hypermethylation, either expression of mutant IDH1/2 or TET2 resulted in poor cell differentiation and epigenetic alterations in hematopoietic cells, suggesting a sharing of the oncogenetic impact. In this study, we investigated the frequency of genetic alterations in IDH1/2 and TET2 genes in Egyptian cohort of adult patients with de novo AML, and the association of IDH1/2 and TET2 genetic Polymorphism with AML prognostic criteria and explore prognostic molecular markers with clinical outcome. METHODS The SNP assay for IDH1, IDH2 and TET2 genes polymorphism tested with RT-PCR included three polymorphisms that are rs121913500, rs121913503, and rs2454206 respectively, were tested on 141 adult Egyptian patients fulfilling the AML diagnostic criteria. RESULT The incidence of IDH mutations is 11/141 (7.8%); 5/141 (3.5%) IDH1 mutant and 6/141 (4.3%) IDH2 mutant. And the incidence of TET2 mutations is 72/141 (51.1%); 15/141 (10.7%) homozygous mutation and 57/141 (40.4%) heterozygous mutations. IDH1, IDH2 and TET2 genes mutations with DFS and OS in AML patients were not significantly correlated. CONCLUSIONS TET2 SNP is common in Egyptian AML patients. Further research on IDH, TET2 and their relationships to other hematological malignancies and leukemogenesis transformation is advised and a study of a larger number of cases is needed for potential statistical significance.
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Affiliation(s)
- Manal Atef
- Histology and Genetic Section, Department of Clinical Pathology, National Cancer Institute, Cairo University, Egypt.
| | - Nevine Fawzy Shafik
- Clinical Pathology and Oncologic, Department of Laboratory Medicine, National Cancer Institute, Cairo University, Egypt.
| | - Nagwa H.A. Hassan
- Department of Cytogenetics, Faculty of Science, Ain Shams University, Egypt.
| | - Rasha Mahmoud Allam
- Department of Cancer Epidemiology and Biostatistics, National Cancer Institute, Cairo University, Egypt.
| | - Yomna Mohamed EL-Meligui
- Clinical Pathology and Oncologic, Department of Laboratory Medicine, National Cancer Institute, Cairo University, Egypt.
| | - Hisham Abdelaziz
- Clinical Pathology and Oncologic, Department of Laboratory Medicine, National Cancer Institute, Cairo University, Egypt.
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23
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Sharma P, Medhi PP, Kalita AK, Bhattacharyya M, Nath J, Sarma G, Yanthan Y. Factors Associated With Neurocognitive Impairment Following Chemoradiotherapy in Patients With High-Grade Glioma: Results of a Prospective Trial. Brain Tumor Res Treat 2023; 11:183-190. [PMID: 37550818 PMCID: PMC10409617 DOI: 10.14791/btrt.2023.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/14/2023] [Accepted: 05/08/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND High-grade gliomas (HGG) are highly fatal tumors despite advanced multimodality management. They are also associated with neurocognitive impairment, both due to disease pathology and treatment. We aimed to assess various risk factors responsible for neurocognitive decline in HGG patients undergoing adjuvant chemoradiation. METHODS Newly diagnosed HGG patients who underwent maximal safe resection were included. Patients received volumetric modulated arc therapy to a dose of 60 Gy in 30 fractions, along with concurrent temozolomide (TMZ) at a dose of 75 mg/m²/day orally; thereafter adjuvant TMZ (150-200 mg/m² for 5 days), given every 28 days for 6 to 8 cycles. The Mini-Mental State Examination questionnaire was used to measure cognitive impairment of each study patient at various time points. Cox regression model was used for univariate and multivariable analysis of data to establish possible risk factors. RESULTS Fifty-three patients were enrolled and analyzed. At a median follow-up of 15 months, 30 patients (56.6%) developed cognitive impairment, and 23 patients (43.4%) did not. On univariate analysis, HGG with WHO grade 4, glioblastoma and diffuse midline glioma histology, IDH-wild type, recursive partitioning analysis class IV/V, and only biopsy of primary tumor were significantly associated with neurocognitive impairment, but none of them were independent risk factors on multivariable analysis. Planning target volume and dose received by ipsilateral hippocampus were also significantly correlated with cognitive decline in HGG patients. CONCLUSION Decline in neurocognitive functions in HGG patients is multifactorial and can be attributed to an amalgam of various tumor, patient, and treatment-related factors.
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Affiliation(s)
- Prashasti Sharma
- Department of Radiation Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India.
| | - Partha Pratim Medhi
- Department of Radiation Oncology, All India Institute of Medical Sciences, Guwahati, Assam, India
| | - Apurba Kumar Kalita
- Department of Radiation Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
| | | | - Jyotiman Nath
- Department of Radiation Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
| | - Gautam Sarma
- Department of Radiation Oncology, All India Institute of Medical Sciences, Guwahati, Assam, India
| | - Yanpothung Yanthan
- Department of Radiation Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
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24
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Yano H, Miwa K, Nakayama N, Maruyama T, Ohe N, Ikuta S, Ikegame Y, Yamada T, Takei H, Owashi E, Ohmura K, Yokoyama K, Kumagai M, Muragaki Y, Iwama T, Shinoda J. Differentiation of astrocytoma between grades II and III using a combination of methionine positron emission tomography and magnetic resonance spectroscopy. World Neurosurg X 2023; 19:100193. [PMID: 37123626 PMCID: PMC10141501 DOI: 10.1016/j.wnsx.2023.100193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 04/04/2023] [Indexed: 05/02/2023] Open
Abstract
Objective This study aimed to establish a method for differentiating between grades II and III astrocytomas using preoperative imaging. Methods We retrospectively analyzed astrocytic tumors, including 18 grade II astrocytomas (isocitrate dehydrogenase (IDH)-mutant: IDH-wildtype = 8:10) and 56 grade III anaplastic astrocytomas (37:19). We recorded the maximum methionine (MET) uptake ratios (tumor-to-normal: T/N) on positron emission tomography (PET) and three MRS peak ratios: choline (Cho)/creatine (Cr), N-acetyl aspartate (NAA)/Cr, and Cho/NAA, between June 2015 and June 2020. We then evaluated the cut-off values to differentiate between grades II and III. We compared the grading results between contrast enhancement effects on MR and combinational diagnostic methods (CDM) on a scatter chart using the cutoff values of the T/N ratio and MRS parameters. Results The IDH-mutant group showed significant differences in the Cho/NAA ratio between grades II and III using univariate analysis; however, multiple regression analysis results negated this. The IDH-wildtype group showed no significant differences between the groups. Contrast enhancement effects also showed no significant differences in IDH status. Accordingly, regardless of the IDH status, no statistically independent factors differentiated between grades II and III. However, CDMs showed higher sensitivity and negative predictive value in distinguishing them than MRI contrast examinations for both IDH statuses. We demonstrated a significantly higher diagnostic rate of grade III than of grade II with CDM, which was more striking in the IDH-mutant group than in the wild-type group. Conclusions CDM could be valuable in differentiating between grade II and III astrocytic tumors.
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Affiliation(s)
- Hirohito Yano
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
- Department of Clinical Brain Science, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
- Corresponding author. Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan.
| | - Kazuhiro Miwa
- Department of Neurosurgery, Central Japan International Medical Center, 1-1 Kenkou-no-machi, Minokamo City, 505-8510, Japan
| | - Noriyuki Nakayama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Takashi Maruyama
- Department of Neurosurgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Naoyuki Ohe
- Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Soko Ikuta
- Department of Neurosurgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Yuka Ikegame
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
- Department of Clinical Brain Science, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Tetsuya Yamada
- Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Hiroaki Takei
- Department of Neurosurgery, Central Japan International Medical Center, 1-1 Kenkou-no-machi, Minokamo City, 505-8510, Japan
| | - Etsuko Owashi
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
| | - Kazufumi Ohmura
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
| | - Kazutoshi Yokoyama
- Department of Neurosurgery, Central Japan International Medical Center, 1-1 Kenkou-no-machi, Minokamo City, 505-8510, Japan
| | - Morio Kumagai
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
| | - Yoshihiro Muragaki
- Department of Neurosurgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Jun Shinoda
- Department of Neurosurgery and Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Chubu Neurorehabilitation Hospital, 630 Shimo-kobi, Kobi-cho, Minokamo, 505-0034, Japan
- Department of Clinical Brain Science, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Japan
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Yuzkan S, Mutlu S, Han M, Soylemez Akkurt T, Sencan F, Kusku Cabuk F, Gunaldi O, Tugcu B, Kocak B. Predicting IDH Mutation Status of Grade 2-4 Gliomas with DTI Parameters Derived from Model-based DTI and Model-free Q-Sampling Imaging Reconstructions. World Neurosurg 2023:S1878-8750(23)00882-3. [PMID: 37390902 DOI: 10.1016/j.wneu.2023.06.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE To determine if diffusion tensor imaging (DTI) parameters acquired with model-based DTI and model-free Q-sampling imaging (GQI) reconstructions may noninvasively predict isocitrate dehydrogenase (IDH) mutational status in patients with grade 2-4 gliomas. METHODS Forty patients with known IDH genotype (28 IDH wild-type; 12 IDH mutant) who underwent preoperative DTI evaluation on a 3 Tesla MRI scanner were retrospectively analyzed. Absolute values obtained from model-based and model-free reconstructions were compared. Using the intraclass correlation coefficient, interobserver agreement was assessed for various sampling techniques. Variables having statistically significant distributions between IDH groups were subjected to a receiver operating characteristic (ROC) analysis. Using multivariable logistic regression analysis, independent predictors, if present, were identified and a model was developed. RESULTS Six imaging parameters (3 from model-based DTI and 3 from model-free GQI reconstructions) showed statistically significant differences between groups (p <0.001, power >0.97), with very high correlation to each other (p <0.001). Age difference between the groups was statistically significant (p <0.001). Optimal logistic regression model comprised a GQI-based parameter and age, which were independent predictors as well, producing an area under the ROC curve, accuracy, sensitivity, and specificity of 0.926, 85%, 75%, and 89%, respectively. Using the GQI reconstruction feature alone with a cut-off of 1.60, an 85% of accuracy was also achieved with ROC analysis. CONCLUSIONS The imaging parameters acquired from model-based DTI and model-free GQI reconstructions, combined with the clinical variable age, may have the ability to non-invasively predict the IDH genotype in gliomas, either alone or in particular combinations.
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Affiliation(s)
- Sabahattin Yuzkan
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, 34480, Istanbul, Turkey.
| | - Samet Mutlu
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, 34480, Istanbul, Turkey
| | - Mehmet Han
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, 34480, Istanbul, Turkey
| | - Tuce Soylemez Akkurt
- Department of Pathology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, 34480, Istanbul, Turkey
| | - Fahir Sencan
- Department of Neurosurgery, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, 34480, Istanbul, Turkey
| | - Fatmagul Kusku Cabuk
- Department of Pathology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, 34480, Istanbul, Turkey
| | - Omur Gunaldi
- Department of Neurosurgery, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, 34480, Istanbul, Turkey
| | - Bekir Tugcu
- Department of Neurosurgery, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, 34480, Istanbul, Turkey
| | - Burak Kocak
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, 34480, Istanbul, Turkey
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26
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Morawietz H. Identification of a novel redox switch between metabolism and cardiac function using HyPer power. Pflugers Arch 2023:10.1007/s00424-023-02832-w. [PMID: 37353560 PMCID: PMC10359362 DOI: 10.1007/s00424-023-02832-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 06/25/2023]
Affiliation(s)
- Henning Morawietz
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstr. 74, 01307, Dresden, Germany.
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27
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Zheng J, Dong H, Li M, Lin X, Wang C. Prediction of IDH1 gene mutation by a nomogram based on multiparametric and multiregional MR images. Clinics (Sao Paulo) 2023; 78:100238. [PMID: 37354775 DOI: 10.1016/j.clinsp.2023.100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/19/2023] [Accepted: 06/06/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVE To investigate the value of a nomogram based on multiparametric and multiregional MR images to predict Isocitrate Dehydrogenase-1 (IDH1) gene mutations in glioma. DATA AND METHODS The authors performed a retrospective analysis of 110 MR images of surgically confirmed pathological gliomas; 33 patients with IDH1 gene Mutation (IDH1-M) and 77 patients with Wild-type IDH1 (IDH1-W) were divided into training and validation sets in a 7:3 ratio. The clinical features were statistically analyzed using SPSS and R software. Three glioma regions (rCET, rE, rNEC) were outlined using ITK-SNAP software and projected to four conventional sequences (T1, T2, Flair, T1C) for feature extraction using AI-Kit software. The extracted features were screened using R software. A logistic regression model was established, and a nomogram was generated using the selected clinical features. Eight models were developed based on different sequences and ROIs, and Receiver Operating Characteristic (ROC) curves were used to evaluate the predictive efficacy. Decision curve analysis was performed to assess the clinical usefulness. RESULTS Age was selected with Radscore to construct the nomogram. The Model 1 AUC values based on four sequences and three ROIs were the highest in these models, at 0.93 and 0.89, respectively. Decision curve analysis indicated that the net benefit of model 1 was higher than that of the other models for most Pt-values. CONCLUSION A nomogram based on multiparametric and multiregional MR images can predict the mutation status of the IDH1 gene accurately.
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Affiliation(s)
- Jinjing Zheng
- Department of Radiology, Ningbo Medical Center Lihuili Hospital, Ningbo University, China
| | - Haibo Dong
- Department of Radiology, Ningbo Medical Center Lihuili Hospital, Ningbo University, China.
| | - Ming Li
- Department of Radiology, Ningbo Medical Center Lihuili Hospital, Ningbo University, China
| | - Xueyao Lin
- Department of Radiology, Ningbo Medical Center Lihuili Hospital, Ningbo University, China
| | - Chaochao Wang
- Department of Radiology, Ningbo Medical Center Lihuili Hospital, Ningbo University, China
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Lasocki A, Buckland ME, Molinaro T, Xie J, Whittle JR, Wei H, Gaillard F. Correlating MRI features with additional genetic markers and patient survival in histological grade 2-3 IDH-mutant astrocytomas. Neuroradiology 2023:10.1007/s00234-023-03175-0. [PMID: 37316586 DOI: 10.1007/s00234-023-03175-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE The increasing importance of molecular markers for classification and prognostication of diffuse gliomas has prompted the use of imaging features to predict genotype ("radiogenomics"). CDKN2A/B homozygous deletion has only recently been added to the diagnostic paradigm for IDH[isocitrate dehydrogenase]-mutant astrocytomas; thus, associated radiogenomic literature is sparse. There is also little data on whether different IDH mutations are associated with different imaging appearances. Furthermore, given that molecular status is now generally obtained routinely, the additional prognostic value of radiogenomic features is less clear. This study correlated MRI features with CDKN2A/B status, IDH mutation type and survival in histological grade 2-3 IDH-mutant brain astrocytomas. METHODS Fifty-eight grade 2-3 IDH-mutant astrocytomas were identified, 50 with CDKN2A/B results. IDH mutations were stratified into IDH1-R132H and non-canonical mutations. Background and survival data were obtained. Two neuroradiologists independently assessed the following MRI features: T2-FLAIR mismatch (<25%, 25-50%, >50%), well-defined tumour margins, contrast-enhancement (absent, wispy, solid) and central necrosis. RESULTS 8/50 tumours with CDKN2A/B results demonstrated homozygous deletion; slightly shorter survival was not significant (p=0.571). IDH1-R132H mutations were present in 50/58 (86%). No MRI features correlated with CDKN2A/B status or IDH mutation type. T2-FLAIR mismatch did not predict survival (p=0.977), but well-defined margins predicted longer survival (HR 0.36, p=0.008), while solid enhancement predicted shorter survival (HR 3.86, p=0.004). Both correlations remained significant on multivariate analysis. CONCLUSION MRI features did not predict CDKN2A/B homozygous deletion, but provided additional positive and negative prognostic information which correlated more strongly with prognosis than CDKN2A/B status in our cohort.
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Affiliation(s)
- Arian Lasocki
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Grattan St, Melbourne, Melbourne, Victoria, 3000, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia.
- Department of Radiology, The University of Melbourne, Parkville, Victoria, Australia.
| | - Michael E Buckland
- Department of Neuropathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- School of Medical Sciences, University of Sydney, Camperdown, NSW, Australia
| | - Tahlia Molinaro
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Jing Xie
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - James R Whittle
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Personalised Oncology Division, Walter and Eliza Hall Institute, Parkville, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Victoria, Australia
| | - Heng Wei
- Department of Neuropathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Frank Gaillard
- Department of Radiology, The University of Melbourne, Parkville, Victoria, Australia
- Department of Radiology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
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Rui W, Zhang S, Shi H, Sheng Y, Zhu F, Yao Y, Chen X, Cheng H, Zhang Y, Aili A, Yao Z, Zhang XY, Ren Y. Deep Learning-Assisted Quantitative Susceptibility Mapping as a Tool for Grading and Molecular Subtyping of Gliomas. Phenomics 2023; 3:243-254. [PMID: 37325712 PMCID: PMC10260708 DOI: 10.1007/s43657-022-00087-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 11/16/2022] [Accepted: 11/20/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to explore the value of deep learning (DL)-assisted quantitative susceptibility mapping (QSM) in glioma grading and molecular subtyping. Forty-two patients with gliomas, who underwent preoperative T2 fluid-attenuated inversion recovery (T2 FLAIR), contrast-enhanced T1-weighted imaging (T1WI + C), and QSM scanning at 3.0T magnetic resonance imaging (MRI) were included in this study. Histopathology and immunohistochemistry staining were used to determine glioma grades, and isocitrate dehydrogenase (IDH) 1 and alpha thalassemia/mental retardation syndrome X-linked gene (ATRX) subtypes. Tumor segmentation was performed manually using Insight Toolkit-SNAP program (www.itksnap.org). An inception convolutional neural network (CNN) with a subsequent linear layer was employed as the training encoder to capture multi-scale features from MRI slices. Fivefold cross-validation was utilized as the training strategy (seven samples for each fold), and the ratio of sample size of the training, validation, and test dataset was 4:1:1. The performance was evaluated by the accuracy and area under the curve (AUC). With the inception CNN, single modal of QSM showed better performance in differentiating glioblastomas (GBM) and other grade gliomas (OGG, grade II-III), and predicting IDH1 mutation and ATRX loss (accuracy: 0.80, 0.77, 0.60) than either T2 FLAIR (0.69, 0.57, 0.54) or T1WI + C (0.74, 0.57, 0.46). When combining three modalities, compared with any single modality, the best AUC/accuracy/F1-scores were reached in grading gliomas (OGG and GBM: 0.91/0.89/0.87, low-grade and high-grade gliomas: 0.83/0.86/0.81), predicting IDH1 mutation (0.88/0.89/0.85), and predicting ATRX loss (0.78/0.71/0.67). As a supplement to conventional MRI, DL-assisted QSM is a promising molecular imaging method to evaluate glioma grades, IDH1 mutation, and ATRX loss. Supplementary Information The online version contains supplementary material available at 10.1007/s43657-022-00087-6.
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Affiliation(s)
- Wenting Rui
- Department of Radiology, Huashan Hospital, Fudan University, Mid 12 Wulumuqi Road, Shanghai, 200040 China
| | - Shengjie Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, 200433 China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200433 China
| | - Huidong Shi
- Department of Radiology, Huashan Hospital, Fudan University, Mid 12 Wulumuqi Road, Shanghai, 200040 China
| | - Yaru Sheng
- Department of Radiology, Huashan Hospital, Fudan University, Mid 12 Wulumuqi Road, Shanghai, 200040 China
| | - Fengping Zhu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - YiDi Yao
- Department of Radiology, Huashan Hospital, Fudan University, Mid 12 Wulumuqi Road, Shanghai, 200040 China
| | - Xiang Chen
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, 200433 China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200433 China
| | - Haixia Cheng
- Department of Neuropathology, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Yong Zhang
- GE Healthcare, MR Research, Huatuo Road, Shanghai, 201203 China
| | - Ababikere Aili
- Department of Radiology, Kuqa County People’s Hospital, Xinjiang, 842000 China
| | - Zhenwei Yao
- Department of Radiology, Huashan Hospital, Fudan University, Mid 12 Wulumuqi Road, Shanghai, 200040 China
| | - Xiao-Yong Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, 200433 China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200433 China
| | - Yan Ren
- Department of Radiology, Huashan Hospital, Fudan University, Mid 12 Wulumuqi Road, Shanghai, 200040 China
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Shi DD, Anand S, Abdullah KG, McBrayer SK. DNA damage in IDH-mutant gliomas: mechanisms and clinical implications. J Neurooncol 2023; 162:515-523. [PMID: 36352183 PMCID: PMC10956168 DOI: 10.1007/s11060-022-04172-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/14/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE Since the discovery of IDH mutations in glioma over a decade ago, significant progress has been made in determining how these mutations affect epigenetic, transcriptomic, and metabolic programs in brain tumor cells. In this article, we summarize current understanding of how IDH mutations influence DNA damage in glioma and discuss clinical implications of these findings. METHODS We performed a thorough review of peer-reviewed publications and provide an overview of key mechanisms by which IDH mutations impact response to DNA damage in gliomas, with an emphasis on clinical implications. RESULTS The effects of mutant IDH on DNA damage largely fall into four overarching categories: Gene Expression, Sensitivity to Alkylating Agents, Homologous Recombination, and Oxidative Stress. From a mechanistic standpoint, we discuss how mutant IDH and the oncometabolite (R)-2HG affect each of these categories of DNA damage. We also contextualize these mechanisms with respect to ongoing clinical trials. Studies are underway that incorporate current standard-of-care therapies, including radiation and alkylating agents, in addition to novel therapeutic agents that exert genotoxic stress specifically in IDH-mutant gliomas. Lastly, we discuss key unanswered questions and emerging data in this field that have important implications for our understanding of glioma biology and for the development of new brain tumor therapies. CONCLUSION Mounting preclinical and clinical data suggest that IDH mutations alter DNA damage sensing and repair pathways through distinct mechanisms. Future studies are needed to deepen our understanding of these processes and provide additional mechanistic insights that can be leveraged for therapeutic benefit.
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Affiliation(s)
- Diana D Shi
- Harvard Radiation Oncology Program, MA 02215, Boston, USA
- Children's Medical Center Research Institute, University of Texas Southwestern Medical Center, TX 75390, Dallas, USA
| | - Soummitra Anand
- Children's Medical Center Research Institute, University of Texas Southwestern Medical Center, TX 75390, Dallas, USA
- University of Texas Southwestern Medical School, TX 75390, Dallas, USA
| | - Kalil G Abdullah
- Department of Neurosurgery, University of Pittsburgh School of Medicine, 15213, Pittsburgh, PA, USA.
- Hillman Comprehensive Cancer Center, University of Pittsburgh Medical Center, 15232, Pittsburgh, PA, USA.
| | - Samuel K McBrayer
- Children's Medical Center Research Institute, University of Texas Southwestern Medical Center, TX 75390, Dallas, USA.
- Department of Pediatrics, University of Texas Southwestern Medical Center, TX 75390, Dallas, USA.
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, TX 75235, Dallas, USA.
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Liu X, Liu M, Cao B, Qiao J, Zhang X. Relationship between IDH1/2 and TERT promoter mutation and the prognosis of human glioma patients. Pak J Med Sci 2023; 39:843-847. [PMID: 37250582 PMCID: PMC10214788 DOI: 10.12669/pjms.39.3.7149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/20/2022] [Accepted: 01/27/2023] [Indexed: 11/02/2023] Open
Abstract
Objective To investigate the relationship between isocitrate dehydrogenase (IDH) 1/2 mutation, telomerase reverse transcriptase (TERT) gene promoter mutation and the prognosis of human glioma patients. Methods One hundred fifteen patients with human glioma, treated surgically in The First Affiliated Hospital of Hebei North University from January 2019 to January 2020, were included. All patients were followed up until January 31, 2022. The mutations of IDH1/2 and TERT promoter were analyzed, and risk factors affecting survival of the patients with glioma were assessed. Results IDH1 gene mutation occurred in 82 cases, IDH2 gene mutation occurred in five cases and TERT promoter mutation occurred in 54 cases. Univariate analysis showed that tumor WHO grade, resection range, preoperative Karnofsky performance status score, postoperative radiotherapy and chemotherapy, IDH1/2 gene and TERT promoter mutation influenced postoperative survival of patients with glioma (P<0.05). Kaplan-Meier survival curve showed that IDH1/2 gene and TERT promoter mutation were significantly different from those of wild-type patients (P<0.05). Conclusion IDH1/2 gene and TERT promoter mutations are more frequent in patients with human glioma. These related factors can be used as molecular markers to aid in the prognosis of patients with glioma.
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Affiliation(s)
- Xipeng Liu
- Xiping Liu, Department of Neurosurgery, The First Affiliated Hospital of Hebei North University Zhangjiakou 075000, Hebei Province, P.R. China
| | - Ming Liu
- Ming Liu, Department of Neurosurgery, The First Affiliated Hospital of Hebei North University Zhangjiakou 075000, Hebei Province, P.R. China
| | - Bing Cao
- Bing Caom, Department of Neurosurgery, The First Affiliated Hospital of Hebei North University Zhangjiakou 075000, Hebei Province, P.R. China
| | - Jianxin Qiao
- Jianxin Qiao, Department of Neurosurgery, The First Affiliated Hospital of Hebei North University Zhangjiakou 075000, Hebei Province, P.R. China
| | - Xiufeng Zhang
- Xiufeng Zhang, Department of Neurosurgery, The First Affiliated Hospital of Hebei North University Zhangjiakou 075000, Hebei Province, P.R. China
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Aiman W, Ali MA, Basit MA, Omar Z, Suleman M, Hassan M, Jamil T, Anwar MS, Shafique Z, Dhanesar G, Faisal MS, Akerman MJ, Maroules M, Anwer F. Efficacy and tolerability of isocitrate dehydrogenase inhibitors in patients with acute myeloid leukemia: A systematic review of clinical trials. Leuk Res 2023; 129:107077. [PMID: 37100025 DOI: 10.1016/j.leukres.2023.107077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/09/2023] [Accepted: 04/12/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Acute myeloid leukemia (AML) is a hematological malignancy due to anomalous differentiation and proliferation of hematopoietic stem cells with myeloid blast buildup. Induction chemotherapy is considered the first line of treatment in most patients with AML. However, targeted therapy in the form of FLT-3, IDH, BCL-2, and immune checkpoint inhibitors, can be considered as the first line depending on their molecular profile, resistance to chemotherapy, comorbidities, etc. This review aims to assess the tolerability and efficacy of isocitrate dehydrogenase (IDH) inhibitors in AML. METHODS We searched Medline, WOS, Embase, and clinicaltrials.gov. PRISMA guidelines were followed in this systematic review. 3327 articles were screened, and 9 clinical trials (N = 1119) were included. RESULTS In randomized clinical trials (RCTs), objective response (OR) was reported in 63-74% of the patients with IDH inhibitors + azacitidine as compared to 19-36 % of the patients with azacitidine monotherapy in newly diagnosed (ND) medically unfit patients. Survival rates were significantly improved with the use of ivosidenib. OR was reported in 39.1-46 % of the patients who relapsed/refractory to chemotherapy. ≥Grade 3 IDH differentiation syndrome and QT prolongation were reported in 3.9-10 % and 2-10 % of the patients, respectively. CONCLUSION IDH inhibitors (ivosidenib for IDH-1 and enasidenib for IDH-2) are safe and effective in treating ND medically unfit or relapsed refractory patients with IDH mutation. However, no survival benefit was reported with enasidenib. More randomized multicenter double-blinded clinical studies are needed to confirm these results and compare them with other targeting agents.
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Affiliation(s)
- Wajeeha Aiman
- Saint Michael's Medical Center, New York College of Medicine, Newark, NJ, USA; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Muhammad Ashar Ali
- New York Medical College at St. Mary's and St. Clare's, Denville, NJ, USA; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA.
| | - Muhammad Abdul Basit
- Services Institute of Medical Sciences, Lahore, Pakistan; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Zainab Omar
- Dubai Medical College for Girls, Dubai, United Arab Emirates; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Muhammad Suleman
- Islamic International Medical College, Rawalpindi, Pakistan; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Muhammad Hassan
- Banner University Medical Center, Tucson, AZ, USA; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Taimoor Jamil
- King Edward Medical University, Lahore, Pakistan; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Muhammad Saad Anwar
- King Edward Medical University, Lahore, Pakistan; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Zubair Shafique
- Sahiwal Medical College, Sahiwal, Pakistan; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Gurneel Dhanesar
- New York Medical College at St. Mary's and St. Clare's, Denville, NJ, USA; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Muhammad Salman Faisal
- Roswell Park Cancer Institute, Buffalo, NY, USA; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Michael J Akerman
- New York Medical College at St. Mary's and St. Clare's, Denville, NJ, USA; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Michael Maroules
- New York Medical College at St. Mary's and St. Clare's, Denville, NJ, USA; Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA
| | - Faiz Anwer
- Cancer Center, Saint Mary's General Hospital, Passaic, NJ, USA; Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, USA
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Cao M, Wang X, Liu F, Xue K, Dai Y, Zhou Y. A three-component multi-b-value diffusion-weighted imaging might be a useful biomarker for detecting microstructural features in gliomas with differences in malignancy and IDH-1 mutation status. Eur Radiol 2023; 33:2871-2880. [PMID: 36346441 DOI: 10.1007/s00330-022-09212-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/21/2022] [Accepted: 09/30/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The purpose of the study was to explore the performance of a three-component diffusion model in evaluating the degree of malignancy and isocitrate dehydrogenase 1 (IDH-1) gene type of gliomas. METHODS Overall, 60 patients with gliomas were enrolled. The intermediate and perfusion-related diffusion coefficients (Dint and Dp) and fractions of strictly limited, intermediate, and perfusion-related diffusion (Fvery-slow, Fint, and Fp) were obtained with a three-component diffusion model. Parameters were also obtained from a diffusion kurtosis model and mono- and biexponential models. All parameters were compared between different tumor grades and IDH-1 gene types. Diagnostic performance and logistic regression analyses were performed. RESULTS High-grade gliomas (HGGs) had significantly higher Fint, Fvery-slow, and Dp values but significantly lower Fp and Dint values than low-grade gliomas (LGGs), and Fint and Fp differed significantly among grade II, III, and IV gliomas (p < 0.05 for all). Fint achieved the highest AUC of 0.872 in differentiating between LGGs and HGGs. Logistic regression analysis revealed that in each model, Fint, diffusion coefficient (D), apparent diffusion coefficient (ADC), mean diffusivity (MD), and mean kurtosis (MK) were associated with glioma grading. After multiple regression analysis, Fint remained the only differentiator. Additionally, Fint and Fp showed significant differences between IDH-1 mutated and IDH-1 wild-type gliomas (p = 0.007 and 0.01, respectively). CONCLUSIONS The three-component DWI model served as a useful biomarker for detecting microstructural features in gliomas with different grades and IDH-1 mutation statuses. KEY POINTS • The three-component model enables the estimation of an intermediate diffusion component. • The three-component model performed better than the other models in glioma grading and genotyping. • Fint was useful in evaluating the grade and genotype of gliomas.
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Affiliation(s)
- Mengqiu Cao
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Rd., Shanghai, 200127, China
| | - Xiaoqing Wang
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Rd., Shanghai, 200127, China
| | - Fang Liu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Rd., Shanghai, 200127, China
| | - Ke Xue
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Yongming Dai
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Yan Zhou
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Rd., Shanghai, 200127, China.
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Davis AR, Canady BC, Aggarwal N, Bailey NG. Clinicopathologic Features of IDH2 R172-Mutated Myeloid Neoplasms. Am J Clin Pathol 2023:7083610. [PMID: 36946516 DOI: 10.1093/ajcp/aqad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/02/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES IDH1 and IDH2 are among the most commonly mutated genes in myeloid neoplasms (MNs). It has been proposed that IDH2 R172 mutations (mR172) define a molecular subtype of acute myeloid leukemia (AML), but the clinicopathologic features of AML with mR172 have not been fully described. METHODS We retrospectively identified and characterized all mR172 MNs with increased blasts in our archive for comparison to a similar number of MNs with IDH2 R140 (mR140) and IDH1 R132 (mR132) mutations (n = 39). RESULTS mR172 cases had lower leukocyte counts and bone marrow cellularity than did non-mR172 cases. mR172 MNs often displayed blasts with highly invaginated, cleaved nuclei and typically expressed CD34, HLA-DR, CD117, and CD13 but often with diminished CD33. mR172 cases often had co-occurring mutations in myelodysplasia-associated genes and/or an adverse karyotype. Despite frequent adverse-risk genetic changes, in our cohort mR172 cases had significantly improved overall survival vs non-mR172 cases (P = .01), and we validated that mR172 was associated with improved survival in an independent large data set. CONCLUSIONS We show that MNs with mR172 represent a morphologically and phenotypically distinct subtype, which in our cohort exhibited relatively favorable survival that is not captured in current AML risk assignment.
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Affiliation(s)
- Adam R Davis
- Department of Pathology, UPMC, Pittsburgh, PA, USA
| | - Briana C Canady
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Nidhi Aggarwal
- Department of Pathology, UPMC, Pittsburgh, PA, USA
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Nathanael G Bailey
- Department of Pathology, UPMC, Pittsburgh, PA, USA
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Mattice AMS, Varma A, Storey KB. Role of NADP +-dependent isocitrate dehydrogenase from muscle tissue of Rana sylvatica in ROS defense during freeze-tolerance. Biochimie 2023:S0300-9084(23)00070-6. [PMID: 36958591 DOI: 10.1016/j.biochi.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023]
Abstract
The wood frog, Rana sylvatica, employs freeze tolerance as a winter survival strategy in seasonally cold environments. At subzero temperatures, up to 65-70% of total body water can freeze in extracellular spaces, halting vital functions (breathing, heartbeat) and causing ischemia that, in turn, can have numerous consequences including the generation of damaging reactive oxygen species (ROS). NADPH serves as a key donor of reductive power for most ROS detoxifying enzymes and can be generated by several metabolic pathways. One source of NADPH reducing power is the NADP-dependent isocitrate dehydrogenase (IDH) reaction. The present study evaluated the properties and regulation of IDH from skeletal muscle of R. sylvatica when frogs were exposed to stress conditions: freezing, dehydration or anoxia. Purified IDH exhibited higher affinity for isocitrate under all stress conditions as compared to controls, suggesting that the enzyme is primed to synthesize NADPH relative to the control state. Immunoblotting showed reduced serine and threonine phosphorylation of muscle IDH from frozen frogs and decreased serine phosphorylation on IDH from dehydrated frogs relative to control and anoxic states, demonstrating a reversible phosphorylation regulatory mechanism for IDH activity during freezing stress. Taken together, these results suggest activation and maintenance of IDH activity despite hypometabolic conditions. This initiation in activity of IDH during freezing may play a role in antioxidant defense by contributing to maintenance of the NADPH pool under stress conditions.
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Affiliation(s)
- Amanda M S Mattice
- Institute of Biochemistry & Department of Biology, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada
| | - Anchal Varma
- Institute of Biochemistry & Department of Biology, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada
| | - Kenneth B Storey
- Institute of Biochemistry & Department of Biology, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada.
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Parsons MW, Sabsevitz DS. Cognitive issues in patients with IDH mutant gliomas: from neuroscience to clinical neuropsychology. J Neurooncol 2023. [PMID: 36940053 DOI: 10.1007/s11060-023-04289-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/01/2023] [Indexed: 03/21/2023]
Abstract
PURPOSE The understanding of cognitive symptoms in patients with IDH-Mutant gliomas (IDH-Mut) is rapidly developing. In this article, we summarize the neuroscientific knowledge base regarding the influence of IDH-Mut tumors and their treatment on cognition and provide guidance regarding the management of these symptoms in patients. METHODS We performed a review of peer reviewed publications relevant to IDH-Mut glioma and cognitive outcomes and provide an overview of the literature as well as a case example to clarify management strategies. RESULTS At the time of presentation, patients with IDH-Mut gliomas have a favorable cognitive profile as compared with those with IDH-wild type (WT) tumors. The relatively low cognitive burden may reflect the slower growth rate of IDH-Mut tumors, which is less disruptive to both local and widespread neural networks. Human connectomic research using a variety of modalities has demonstrated relatively preserved network efficiency in patients with IDH-Mut gliomas as compared with IDH-WT tumors. Risk of cognitive decline from surgery can potentially be mitigated by careful integration of intra-operative mapping. Longer term cognitive risks of tumor treatment, including chemotherapy and radiation, are best managed by instituting neuropsychological assessment as part of the long-term care of patients with IDH-Mutant glioma. A specific timeline for such integrative care is provided. CONCLUSIONS Given the relative recency of the IDH-mutation based classification of gliomas, as well as the long time course of this disease, a thoughtful and comprehensive strategy to studying patient outcomes and devising methods of cognitive risk reduction is required.
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Ando K, Natsumeda M, Kawamura M, Shirakawa K, Okada M, Tsukamoto Y, Eda T, Watanabe J, Saito S, Takahashi H, Kakita A, Oishi M, Fujii Y. Elevated ratio of C-type lectin-like receptor 2 level and platelet count (C2PAC) aids in the diagnosis of post-operative venous thromboembolism in IDH-wildtype gliomas. Thromb Res 2023; 223:36-43. [PMID: 36706720 DOI: 10.1016/j.thromres.2023.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/08/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Podoplanin (PDPN) is known to induce platelet aggregation via interacting with the C-type lectin-like receptor-2 on platelets and is involved in postoperative venous thromboembolism (VTE) formation. In this study, we investigate the correlation between soluble C-type lectin-like receptor (sCLEC-2) levels and PDPN expression in patients with high grade gliomas and the relationship between sCLEC-2 levels and the occurrence of VTE. MATERIALS AND METHODS Forty-four patients harboring high grade gliomas, treated surgically at the Department of Neurosurgery, Niigata University from April 2018 to August 2020, were included. Patients with high grade gliomas were divided into isocitrate dehydrogenase (IDH)- wildtype and mutant groups, and the presence or absence of VTE and the intensity of PDPN by immunohistochemistry were confirmed. Platelet counts, as well as plasma sCLEC-2 and PDPN were measured in these patients. Furthermore, the levels of sCLEC-2 concentration were divided by the platelet count (C2PAC index) for comparison. RESULTS IDH-wildtype glioma patients highly expressed PDPN (P < 0.001) compared to IDH-mutant glioma patients. In total, 9 (20.5 %) patients were diagnosed with VTE during the follow-up period, of which 8 patients harbored IDH-wildtype gliomas, and one patient an IDH-mutant glioma. Mean sCLEC-2 levels and C2PAC index in patients with IDH-wildtype gliomas were significantly higher than that of low or no PDPN expression group, which included patients with IDH-mutant gliomas (P = 0.0004, P = 0.0002). In patients with IDH-wildtype gliomas, the C2PAC index in patients with VTE was significantly higher than in patients without VTE (P = 0.0492). The optimal cutoff point of C2PAC for predicting VTE in IDH-wildtype glioma patients was 3.7 with a sensitivity of 87.5 % and specificity of 51.9 %. CONCLUSION Platelet activation is strongly involved in the development of VTE in patients with IDH-wildtype high grade gliomas, and C2PAC index is a potential marker to detect VTE formation after surgery.
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Affiliation(s)
- Kazuhiro Ando
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan.
| | - Manabu Natsumeda
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Masahide Kawamura
- Department Research and Development, LSI Medience Corporation, Tokyo, Japan
| | - Kamon Shirakawa
- Department Research and Development, LSI Medience Corporation, Tokyo, Japan
| | - Masayasu Okada
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Yoshihiro Tsukamoto
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Takeyoshi Eda
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Jun Watanabe
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Shoji Saito
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Haruhiko Takahashi
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Makoto Oishi
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Yukihiko Fujii
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
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DiNardo CD, Hochhaus A, Frattini MG, Yee K, Zander T, Krämer A, Chen X, Ji Y, Parikh NS, Choi J, Wei AH. A phase 1 study of IDH305 in patients with IDH1 R132-mutant acute myeloid leukemia or myelodysplastic syndrome. J Cancer Res Clin Oncol 2023; 149:1145-1158. [PMID: 35353219 DOI: 10.1007/s00432-022-03983-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/10/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Isocitrate dehydrogenase enzyme 1 (IDH1) mutations at 132nd amino acid residue (R132*) result in the cellular accumulation of the oncometabolite, 2-hydroxyglutarate (2-HG). IDH305 is an orally bioavailable, brain-penetrant, mutant-selective allosteric IDH1 inhibitor demonstrating target engagement in preclinical models. This first-in human study was designed to identify the recommended dose for expansion/maximum tolerated dose of IDH305 in patients with IDH1R132-mutant acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). METHODS IDH305 was given at doses 75-750 mg twice daily in 41 patients with IDH1R132-mutant AML/MDS. Dose escalation was designed using Bayesian hierarchical model with overdose control principle and relationship with dose-limiting toxicity. RESULTS IDH305 exhibited rapid absorption with mean T1/2 approximately 4-10 h across doses. Interpatient variability was moderate and exposure increased with dose in a less than dose proportional manner. Most patients (35/41) demonstrated target engagement with reduction in 2-HG concentration at all doses. Complete remission (CR) or CR with incomplete count recovery occurred in 10/37 (27%) patients with AML and 1/ 4 patients with MDS. Adverse events (AEs) suspected to be related to study drug were reported in 53.7% of patients: increased blood bilirubin (14.6%), nausea (14.6%), increased alanine aminotransferase and aspartate aminotransferase (12.2%, each); most frequent grade 3 or 4 AEs were differentiation syndrome and tumor lysis syndrome (n = 3; 7.3%, each). Hepatotoxicity was manageable with dose modification. CONCLUSION Due to potentially narrow therapeutic window, the study was prematurely halted and recommended phase 2 dose could not be declared. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT02381886.
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Affiliation(s)
- Courtney D DiNardo
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Andreas Hochhaus
- Klinik für Innere Medizin II, Hämatologie/Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Mark G Frattini
- Hematology/Oncology Division, Columbia University Medical Center, New York City, NY, USA
| | - Karen Yee
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Thomas Zander
- Department of Internal Medicine I, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf; Gastrointestinal Cancer Group Cologne (GCGC), University of Cologne, Cologne, Germany
| | - Alwin Krämer
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Xueying Chen
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Yan Ji
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Nehal S Parikh
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Joanne Choi
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - Andrew H Wei
- Australian Centre for Blood Diseases, Monash University, Melbourne, VIC, Australia
- Department of Clinical Haematology, The Alfred Hospital, Melbourne, VIC, Australia
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Guo D, Jiang B. Noninvasively evaluating the grade and IDH mutation status of gliomas by using mono-exponential, bi-exponential diffusion-weighted imaging and three-dimensional pseudo-continuous arterial spin labeling. Eur J Radiol 2023; 160:110721. [PMID: 36738600 DOI: 10.1016/j.ejrad.2023.110721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/14/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To noninvasively assess the diagnostic performance of diffusion-weighted imaging (DWI), bi-exponential intravoxel incoherent motion imaging (IVIM) and three-dimensional pseudo-continuous arterial spin labeling (3D pCASL) in differentiating lower-grade gliomas (LGGs) from high-grade gliomas (HGGs), and predicting the isocitrate dehydrogenase (IDH) mutation status. MATERIALS AND METHODS Ninety-five patients with pathologically confirmed grade 2-4 gliomas with preoperative DWI, IVIM and 3D pCASL were enrolled in this study. The Student's t test and Mann-Whitney U test were used to evaluate differences in parameters of DWI, IVIM and 3D pCASL between LGG and HGG as well as between mutant and wild-type IDH in grade 2 and 3 diffusion astrocytoma; receiver operator characteristic (ROC) analysis was used to assess the diagnostic performance. RESULTS The value of ADCmean, ADCmin, Dmean and Dmin in HGGs were lower than in LGGs, while the value of CBFmean and CBFmax in HGGs were higher than in LGGs. In ROC analysis, the AUC values of Dmean, Dmin and CBFmax were 0.827, 0.878 and 0.839, respectively. The combination of CBFmax and Dmin displayed the highest diagnostic performance to distinguish LGGs from HGGs, with AUC 0.906, sensitivity 82.4 %, and specificity 86.4 %. In grades 2 and 3 diffusion astrocytoma patients, ADCmin, Dmean, Dmin, CBFmean and CBFmax showed significant differences between IDHmut and IDHwt group (p < 0.05, 0.001, 0.001, 0.01 and 0.001, respectively) and the AUC values were 0. 709, 0.849, 0.919, 0.755 and 0.873, respectively. Similarly, the combination of CBFmax and Dmin demonstrated the highest AUC value (0.938) in prediction IDH mutation status, with sensitivity 92.9 %, and specificity 95.5 %. CONCLUSION The combination of IVIM and 3D pCASL can be used in prediction histologic grade and IDH mutation status of glioma noninvasively.
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Affiliation(s)
- Da Guo
- Department of Radiology, The Sixth People's Hospital of Nanchong, Sichuan Province, People's Republic of China
| | - Binghu Jiang
- Department of Radiology, Nanchong Central Hospital, Sichuan Province, People's Republic of China.
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Pei D, Guan F, Hong X, Liu Z, Wang W, Qiu Y, Duan W, Wang M, Sun C, Wang W, Wang X, Guo Y, Wang Z, Liu Z, Xing A, Guo Z, Luo L, Liu X, Cheng J, Zhang B, Zhang Z, Yan J. Radiomic features from dynamic susceptibility contrast perfusion-weighted imaging improve the three-class prediction of molecular subtypes in patients with adult diffuse gliomas. Eur Radiol 2023. [PMID: 36853347 DOI: 10.1007/s00330-023-09459-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/21/2022] [Accepted: 01/20/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVES To investigate whether radiomic features extracted from dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) can improve the prediction of the molecular subtypes of adult diffuse gliomas, and to further develop and validate a multimodal radiomic model by integrating radiomic features from conventional and perfusion MRI. METHODS We extracted 1197 radiomic features from each sequence of conventional MRI and DSC-PWI, respectively. The Boruta algorithm was used for feature selection and combination, and a three-class random forest method was applied to construct the models. We also constructed a combined model by integrating radiomic features and clinical metrics. The models' diagnostic performance for discriminating the molecular subtypes (IDH wild type [IDHwt], IDH mutant and 1p/19q-noncodeleted [IDHmut-noncodel], and IDH mutant and 1p/19q-codeleted [IDHmut-codel]) was compared using AUCs in the validation set. RESULTS We included 272 patients (training set, n = 166; validation set, n = 106) with grade II-IV gliomas (mean age, 48.7 years; range, 19-77 years). The proportions of the molecular subtypes were 66.2% IDHwt, 15.1% IDHmut-noncodel, and 18.8% IDHmut-codel. Nineteen radiomic features (13 from conventional MRI and 6 from DSC-PWI) were selected to build the multimodal radiomic model. In the validation set, the multimodal radiomic model showed better performance than the conventional radiomic model did in predicting the IDHwt and IDHmut-codel subtypes, which was comparable to the conventional radiomic model in predicting the IDHmut-noncodel subtype. The multimodal radiomic model yielded similar performance as the combined model in predicting the three molecular subtypes. CONCLUSIONS Adding DSC-PWI to conventional MRI can improve molecular subtype prediction in patients with diffuse gliomas. KEY POINTS • The multimodal radiomic model outperformed conventional MRI when predicting both the IDH wild type and IDH mutant and 1p/19q-codeleted subtypes of gliomas. • The multimodal radiomic model showed comparable performance to the combined model in the prediction of the three molecular subtypes. • Radiomic features from T1-weighted gadolinium contrast-enhanced and relative cerebral blood volume images played an important role in the prediction of molecular subtypes.
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Park YW, Han K, Kim S, Kwon H, Ahn SS, Moon JH, Kim EH, Kim J, Kang SG, Chang JH, Kim SH, Lee SK. Revisiting prognostic factors in glioma with leptomeningeal metastases: a comprehensive analysis of clinical and molecular factors and treatment modalities. J Neurooncol 2023. [PMID: 36841906 DOI: 10.1007/s11060-022-04233-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/30/2022] [Indexed: 02/27/2023]
Abstract
PURPOSE To comprehensively investigate prognostic factors, including clinical and molecular factors and treatment modalities, in adult glioma patients with leptomeningeal metastases (LM). METHODS Total 226 patients with LM (from 2001 to 2021 among 1495 grade 2 to 4 glioma patients, 88.5% of LM patients being IDH-wildtype) with complete information on IDH mutation, 1p/19q codeletion, and MGMT promoter methylation status were enrolled. Predictors of overall survival (OS) of entire patients were determined by time-dependent Cox analysis, including clinical, molecular, and treatment data. Subgroup analyses were performed for patients with LM at initial diagnosis and LM diagnosed at recurrence (herein, initial and recurrent LM). Identical analyses were performed in IDH-wildtype glioblastoma patients. RESULTS Median OS was 17.0 (IQR 9.7-67.1) months, with shorter median OS in initial LM than recurrent LM patients (12.2 vs 20.6 months, P < 0.001). In entire patients, chemotherapy and antiangiogenic therapy were predictors of longer OS, while male sex and initial LM were predictors of shorter OS. In initial LM, higher KPS, chemotherapy, and antiangiogenic therapy were predictors of longer OS, while male sex was a predictor of shorter OS. In recurrent LM, chemotherapy and longer interval between initial glioma and LM diagnoses were predictors of longer OS, while male sex was a predictor of shorter OS. A similar trend was observed in IDH-wildtype glioblastoma. CONCLUSION Active chemotherapy and antiangiogenic therapy demonstrated survival benefit in glioma patients with LM. There is consistent female survival advantage, whereas longer interval between initial glioma diagnosis and LM development suggests longer OS in recurrent LM.
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Roh J, Im M, Kang J, Youn B, Kim W. Long non-coding RNA in glioma: novel genetic players in temozolomide resistance. Anim Cells Syst (Seoul) 2023; 27:19-28. [PMID: 36819921 PMCID: PMC9937017 DOI: 10.1080/19768354.2023.2175497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Glioma is the most common primary malignant brain tumor in adults and accounts for approximately 80% of brain and central nervous system tumors. In 2021, the World Health Organization (WHO) published a new taxonomy for glioma based on its histological features and molecular alterations. Isocitrate dehydrogenase (IDH) catalyzes the decarboxylation of isocitrate, a critical metabolic reaction in energy generation in cells. Mutations in the IDH genes interrupt cell differentiation and serve as molecular biomarkers that can be used to classify gliomas. For example, the mutant IDH is widely detected in low-grade gliomas, whereas the wild type is in high-grade ones, including glioblastomas. Long non-coding RNAs (lncRNAs) are epigenetically involved in gene expression and contribute to glioma development. To investigate the potential use of lncRNAs as biomarkers, we examined lncRNA dysregulation dependent on the IDH mutation status. We found that several lncRNAs, namely, AL606760.2, H19, MALAT1, PVT1 and SBF2-AS1 may function as glioma risk factors, whereas AC068643.1, AC079228.1, DGCR5, FAM13A-AS1, HAR1A and WDFY3-AS2 may have protective effects. Notably, H19, MALAT1, PVT1, and SBF2-AS1 have been associated with temozolomide resistance in glioma patients. This review study suggests that targeting glioma-associated lncRNAs might aid the treatment of glioma.
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Affiliation(s)
- Jungwook Roh
- Department of Science Education, Korea National University of Education, Cheongju-si, Republic of Korea
| | - Mijung Im
- Department of Science Education, Korea National University of Education, Cheongju-si, Republic of Korea
| | - JiHoon Kang
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory, Emory University School of Medicine, Atlanta, GA, USA
| | - BuHyun Youn
- Department of Biological Sciences, Pusan National University, Busan, Republic of Korea, BuHyun Youn Department of Biological Sciences, Pusan National University, Busandaehak-ro 63beon-gil 2, Geumjeong-gu, Busan46241, Republic of Korea; Wanyeon Kim Department of Biology Education, Korea National University of Education, 250 Taeseongtabyeon-ro, Gangnae-myeon, Heungdeok-gu, Cheongju-si, Chungbuk28173, Republic of Korea
| | - Wanyeon Kim
- Department of Science Education, Korea National University of Education, Cheongju-si, Republic of Korea,Department of Biology Education, Korea National University of Education, Cheongju-si, Republic of Korea, BuHyun Youn Department of Biological Sciences, Pusan National University, Busandaehak-ro 63beon-gil 2, Geumjeong-gu, Busan46241, Republic of Korea; Wanyeon Kim Department of Biology Education, Korea National University of Education, 250 Taeseongtabyeon-ro, Gangnae-myeon, Heungdeok-gu, Cheongju-si, Chungbuk28173, Republic of Korea
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Ikeda S, Sakata A, Fushimi Y, Okuchi S, Arakawa Y, Makino Y, Mineharu Y, Nakajima S, Hinoda T, Yoshida K, Miyamoto S, Nakamoto Y. Telomerase reverse transcriptase promoter mutation and histologic grade in IDH wild-type histological lower-grade gliomas: The value of perfusion-weighted image, diffusion-weighted image, and 18F-FDG-PET. Eur J Radiol 2023; 159:110658. [PMID: 36571926 DOI: 10.1016/j.ejrad.2022.110658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE The telomerase reverse transcriptase promoter (TERTp) mutation is an unfavorable prognostic factor in isocitrate dehydrogenase-wildtype (IDHwt) histologically lower-grade astrocytoma (LGA), which was incorporated as a key component in the WHO 2021 classification of IDHwt LGA, replacing histologic grades in the WHO 2016 classification. The purpose of this study was to identify the imaging characteristics predictive of TERTp mutations in IDHwt LGA. METHODS This retrospective study was approved by our institutional review board. This single-center study retrospectively included 59 patients with pathologically confirmed IDHwt LGA with known TERTp mutation status. In addition to clinical information and morphological characteristics, semi-quantitative imaging biomarkers such as the tumor-to-normal ratio (T/N ratio) on 18F-FDG-PET, normalized apparent diffusion coefficient (nADC), and histogram parameters from normalized relative cerebral blood volume (nrCBV) maps were compared between (a) TERTp-wildtype and TERTp-mutant tumors or (b) grade II and grade III astrocytoma. A p value < 0.05 was considered significant. RESULTS There were no significant differences in the conventional imaging findings, T/N ratio on FDG-PET, nrCBV or ADC histogram metrics between IDHwt LGA with TERTp mutations and those without. Grade III IDHwt astrocytomas exhibited significantly higher nrCBV values, T/N ratio and lower ADC parameters than grade II IDHwt astrocytoma. CONCLUSIONS In patients with IDHwt LGA, T/N ratio, nrCBV values and nADC may be surrogate markers for predicting histologic grade, but are not useful for predicting TERTp mutations.
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Affiliation(s)
- Satoshi Ikeda
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Sachi Okuchi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yasuhide Makino
- Department of Neurosurgery, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan
| | - Yohei Mineharu
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Satoshi Nakajima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takuya Hinoda
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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Qiu X, Gao J, Hu J, Yang J, Hu W, Huang Q, Zhang H, Lu JJ, Kong L. Proton radiotherapy in the treatment of IDH-mutant diffuse gliomas: an early experience from shanghai proton and heavy ion center. J Neurooncol 2022. [PMID: 36583815 DOI: 10.1007/s11060-022-04202-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/27/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE According to the presence or absence of isocitrate dehydrogenase (IDH) mutation, the 2021 WHO classification system bisected diffuse gliomas into IDH-mutant tumors and IDH-wildtype tumors. This study was aimed to evaluate the outcomes of proton radiotherapy treating IDH-mutant diffuse gliomas. PATIENTS AND METHODS Between May 2015 and May 2022, a total of 52 consecutive patients with IDH-mutant diffuse gliomas were treated at Shanghai Proton and Heavy Ion Center. Tumor histologies were 33 cases of astrocytoma and 19 cases of oligodendroglioma. Tumor classified by WHO grade 2, 3 and 4 were 22, 25, and 5 cases, respectively. All 22 patients with WHO grade 2 tumors and one patient with brain stem WHO grade 4 tumor were irradiated with 54GyE. The other 29 patients with WHO grade 3 and 4 tumors were irradiated with 60GyE. Temozolomide was recommended to all patients, and was eventually conducted in 50 patients. RESULTS The median follow-up time was 21.7 months. The 12/24-month progression-free survival (PFS) and overall survival (OS) rates for the entire cohort were 97.6%/78.4% and 100%/91.0% group. Examined by both univariate and multivariate analysis, WHO grade of tumor were of the most significant impact for both PFS and OS. No severe acute toxicity (grade 3 or above) was found. In terms of late toxicity, grade 3 radio-necrosis was developed in one case of oligodendroglioma, WHO grade 3. CONCLUSION Proton radiotherapy produced a favorable outcome with acceptable adverse-effects in patients with IDH-mutant diffuse gliomas.
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Gueble SE, Vasquez JC, Bindra RS. The Role of PARP Inhibitors in Patients with Primary Malignant Central Nervous System Tumors. Curr Treat Options Oncol 2022; 23:1566-1589. [PMID: 36242713 DOI: 10.1007/s11864-022-01024-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2022] [Indexed: 01/30/2023]
Abstract
OPINION STATEMENT Primary malignant central nervous (CNS) tumors are a devastating group of diseases with urgent need for improved treatment options. Surgery, radiation, and cytotoxic chemotherapy remain the primary standard treatment modalities, with molecularly targeted therapies having proven efficacy in only small subsets of cases. Poly(ADP-ribose) polymerase (PARP) inhibitors, which have had immense success in the treatment of extracranial cancers with homologous recombination deficiency (HRD), are emerging as a potential targeted treatment for various CNS tumors. Although few primary CNS tumors display canonical BRCA gene defects, preclinical evidence suggests that PARP inhibitors may benefit certain CNS tumors with functional HRD or elevated replication stress. In addition, other preclinical studies indicate that PARP inhibitors may synergize with standard therapies used for CNS tumors including radiation and alkylating agents and may prevent or overcome drug resistance. Thus far, initial clinical trials with early-generation PARP inhibitors, typically as monotherapy or in the absence of selective biomarkers, have shown limited efficacy. However, the scientific rationale remains promising, and many clinical trials are ongoing, including investigations of more CNS penetrant or more potent inhibitors and of combination therapy with immune checkpoint inhibitors. Early phase trials are also critically focusing on determining active drug CNS penetration and identifying biomarkers of therapy response. In this review, we will discuss the preclinical evidence supporting use of PARP inhibitors in primary CNS tumors and clinical trial results to date, highlighting ongoing trials and future directions in the field that may yield important findings and potentially impact the treatment of these devastating malignancies in the coming years.
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Affiliation(s)
- Susan E Gueble
- Department of Therapeutic Radiology, Yale School of Medicine, P.O. Box 208040, HRT 134, New Haven, CT, 06520-8040, USA
| | - Juan C Vasquez
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Ranjit S Bindra
- Department of Therapeutic Radiology, Yale School of Medicine, P.O. Box 208040, HRT 134, New Haven, CT, 06520-8040, USA. .,Department of Pathology, Yale School of Medicine, New Haven, CT, 06520, USA.
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Kim M, Kim S, Park YW, Han K, Ahn SS, Moon JH, Kim EH, Kim J, Kang SG, Chang JH, Kim SH, Lee SK. Sex as a prognostic factor in adult-type diffuse gliomas: an integrated clinical and molecular analysis according to the 2021 WHO classification. J Neurooncol 2022; 159:695-703. [PMID: 35988090 DOI: 10.1007/s11060-022-04114-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/04/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE To investigate whether type-specific sex differences in survival exist independently of clinical and molecular factors in adult-type diffuse gliomas according to the 2021 World Health Organization (WHO) classification. METHODS A retrospective chart and imaging review of 1325 patients (mean age, 54 ± 15 years; 569 females) with adult-type diffuse gliomas (oligodendroglioma, IDH-mutant, and 1p/19q-codeleted, n = 183; astrocytoma, IDH-mutant, n = 211; glioblastoma, IDH-wildtype, n = 800; IDH-wildtype diffuse glioma, NOS, n = 131) was performed. The demographic information, extent of resection, imaging data, and molecular data including O6-methylguanine-methyltransferase promoter methylation (MGMT) promotor methylation were collected. Sex differences in survival were analyzed using Cox analysis. RESULTS In patients with glioblastoma, IDH-wildtype, female sex remained as an independent predictor of better overall survival (hazard ratio = 0.91, P = 0.031), along with age, histological grade 4, MGMT promoter methylation status, and gross total resection. Female sex showed a higher prevalence of MGMT promoter methylation (40.2% vs 32.0%, P = 0.017) but there was no interaction effect between female sex and MGMT promoter methylation status (P-interaction = 0.194), indicating independent role of female sex. The median OS for females were 19.2 months (12.3-35.0) and 16.2 months (10.5-30.6) for males. No sex difference in survival was seen in other types of adult-type diffuse gliomas. CONCLUSION There was a female survival advantage in glioblastoma, IDH-wildtype, independently of clinical data or MGMT promoter methylation status. There was no sex difference in survival in other types of adult-type diffuse gliomas, suggesting type-specific sex effects solely in glioblastoma, IDH-wildtype.
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Wu LF, Wang DP, Shen J, Gao LJ, Zhou Y, Liu QH, Cao JM. Global profiling of protein lysine malonylation in mouse cardiac hypertrophy. J Proteomics 2022; 266:104667. [PMID: 35788409 DOI: 10.1016/j.jprot.2022.104667] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/06/2022] [Accepted: 06/19/2022] [Indexed: 10/17/2022]
Abstract
Lysine malonylation, a novel identified protein posttranslational modification (PTM), is conservative and present in both eukaryotic and prokaryotic cells. Previous studies have reported that malonylation plays an important role in inflammation, angiogenesis, and diabetes. However, its potential role in cardiac remodeling remains unknown. Here, we observed a reduced lysine malonylation in hypertrophic mice hearts created by transverse aortic constriction (TAC) for 8 weeks. We also detected a decreased lysine malonylation in hypertrophic H9C2 cardiomyocytes induced by angiotensin II for 48 h. Using a proteomic method based on affinity purification and LC-MS/MS, we identified total 679 malonylated sites in 330 proteins in the hearts of sham mice and TAC mice. Bioinformatic analysis of the proteomic data revealed enrichment of malonylated proteins involved in cardiac structure and contraction, cGMP-PKG pathway, and metabolism. Specifically, we detected a decreased lysine malonylation in myocardial isocitrate dehydrogenase 2 (IDH2) by immunoprecipitation coupled with Western blotting both in vivo and in vitro. Together, our work suggests an important role and implication of protein lysine malonylation in cardiac hypertrophy, especially the IDH2. SIGNIFICANCE: Heart failure is the terminal stage of cardiac hypertrophy, which imposes an enormous clinical and economic burden worldwide. Despite our knowledge on the pathophysiology of the disease, current therapeutic approaches are still largely limited. Cardiac hypertrophy can be regulated at post-translational modifications (PTMs), and several PTMs have been reported in cardiac hypertrrophy and heart failure. In our study, we first reported a novel PTMs, lysine malonylation, in cardiac hypertophy. we found a reduced lysine malonylation in hypertrophic mice hearts in vivo and H9C2 cardiomyocytes after stimulating with angiotensinII for 48 h in vitro. Using affinity purification and LC-MS/MS, we identified 679 malonylated sites in 330 proteins in the hearts of sham and TAC mice. Compared to the sham group, 5 sites in 2 proteins were quantified as downregulated targets using a 2-fold threshold (downregulation <0.5-fold, P < 0.05). Functional analysis showed a significant enrichment in cardiac structure and contraction, cGMP-PKG pathway and metabolism. Notably, we identified a decreased Kmal level in isocitrate dehydrogenase 2 (IDH2), but the protein level of IDH2 has no changed in cardiac hypertrophy, These results highlight that lysine malonylation is associated with cardiac hypertrophy, and may be a new therapeutic target of the disease.
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Affiliation(s)
- Li-Fei Wu
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, and the Department of Physiology, Shanxi Medical University, Taiyuan, China; Department of Pathophysiology, Shanxi Medical University, Taiyuan, China
| | - De-Ping Wang
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, and the Department of Physiology, Shanxi Medical University, Taiyuan, China
| | - Jing Shen
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, and the Department of Physiology, Shanxi Medical University, Taiyuan, China
| | - Li-Juan Gao
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, and the Department of Physiology, Shanxi Medical University, Taiyuan, China
| | - Ying Zhou
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, and the Department of Physiology, Shanxi Medical University, Taiyuan, China
| | - Qing-Hua Liu
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, and the Department of Physiology, Shanxi Medical University, Taiyuan, China; Department of Pathophysiology, Shanxi Medical University, Taiyuan, China
| | - Ji-Min Cao
- Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, and the Department of Physiology, Shanxi Medical University, Taiyuan, China.
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Lv H, Jiang H, Zhang M, Luo H, Hong Z, Yang H, Xu W, Shen B, Zhang W, Qiu H, Zhu R. Maffucci syndrome complicated by giant chondrosarcoma in the left ankle with an IDH1 R132C mutation: a case report. World J Surg Oncol 2022; 20:218. [PMID: 35765075 PMCID: PMC9241289 DOI: 10.1186/s12957-022-02686-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 06/14/2022] [Indexed: 12/01/2022] Open
Abstract
Background Maffucci syndrome (MS) is a rare, nonhereditary congenital mesodermal dysplasia characterized by multiple enchondromas and hemangiomas, associated with an increased risk of developing malignant tumors. Given their rarity, the pathogenesis of these tumors has not been clarified, and there is no standard treatment. Case presentation We present a case of a 45-year-old man with MS to supplement the clinical manifestations and explore the molecular mechanism of MS. The patient underwent amputation surgery to inhibit tumor development and was diagnosed with MS with 1–2 grade giant chondrosarcoma in the left ankle. In addition, the whole exon analysis results revealed isocitrate dehydrogenase 1 (IDH1) R132C mutation in chondrosarcoma lesions but not in blood DNA. Conclusions This case report showed MS complicated by giant chondrosarcoma in the left ankle with an IDH1 R132C mutation, which is appropriate to monitor the development of MS pathology and other concomitant lesions. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02686-z.
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Affiliation(s)
- Haiyan Lv
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, 317000, Zhejiang, China
| | - Hantao Jiang
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, 317000, Zhejiang, China
| | - Minge Zhang
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, 317000, Zhejiang, China
| | - Huarong Luo
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, 317000, Zhejiang, China
| | - Zhenghua Hong
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, 317000, Zhejiang, China
| | - Hai Yang
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, 317000, Zhejiang, China
| | - Weiming Xu
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, 317000, Zhejiang, China
| | - Bo Shen
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, 317000, Zhejiang, China
| | - Wei Zhang
- DIAN Diagnostics, Hangzhou, 310058, Zhejiang, China
| | - Hao Qiu
- DIAN Diagnostics, Hangzhou, 310058, Zhejiang, China
| | - Rangteng Zhu
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, 317000, Zhejiang, China.
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Han Z, Chen Q, Zhang L, Mo X, You J, Chen L, Fang J, Wang F, Jin Z, Zhang S, Zhang B. Radiogenomic association between the T2-FLAIR mismatch sign and IDH mutation status in adult patients with lower-grade gliomas: an updated systematic review and meta-analysis. Eur Radiol 2022. [PMID: 35169897 DOI: 10.1007/s00330-022-08607-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/24/2021] [Accepted: 01/22/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To reveal a radiogenomic correlation between the presence of the T2-fluid-attenuated inversion recovery resection (T2-FLAIR) mismatch sign on MR images and isocitrate dehydrogenase (IDH) mutation status in adult patients with lower-grade gliomas (LGGs). METHODS A web-based systemic search for eligible literature up to April 13, 2021, was conducted on PubMed, Embase, and the Cochrane Library databases by two independent reviewers. This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We included studies evaluating the accuracy of the T2-FLAIR mismatch sign in diagnosing the IDH mutation in adult patients with LGGs. The T2-FLAIR mismatch sign was defined as a T2-hyperintense lesion that is hypointense on FLAIR except for a hyperintense rim. RESULTS Fourteen studies (n = 1986) were finally identified. The mean age of patients in the included studies ranged from 38.5 to 56 years. The pooled area under the curve (AUC), sensitivity, and specificity were obtained for each molecular profile: IDHmut-Codel: 0.46 (95% confidence interval [CI]: 0.42-0.50), 1% (95%CI: 0-7%), and 69% (95%CI: 62-75%), respectively; IDHmut-Noncodel: 0.75 (95%CI: 0.71-0.79), 42% (95%CI: 34-50%), and 99% (95%CI: 96-100%), respectively; IDH-Mutation regardless of 1p/19q codeletion status: 0.77 (95%CI: 0.73-0.80), 29% (95%CI: 21-40%), and 99% (95%CI: 92-100%), respectively. CONCLUSIONS The T2-FLAIR mismatch sign was an insensitive but highly specific marker for IDHmut-Noncodel and IDH-Mutation LGGs, whereas it was not a useful marker for IDHmut-Codel LGGs. The findings might identify the T2-FLAIR mismatch sign as a non-invasive imaging biomarker for the selection of patients with IDH-mutant LGGs. KEY POINTS • The T2-FLAIR mismatch sign was not a sensitive sign for IDH mutation in LGGs. • The T2-FLAIR mismatch sign was related to IDHmut-Noncodel with a specificity of 99%. • The pooled specificity (69%) of the T2-FLAIR mismatch sign for IDHmut-Codel was low.
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Wu S, Zhang X, Rui W, Sheng Y, Yu Y, Zhang Y, Yao Z, Qiu T, Ren Y. A nomogram strategy for identifying the subclassification of IDH mutation and ATRX expression loss in lower-grade gliomas. Eur Radiol 2022; 32:3187-3198. [PMID: 35133485 DOI: 10.1007/s00330-021-08444-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/22/2021] [Accepted: 10/25/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To construct a radiomics nomogram based on multiparametric MRI data for predicting isocitrate dehydrogenase 1 mutation (IDH +) and loss of nuclear alpha thalassemia/mental retardation syndrome X-linked expression (ATRX -) in patients with lower-grade gliomas (LrGG; World Health Organization [WHO] 2016 grades II and III). METHODS A total of 111 LrGG patients (76 mutated IDH and 35 wild-type IDH) were enrolled, divided into a training set (n = 78) and a validation set (n = 33) for predicting IDH mutation. IDH + LrGG patients were further stratified into the ATRX - (n = 38) and ATRX + (n = 38) subtypes. A total of 250 radiomics features were extracted from the region of interest of each tumor, including that from T2 fluid-attenuated inversion recovery (T2 FLAIR), contrast-enhanced T1 WI, ASL-derived cerebral blood flow (CBF), DWI-derived ADC, and exponential ADC (eADC). A radiomics signature was selected using the Elastic Net regression model, and a radiomics nomogram was finally constructed using the age, gender information, and above features. RESULTS The radiomics nomogram identified LrGG patients for IDH mutation (C-index: training sets = 0.881, validation sets = 0.900) and ATRX loss (C-index: training sets = 0.863, validation sets = 0.840) with good calibration. Decision curve analysis further confirmed the clinical usefulness of the two nomograms for predicting IDH and ATRX status. CONCLUSIONS The nomogram incorporating age, gender, and the radiomics signature provided a clinically useful approach in noninvasively predicting IDH and ATRX mutation status for LrGG patients. The proposed method could facilitate MRI-based clinical decision-making for the LrGG patients. KEY POINTS • Non-invasive determination of IDH and ATRX gene status of LrGG patients can be obtained with a radiomics nomogram. • The proposed nomogram is constructed by radiomics signature selected from 250 radiomics features, combined with age and gender. • The proposed radiomics nomogram exhibited good calibration and discrimination for IDH and ATRX gene mutation stratification of LrGG patients in both training and validation sets.
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Affiliation(s)
- Shiman Wu
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Xi Zhang
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Wenting Rui
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Yaru Sheng
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Yang Yu
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Yong Zhang
- GE Healthcare, Shanghai, People's Republic of China
| | - Zhenwei Yao
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Tianming Qiu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China.
| | - Yan Ren
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China.
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