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Hopper AB, Connor M, Karunamuni R, Sanghvi P, Kim GGY, Bruggeman A, Moiseenko V, Farid N, McDonald C, Hattangadi-Gluth JA. Feasibility of Cognitive-Sparing Stereotactic Radiosurgery for Brain Metastases: Initial Report of Phase II COG-SRS Trial. Int J Radiat Oncol Biol Phys 2023; 117:e108. [PMID: 37784641 DOI: 10.1016/j.ijrobp.2023.06.884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiotherapy at high doses leads to white matter (WM) and hippocampal injury which can cause cognitive decline. We designed the first, to our knowledge, evidence-based cognitive sparing brain SRS trial for patients with limited brain metastases. In this report we analyze feasibility of cognitive-sparing SRS, utilizing dose constraints for eloquent WM tracts and bilateral hippocampi. MATERIALS/METHODS This is a single-institution phase II NCI-funded clinical trial (NCT04343157) of cognitive-sparing brain SRS; eloquent regions of interest (ROI) and associated cognitive domains are outlined in Table 1. Patients underwent high-resolution quantitative diffusion and volumetric MRI at baseline and post-SRS follow-up. Comprehensive neurocognitive assessment was performed at baseline and 3 months post-SRS by a neuropsychologist evaluating different neurocognitive domains (Table 1). Clinical processing/workflow was largely automated with robust, validated segmentation tools of eloquent WM tracts and the hippocampi. Single fraction dose constraints to WM tracts were 12 Gy Dmax and 8.4 Gy to hippocampi with 3 and 5 fraction equivalent doses, based on our prior NTCP studies. Patient accrual, follow up imaging and neurocognitive testing is still active. RESULTS To date, n = 59 patients and 114 lesions have been treated with cognitive-sparing Linac-based SRS on trial. Median age is 63 years. Lung cancer was the most common primary (35.6%), along with breast cancer (23.7%) and melanoma (15.3%). Patients had 1-4 brain metastases; median prescription dose was 24 Gy/1, 27 Gy/3, or 30 Gy/5 depending on target volume. Most patients were treated < 7 business days from MRI. Cognitive endpoints have been collected on 89.5% of patients. Cognitive sparing constraints were met in 79.3% of plans while maintaining standard clinical SRS plan indices and coverage benchmarks. 38.9% of the plans that failed to meet the Dmax constraint kept D0.03cc under constraints. Plans going over constraints had tumors overlying or within 1 mm of eloquent ROIs. Local control for treated lesions at 6 months was 97.9% and 95.7% at 12 months. Distant intracranial control was 68.1% at 6 and 12 months. Median OS was 18 months. CONCLUSION Cognitive-sparing SRS treatment planning was successfully implemented for the majority of treated lesions with excellent local control. Mitigation of damage to eloquent structures has potential to further reduce cognitive decline after SRS. Full neurocognitive outcomes will be reported after accrual and testing are complete.
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Affiliation(s)
- A B Hopper
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - M Connor
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - R Karunamuni
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - P Sanghvi
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - G G Y Kim
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - A Bruggeman
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - V Moiseenko
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - N Farid
- Department of Radiology, University of California San Diego, La Jolla, CA
| | - C McDonald
- Department of Radiation Medicine and Applied Sciences, UC San Diego, La Jolla, CA
| | - J A Hattangadi-Gluth
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
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Simon A, Hermann G, Retson T, Olson S, Dale A, Farid N, Hsiao A, Hattangadi-Gluth J. Application of 4D Flow MRI to Predict Clinical Outcomes after Stereotactic Radiosurgery (SRS) for Cerebral Arteriovenous Malformations (AVMs). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hermann G, Houri J, Connor M, Karunamuni R, Hsiao A, Noorbakhsh A, Simon A, Seibert T, Farid N, Rudie J, Hattangadi-Gluth J. 3D convolutional neural network for automated segmentation of intracranial metastases and organs at risk for brain SRS: Implications for treatment planning and longitudinal tracking. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Meyer E, Kruglov D, Krivic M, Tanveer M, Argaez-Ramirez R, Zhang Y, Briseno Ojeda A, Smirnova K, Alekseev K, Safari Mugisho M, Cimbili B, Farid N, Dang Y, Shahid M, Ensan M, Banar J, Bao H, Matters-Kammerer M, Gustavsson U, Demuynck F, Zwick T, Acar M, Fager C, van der Heijden M, Ivashina M, Caratelli D, Hasselblad M, Ulusoy C, Smolders A, Eriksson K, Johannson M, Maaskant R, Quay R, Floriot D, Bao M, Bronckers L, Fridén J, van Beurden M, de Hon B, Kolitsidas C, Blanco D, Willems F, Eriksson T, Filippi A, Ponzini F, Johannsen U. The state of the art in beyond 5G distributed massive multiple-input multiple-output communication system solutions. Open Res Eur 2022; 2:106. [PMID: 37982077 PMCID: PMC10654493 DOI: 10.12688/openreseurope.14501.1] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/21/2023]
Abstract
Beyond fifth generation (5G) communication systems aim towards data rates in the tera bits per second range, with improved and flexible coverage options, introducing many new technological challenges in the fields of network architecture, signal pro- cessing, and radio frequency front-ends. One option is to move towards cell-free, or distributed massive Multiple-Input Multiple-Output (MIMO) network architectures and highly integrated front-end solutions. This paper presents an outlook on be- yond 5G distributed massive MIMO communication systems, the signal processing, characterisation and simulation challenges, and an overview of the state of the art in millimetre wave antennas and electronics.
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Affiliation(s)
- E. Meyer
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - D. Kruglov
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - M. Krivic
- Keysight Technologies, Kortrijksesteenweg 1093B, 9051 Gent, Belgium
| | - M. Tanveer
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - R. Argaez-Ramirez
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - Y. Zhang
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | | | - K. Smirnova
- Karlsruhe Institute of Technology, 6131 Karlsruhe, Germany
| | - K. Alekseev
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - M. Safari Mugisho
- Fraunhofer Institute for Applied Solid State Physics, IAF, Tullastraße 72, 79108 Freiburg, Germany
| | - B. Cimbili
- Fraunhofer Institute for Applied Solid State Physics, IAF, Tullastraße 72, 79108 Freiburg, Germany
| | - N. Farid
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - Y. Dang
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - M. Shahid
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - M. Ensan
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - J. Banar
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - H. Bao
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - M. Matters-Kammerer
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - U. Gustavsson
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - F. Demuynck
- Keysight Technologies, Kortrijksesteenweg 1093B, 9051 Gent, Belgium
| | - T. Zwick
- Karlsruhe Institute of Technology, 6131 Karlsruhe, Germany
| | - M. Acar
- NXP Semiconductors, High Tech Campus 60, 5656 AG Eindhoven, The Netherlands
| | - C. Fager
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - M. van der Heijden
- NXP Semiconductors, High Tech Campus 60, 5656 AG Eindhoven, The Netherlands
| | - M. Ivashina
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - D. Caratelli
- The Antenna Company, High Tech Campus 29, 5656 AE Eindhoven, The Netherlands
| | - M. Hasselblad
- Gapwaves, Nellickevagen 22, 412 63 Gothenburg, Sweden
| | - C. Ulusoy
- Karlsruhe Institute of Technology, 6131 Karlsruhe, Germany
| | - A.B. Smolders
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - K. Eriksson
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - M. Johannson
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - R. Maaskant
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - R. Quay
- Fraunhofer Institute for Applied Solid State Physics, IAF, Tullastraße 72, 79108 Freiburg, Germany
| | - D. Floriot
- United Monolithic Semiconductors SAS, Bâtiment Charmille, Mosaic parc de Courtaboeuf, 10 avenue du Québec, 91140, Villebon-sur-Yvette, France
| | - M. Bao
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - L.A. Bronckers
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - J. Fridén
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - M.C. van Beurden
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - B.P. de Hon
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - C. Kolitsidas
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - D. Blanco
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - F.M.J. Willems
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - T. Eriksson
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - A. Filippi
- NXP Semiconductors, High Tech Campus 60, 5656 AG Eindhoven, The Netherlands
| | - F. Ponzini
- Ericsson Telecomunicazioni SpA, Via Anagnina 203, 00118 Rome, Italy
| | - U. Johannsen
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
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Huynh-Le M, Karunamuni R, Moiseenko V, Farid N, McDonald C, Hattangadi-Gluth J, Seibert T. OC-0168 Dose-dependent atrophy of the amygdala after radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30588-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Simon A, Li C, Karunamuni R, Retson T, Handwerker J, Farid N, Hsiao A, Hattangadi-Gluth J. Novel 4D-Flow MRI to Assess Quantitative Arterial Hemodynamic Response after Brain Stereotactic Radiosurgery (SRS) for Cerebral Arteriovenous Malformations (AVMs). Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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7
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Tringale K, Nguyen T, Bahrami N, Marshall D, Leyden K, Karunamuni R, Seibert T, Gorman M, Connor M, Burkeen J, Piccioni D, Farid N, McDonald C, Hattangadi-Gluth J. Early Diffusion Imaging Biomarkers of Prefrontal Lobe White Matter Microstructural Damage are Associated with Executive Dysfunction Following Radiation Therapy in Patients with Primary Brain Tumors: A Prospective, Longitudinal Study. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bahrami N, Piccioni D, Karunamuni R, Chang YH, White N, Delfanti R, Seibert TM, Hattangadi-Gluth JA, Dale A, Farid N, McDonald CR. Edge Contrast of the FLAIR Hyperintense Region Predicts Survival in Patients with High-Grade Gliomas following Treatment with Bevacizumab. AJNR Am J Neuroradiol 2018; 39:1017-1024. [PMID: 29622553 DOI: 10.3174/ajnr.a5620] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 02/07/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Treatment with bevacizumab is standard of care for recurrent high-grade gliomas; however, monitoring response to treatment following bevacizumab remains a challenge. The purpose of this study was to determine whether quantifying the sharpness of the fluid-attenuated inversion recovery hyperintense border using a measure derived from texture analysis-edge contrast-improves the evaluation of response to bevacizumab in patients with high-grade gliomas. MATERIALS AND METHODS MRIs were evaluated in 33 patients with high-grade gliomas before and after the initiation of bevacizumab. Volumes of interest within the FLAIR hyperintense region were segmented. Edge contrast magnitude for each VOI was extracted using gradients of the 3D FLAIR images. Cox proportional hazards models were generated to determine the relationship between edge contrast and progression-free survival/overall survival using age and the extent of surgical resection as covariates. RESULTS After bevacizumab, lower edge contrast of the FLAIR hyperintense region was associated with poorer progression-free survival (P = .009) and overall survival (P = .022) among patients with high-grade gliomas. Kaplan-Meier curves revealed that edge contrast cutoff significantly stratified patients for both progression-free survival (log-rank χ2 = 8.3, P = .003) and overall survival (log-rank χ2 = 5.5, P = .019). CONCLUSIONS Texture analysis using edge contrast of the FLAIR hyperintense region may be an important predictive indicator in patients with high-grade gliomas following treatment with bevacizumab. Specifically, low FLAIR edge contrast may partially reflect areas of early tumor infiltration. This study adds to a growing body of literature proposing that quantifying features may be important for determining outcomes in patients with high-grade gliomas.
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Affiliation(s)
- N Bahrami
- From the Center for Multimodal Imaging and Genetics (N.B., N.W., C.R.M.) .,Department of Psychiatry (N.B., Y.-H.C., C.R.M.).,Department of Radiology (N.B., N.W., R.D., A.D., N.F., C.R.M.).,Multimodal Imaging Laboratory (N.B., N.W., A.D., C.R.M.)
| | - D Piccioni
- Department of Neurosciences (D.P., A.D., N.F.)
| | - R Karunamuni
- Department of Radiation Medicine (R.K., T.M.S., J.A.H.-G.), University of California, San Diego, La Jolla, California
| | - Y-H Chang
- Department of Psychiatry (N.B., Y.-H.C., C.R.M.)
| | - N White
- From the Center for Multimodal Imaging and Genetics (N.B., N.W., C.R.M.).,Department of Radiology (N.B., N.W., R.D., A.D., N.F., C.R.M.).,Multimodal Imaging Laboratory (N.B., N.W., A.D., C.R.M.)
| | - R Delfanti
- Department of Radiology (N.B., N.W., R.D., A.D., N.F., C.R.M.)
| | - T M Seibert
- Department of Radiation Medicine (R.K., T.M.S., J.A.H.-G.), University of California, San Diego, La Jolla, California
| | - J A Hattangadi-Gluth
- Department of Radiation Medicine (R.K., T.M.S., J.A.H.-G.), University of California, San Diego, La Jolla, California
| | - A Dale
- Multimodal Imaging Laboratory (N.B., N.W., A.D., C.R.M.).,Department of Neurosciences (D.P., A.D., N.F.)
| | - N Farid
- Department of Radiology (N.B., N.W., R.D., A.D., N.F., C.R.M.).,Department of Neurosciences (D.P., A.D., N.F.)
| | - C R McDonald
- From the Center for Multimodal Imaging and Genetics (N.B., N.W., C.R.M.).,Department of Psychiatry (N.B., Y.-H.C., C.R.M.).,Department of Radiology (N.B., N.W., R.D., A.D., N.F., C.R.M.).,Multimodal Imaging Laboratory (N.B., N.W., A.D., C.R.M.)
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Li CQ, Hsiao A, Hattangadi-Gluth J, Handwerker J, Farid N. Early Hemodynamic Response Assessment of Stereotactic Radiosurgery for a Cerebral Arteriovenous Malformation Using 4D Flow MRI. AJNR Am J Neuroradiol 2018; 39:678-681. [PMID: 29371257 DOI: 10.3174/ajnr.a5535] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/13/2017] [Indexed: 11/07/2022]
Abstract
Brain AVMs treated with stereotactic radiosurgery typically demonstrate a minimum latency period of 1-3 years between treatment and nidus obliteration. Assessment of treatment response is usually limited to evaluation of AVM nidus structural changes using conventional MR imaging and MRA techniques. This report describes the use of 4D Flow MRI to also measure radiation-induced hemodynamic changes in a Spetzler-Martin grade III AVM, which were detectable as early as 6 months after treatment.
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Affiliation(s)
- C Q Li
- From the Department of Radiology (C.Q.L., A.H., J.H., N.F.), University of California, San Diego, San Diego, California
| | - A Hsiao
- From the Department of Radiology (C.Q.L., A.H., J.H., N.F.), University of California, San Diego, San Diego, California
| | - J Hattangadi-Gluth
- Department of Radiation Medicine and Applied Sciences (J.H.-G.), University of California, San Diego, La Jolla, California
| | - J Handwerker
- From the Department of Radiology (C.Q.L., A.H., J.H., N.F.), University of California, San Diego, San Diego, California
| | - N Farid
- From the Department of Radiology (C.Q.L., A.H., J.H., N.F.), University of California, San Diego, San Diego, California
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Tringale K, Karunamuni R, Nguyen T, Seibert T, Leyden K, Uttarwar V, Murzin V, Marshall D, Simpson D, Sanghvi P, Moiseenko V, Gorman M, Farid N, White N, Dale A, McDonald C, Hattangadi J. Diffusion Imaging Biomarkers of Regional White Matter Injury Correlate With Change in Executive Function and Processing Speed After Brain Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tringale K, Karunamuni R, Nguyen T, Seibert T, Leyden K, Uttarwar V, Murzin V, Marshall D, Simpson D, Sanghvi P, Moiseenko V, Gorman M, Farid N, White N, Dale A, McDonald C, Hattangadi J. Prospective Trial of Quantitative Neuroimaging Correlates of Verbal and Nonverbal Memory Decline. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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12
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Seibert T, Karunamuni R, Tringale K, Nguyen T, Leyden K, Uttarwar V, Marshall D, Simpson D, Sanghvi P, Moiseenko V, Brewer J, Gorman M, Farid N, White N, Dale A, McDonald C, Hattangadi J. Atrophy of Entorhinal Cortex After Radiation Therapy Associated With Memory Decline. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Krishnan AP, Karunamuni R, Leyden KM, Seibert TM, Delfanti RL, Kuperman JM, Bartsch H, Elbe P, Srikant A, Dale AM, Kesari S, Piccioni DE, Hattangadi-Gluth JA, Farid N, McDonald CR, White NS. Restriction Spectrum Imaging Improves Risk Stratification in Patients with Glioblastoma. AJNR Am J Neuroradiol 2017; 38:882-889. [PMID: 28279985 DOI: 10.3174/ajnr.a5099] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 12/09/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE ADC as a marker of tumor cellularity has been promising for evaluating the response to therapy in patients with glioblastoma but does not successfully stratify patients according to outcomes, especially in the upfront setting. Here we investigate whether restriction spectrum imaging, an advanced diffusion imaging model, performed after an operation but before radiation therapy, could improve risk stratification in patients with newly diagnosed glioblastoma relative to ADC. MATERIALS AND METHODS Pre-radiation therapy diffusion-weighted and structural imaging of 40 patients with glioblastoma were examined retrospectively. Restriction spectrum imaging and ADC-based hypercellularity volume fraction (restriction spectrum imaging-FLAIR volume fraction, restriction spectrum imaging-contrast-enhanced volume fraction, ADC-FLAIR volume fraction, ADC-contrast-enhanced volume fraction) and intensities (restriction spectrum imaging-FLAIR 90th percentile, restriction spectrum imaging-contrast-enhanced 90th percentile, ADC-FLAIR 10th percentile, ADC-contrast-enhanced 10th percentile) within the contrast-enhanced and FLAIR hyperintensity VOIs were calculated. The association of diffusion imaging metrics, contrast-enhanced volume, and FLAIR hyperintensity volume with progression-free survival and overall survival was evaluated by using Cox proportional hazards models. RESULTS Among the diffusion metrics, restriction spectrum imaging-FLAIR volume fraction was the strongest prognostic metric of progression-free survival (P = .036) and overall survival (P = .007) in a multivariate Cox proportional hazards analysis, with higher values indicating earlier progression and shorter survival. Restriction spectrum imaging-FLAIR 90th percentile was also associated with overall survival (P = .043), with higher intensities, indicating shorter survival. None of the ADC metrics were associated with progression-free survival/overall survival. Contrast-enhanced volume exhibited a trend toward significance for overall survival (P = .063). CONCLUSIONS Restriction spectrum imaging-derived cellularity in FLAIR hyperintensity regions may be a more robust prognostic marker than ADC and conventional imaging for early progression and poorer survival in patients with glioblastoma. However, future studies with larger samples are needed to explore its predictive ability.
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Affiliation(s)
- A P Krishnan
- From the Multimodal Imaging Laboratory (A.P.K., K.M.L., T.M.S., J.M.K., H.B., P.E., A.S., A.M.D., N.F., C.R.M., N.S.W.)
| | - R Karunamuni
- Departments of Radiation Medicine (R.K., T.M.S., J.A.H.-G., C.R.M.)
| | - K M Leyden
- From the Multimodal Imaging Laboratory (A.P.K., K.M.L., T.M.S., J.M.K., H.B., P.E., A.S., A.M.D., N.F., C.R.M., N.S.W.)
| | - T M Seibert
- From the Multimodal Imaging Laboratory (A.P.K., K.M.L., T.M.S., J.M.K., H.B., P.E., A.S., A.M.D., N.F., C.R.M., N.S.W.).,Departments of Radiation Medicine (R.K., T.M.S., J.A.H.-G., C.R.M.)
| | - R L Delfanti
- Radiology (R.L.D., J.M.K., H.B., A.M.D., N.F., N.S.W.)
| | - J M Kuperman
- Radiology (R.L.D., J.M.K., H.B., A.M.D., N.F., N.S.W.)
| | - H Bartsch
- From the Multimodal Imaging Laboratory (A.P.K., K.M.L., T.M.S., J.M.K., H.B., P.E., A.S., A.M.D., N.F., C.R.M., N.S.W.).,Radiology (R.L.D., J.M.K., H.B., A.M.D., N.F., N.S.W.)
| | - P Elbe
- From the Multimodal Imaging Laboratory (A.P.K., K.M.L., T.M.S., J.M.K., H.B., P.E., A.S., A.M.D., N.F., C.R.M., N.S.W.)
| | - A Srikant
- From the Multimodal Imaging Laboratory (A.P.K., K.M.L., T.M.S., J.M.K., H.B., P.E., A.S., A.M.D., N.F., C.R.M., N.S.W.)
| | - A M Dale
- From the Multimodal Imaging Laboratory (A.P.K., K.M.L., T.M.S., J.M.K., H.B., P.E., A.S., A.M.D., N.F., C.R.M., N.S.W.).,Radiology (R.L.D., J.M.K., H.B., A.M.D., N.F., N.S.W.).,Neurosciences (A.M.D., D.E.P.)
| | - S Kesari
- Department of Translational Neuro-Oncology and Neurotherapeutics (S.K.), John Wayne Cancer Institute and Pacific Neuroscience Institute at Providence Saint John's Health Center, Santa Monica, California
| | | | | | - N Farid
- From the Multimodal Imaging Laboratory (A.P.K., K.M.L., T.M.S., J.M.K., H.B., P.E., A.S., A.M.D., N.F., C.R.M., N.S.W.).,Radiology (R.L.D., J.M.K., H.B., A.M.D., N.F., N.S.W.)
| | - C R McDonald
- From the Multimodal Imaging Laboratory (A.P.K., K.M.L., T.M.S., J.M.K., H.B., P.E., A.S., A.M.D., N.F., C.R.M., N.S.W.).,Departments of Radiation Medicine (R.K., T.M.S., J.A.H.-G., C.R.M.).,Psychiatry (C.R.M.), University of California, San Diego, La Jolla, California
| | - N S White
- From the Multimodal Imaging Laboratory (A.P.K., K.M.L., T.M.S., J.M.K., H.B., P.E., A.S., A.M.D., N.F., C.R.M., N.S.W.) .,Radiology (R.L.D., J.M.K., H.B., A.M.D., N.F., N.S.W.)
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Seibert T, Karunamuni R, Kaifi S, Burkeen J, Krishnan A, McDonald C, White N, Farid N, Bartsch H, Nguyen T, Moiseenko V, Brewer J, Dale A, Hattangadi J. Selective Vulnerability of Cerebral Cortex Regions to Radiation Dose–Dependent Atrophy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pettersson N, Karunamuni R, Connor M, Moiseenko V, Dale A, Bartsch H, Brewer J, Krishnan A, Kuperman J, Hagler D, McDonald C, Farid N, White N, Hattangadi-Gluth J, Cervino L. SU-F-T-118: Characterization of Change in Fractional Anisotropy After Radiation Therapy: Does Nearby Disruption Predict for White Matter Damage? Med Phys 2016. [DOI: 10.1118/1.4956254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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16
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Pettersson N, Bartsch H, Brewer J, Cervino L, Connor M, Dale A, Hagler D, Karunamuni R, Krishnan A, Kuperman J, McDonald C, Farid N, White N, Hattangadi-Gluth J, Moiseenko V. PV-0476: Fractional anisotropy dose-response relationship of the corpus callosum. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31725-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Marshall D, Karunamuni R, White N, McDonald C, Moiseenko V, Bartsch H, Seibert T, Farid N, Brewer J, Krishnan A, Dale A, Hattangadi J. Quantitative Analysis of Radiation Induced Microstructural Injury to White Matter and Hippocampus in Brain Tumor Patients. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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18
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Karunamuni R, Bartsch H, White N, Moiseenko V, Carmona R, Marshall D, Seibert T, McDonald C, Farid N, Krishnan A, Brewer J, Dale A, Hattangadi J. Dose-Dependent Cortical Thinning After Partial-Brain Radiation in Glioblastoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Erreguig L, El Idrissi Slitine N, Farid N, Maoulainine F. P-449 – ictère néonatal au CHU Mohammed VI de Marrakech. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30626-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Steed TC, Treiber JM, Patel KS, Taich Z, White NS, Treiber ML, Farid N, Carter BS, Dale AM, Chen CC. Iterative probabilistic voxel labeling: automated segmentation for analysis of The Cancer Imaging Archive glioblastoma images. AJNR Am J Neuroradiol 2014; 36:678-85. [PMID: 25414001 DOI: 10.3174/ajnr.a4171] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 09/30/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Robust, automated segmentation algorithms are required for quantitative analysis of large imaging datasets. We developed an automated method that identifies and labels brain tumor-associated pathology by using an iterative probabilistic voxel labeling using k-nearest neighbor and Gaussian mixture model classification. Our purpose was to develop a segmentation method which could be applied to a variety of imaging from The Cancer Imaging Archive. MATERIALS AND METHODS Images from 2 sets of 15 randomly selected subjects with glioblastoma from The Cancer Imaging Archive were processed by using the automated algorithm. The algorithm-defined tumor volumes were compared with those segmented by trained operators by using the Dice similarity coefficient. RESULTS Compared with operator volumes, algorithm-generated segmentations yielded mean Dice similarities of 0.92 ± 0.03 for contrast-enhancing volumes and 0.84 ± 0.09 for FLAIR hyperintensity volumes. These values compared favorably with the means of Dice similarity coefficients between the operator-defined segmentations: 0.92 ± 0.03 for contrast-enhancing volumes and 0.92 ± 0.05 for FLAIR hyperintensity volumes. Robust segmentations can be achieved when only postcontrast T1WI and FLAIR images are available. CONCLUSIONS Iterative probabilistic voxel labeling defined tumor volumes that were highly consistent with operator-defined volumes. Application of this algorithm could facilitate quantitative assessment of neuroimaging from patients with glioblastoma for both research and clinical indications.
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Affiliation(s)
- T C Steed
- From the Neurosciences Graduate Program (T.C.S.) School of Medicine (T.C.S., J.M.T.) Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | - J M Treiber
- School of Medicine (T.C.S., J.M.T.) Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | - K S Patel
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California Weill-Cornell Medical College (K.S.P.), New York Presbyterian Hospital, New York, New York
| | - Z Taich
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | - N S White
- Multimodal Imaging Laboratory (N.S.W., N.F., A.M.D.)
| | - M L Treiber
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | - N Farid
- Multimodal Imaging Laboratory (N.S.W., N.F., A.M.D.) Department of Radiology (N.F., A.M.D.)
| | - B S Carter
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | - A M Dale
- Multimodal Imaging Laboratory (N.S.W., N.F., A.M.D.) Department of Radiology (N.F., A.M.D.)
| | - C C Chen
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
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Seibert T, White N, Kim G, McDonald C, Farid N, Moiseenko V, Bartsch H, Kuperman J, Holland D, Mundt A, Dale A, Hattangadi-Gluth J. Distortion Inherent to Magnetic Resonance Imaging (MRI) Can Lead to Geometric Miss in Radiosurgery Planning. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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22
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McDonald CR, White NS, Farid N, Lai G, Kuperman JM, Bartsch H, Hagler DJ, Kesari S, Carter BS, Chen CC, Dale AM. Recovery of white matter tracts in regions of peritumoral FLAIR hyperintensity with use of restriction spectrum imaging. AJNR Am J Neuroradiol 2013; 34:1157-63. [PMID: 23275591 DOI: 10.3174/ajnr.a3372] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE DTI is being increasingly used to visualize critical white matter tracts adjacent to brain tumors before neurosurgical resection. However, brain tumors, particularly high-grade gliomas, are typically surrounded by regions of FLAIR hyperintensity that include edema, which increase isotropic diffusion, degrading the ability of standard DTI to uncover orientation estimates within these regions. We introduce a new technique, RSI, which overcomes this limitation by removing the spherical, fast diffusion component introduced by edema, providing better analysis of white matter architecture. MATERIALS AND METHODS A total of 10 patients with high-grade gliomas surrounded by FLAIR-HI that at least partially resolved on follow-up imaging were included. All patients underwent RSI and DTI at baseline (FLAIR-HI present) and at follow-up (FLAIR-HI partially resolved). FA values obtained with RSI and DTI were compared within regions of FLAIR-HI and NAWM at both time points. RESULTS RSI showed higher FA in regions of FLAIR-HI and NAWM relative to DTI, reflecting the ability of RSI to specifically measure the slow, restricted volume fraction in regions of edema and NAWM. Furthermore, a method by time interaction revealed that FA estimates increased when the FLAIR-HI resolved by use of standard DTI but remained stable with RSI. Tractography performed within the region of FLAIR-HI revealed the superior ability of RSI to track fibers through severe edema relative to standard DTI. CONCLUSIONS RSI improves the quantification and visualization of white matter tracts in regions of peritumoral FLAIR-HI associated with edema relative to standard DTI and may provide a valuable tool for neurosurgical planning.
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Affiliation(s)
- C R McDonald
- Departments of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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Blanco-Gozalo V, Blazquez-Medela A, Garcia-Sanchez O, Quiros Y, Montero M, Martinez-Salgado C, Lopez-Hernandez F, Lopez-Novoa J, Yao L, Qing Z, Hua X, Min F, Fei M, Ning W, Cantaluppi V, Figliolini F, Delena M, Beltramo S, Medica D, Tetta C, Segoloni G, Biancone L, Camussi G, Cunha JS, Ferreira VM, Naves MA, Boim MA, Zitman-Gal T, Golan E, Green J, Pasmanik-Chor M, Bernheim J, Benchetrit S, Riera M, Clotet S, Pascual J, Soler M, Nakai K, Fujii H, Kono K, Goto S, Hirata M, Shinohara M, Fukagawa M, Nishi S, Fan Q, Du S, Jiang Y, Wang L, Fang L, Radovits T, Mozes MM, Rosivall L, Kokeny G, Aoki R, Tateoka R, Sekine F, Kikuchi K, Yamashita Y, Itoh Y, Cappuccino L, Garibotto G, D'Amato E, Villaggio B, Gianiorio F, Mij M, Viazzi F, Salvidio G, Verzola D, Piwkowska A, Rogacka D, Audzeyenka I, Kasztan M, Angielski S, Jankowski M, Gaber EW, El-Attar HA, Liu J, Zhang W, He Y, Rogacka D, Piwkowska A, Audzeyenka I, Angielski S, Jankowski M, Macsai E, Takats Z, Derzbach L, Korner A, Vasarhelyi B, Huang MS, Bo H, Liu F, Fu P, Tsotakos NE, Tsilibary EC, Drossopoulou GI, Thawho N, Farid N, Peleg A, Levy A, Nakhoul N, Lenghel AR, Borza G, Catoi C, Bondor CI, Muresan A, Kacso IM, Song JS, Song JH, Ahn SH, Choi BS, Hong YA, Kim MY, Lim JH, Yang KS, Chung S, Shin SJ, Kim HW, Chang YS, Kim YS, Park CW, Takayanagi K, Hasegawa H, Shimizu T, Ikari A, Noiri C, Iwashita T, Tayama Y, Asakura J, Anzai N, Kanozawa K, Kato H, Mitarai T, Huang M, Bo H, Liu F, Fu P, Ashour RH, Fouda AEMM, Saad MA, El-Banna FM, Moustafa FA, Fouda MI, Sanchez-Nino MD, Sanz AB, Poveda J, Saleem M, Mathieson P, Ruiz-Ortega M, Selgas R, Egido J, Ortiz A, Clotet S, Soler MJ, Rebull M, Pascual J, Riera M, Marquez E, Riera M, Pascual J, Soler MJ, Asakura J, Hasegawa H, Takayanagi K, Tayama Y, Shimizu T, Iwashita T, Okazaki S, Kogure Y, Sano T, Hatano M, Kanozawa K, Kato H, Mitarai T, Kreft E, Kowalski R, Kasztan M, Jankowski M, Szczepansk-Konkel M, Fan Q, Liu X, Yang G, Jiang Y, Wang L, Osman NA, NasrAllah MM, Kamal MM, Ahmed AI, Fekih-Mrissa N, Mrad M, Baffoun A, Sayeh A, Hmida J, Gritli N, Galchinskaya V, Topchii I, Semenovykh P, Yefimova N, Zheng D, Hu D, Li X, Peng AI, Olea-Herrero N, Arenas M, Munoz-Moreno C, Moreno-Gomez-Toledano R, Gonzalez-Santander M, Arribas I, Bosch R. Diabetes - experimental models. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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White NS, McDonald CR, Farid N, Kuperman JM, Kesari S, Dale AM. Improved conspicuity and delineation of high-grade primary and metastatic brain tumors using "restriction spectrum imaging": quantitative comparison with high B-value DWI and ADC. AJNR Am J Neuroradiol 2012; 34:958-64, S1. [PMID: 23139079 DOI: 10.3174/ajnr.a3327] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND PURPOSE Restriction spectrum imaging is a sensitive DWI technique for probing separable water diffusion compartments in tissues. Here, we evaluate RSI-CMs derived from the spherically-restricted water compartment for improved tumor conspicuity and delineation from nontumor tissue and reduced sensitivity to edema compared with high-b-value DWI and ADC. MATERIALS AND METHODS RSI was performed in 10 presurgical patients: 4 with glioblastoma, 3 with primary CNS lymphoma, and 3 with metastatic brain tumors. Multidirectional DWI data were collected at b = 500, 1500, and 4000 s/mm(2). Quantification of tumor conspicuity, edema conspicuity, and relative sensitivity to edema for RSI-CMs; DWI at b = 4000 (DWI-4000); and ADC were compared in manually drawn VOIs. Receiver operating characteristic curves were used to evaluate the sensitivity and specificity of each method for delineating tumor from normal-appearing WM. RESULTS Significant TC was seen with both RSI-CMs and DWI-4000, but not ADC. Significant EC was seen with ADC, but not RSI-CMs or DWI-4000. Significantly greater TC was seen with RSI-CMs compared with DWI-4000. Significantly reduced RSE was seen with RSI-CMs compared with both DWI-4000 and ADC. Greater sensitivity and specificity for delineating tumor from normal-appearing WM were seen with RSI-CMs (AUC = 0.91) compared with both DWI-4000 (AUC = 0.77) and ADC (AUC = 0.66). CONCLUSIONS RSI-CMs offer improved conspicuity and delineation of high-grade primary and metastatic brain tumors and reduced sensitivity to edema compared with high-b-value DWI and ADC.
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Affiliation(s)
- N S White
- University of California, San Diego, Department of Radiology, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA.
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Kottler M, Chauvin S, Caron P, Farid N, Christin S, Bouchard P, Counis R. P-201. Gonadotrophin releasing hormone receptor mutations in hypogonadism. Hum Reprod 1999. [DOI: 10.1093/humrep/14.suppl_3.241-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kowluru RA, Jirousek MR, Stramm L, Farid N, Engerman RL, Kern TS. Abnormalities of retinal metabolism in diabetes or experimental galactosemia: V. Relationship between protein kinase C and ATPases. Diabetes 1998; 47:464-9. [PMID: 9519755 DOI: 10.2337/diabetes.47.3.464] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the retinas of diabetic animals, protein kinase C (PKC) activity is elevated, and Na+-K+-ATPase and calcium ATPase activities are subnormal. These abnormalities are also present in another model of diabetic retinopathy, experimental galactosemia. We have investigated the relationship between hyperglycemia-induced abnormalities of PKC and ATPases using a selective inhibitor of beta isoform of PKC (LY333531). Diabetes or experimental galactosemia of 2 months' duration resulted in > 50% elevation of PKC activity in the retina, and administration of LY333531 prevented the elevation. In retinas of the same rats, the LY333531 prevented hyperglycemia-induced decreases of both Na+-K+-ATPase and calcium ATPase activities. Retinal microvessels, the main site of lesions in diabetic retinopathy, likewise showed elevated activity of PKC and inhibition of ATPases in diabetes and in experimental galactosemia, and administration of LY333531 to diabetic animals prevented these abnormalities. PKC activity in sciatic nerves, in contrast, became subnormal in diabetes and experimental galactosemia, and LY333531 had no effect on PKC activity in the sciatic nerve. PKC activity in the cerebral cortex was not affected by diabetes or experimental galactosemia. The results suggest that diabetes-induced reductions in Na+-K+-ATPase and calcium ATPase in the retina are mediated in large part by PKC-beta. The availability of an agent that can normalize the hyperglycemia-induced increase in PKC activity in the retina should facilitate investigation of the role of PKC in the development of diabetic retinopathy.
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Affiliation(s)
- R A Kowluru
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison 53706-1532, USA.
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Petty EM, Green JS, Marx SJ, Taggart RT, Farid N, Bale AE. Mapping the gene for hereditary hyperparathyroidism and prolactinoma (MEN1Burin) to chromosome 11q: evidence for a founder effect in patients from Newfoundland. Am J Hum Genet 1994; 54:1060-6. [PMID: 7911003 PMCID: PMC1918205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
An autosomal dominant syndrome of prolactinomas, carcinoids, and hyperparathyroidism was described in four Newfoundland kindreds in 1980 and in one kindred from the Pacific Northwest in 1983. Because this syndrome shares many features with multiple endocrine neoplasia type 1, the gene for which maps to proximal chromosome 11q, we performed linkage studies with chromosome 11 markers in prolactinoma families to determine whether the two genes map to the same location. All proximal chromosome 11q markers gave positive LOD scores, and no recombinants were seen with PYGM (LOD score 15.25, recombination fraction .0). All affected individuals from Newfoundland shared the same PYGM allele, providing evidence for a founder effect. The disease in the Pacific Northwest kindred cosegregated with a different PYGM allele.
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Affiliation(s)
- E M Petty
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510
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Eltchaninoff H, Cribier A, Koning R, Jolly N, Baala B, Farid N, Letac B. [Angioscopic evaluation of the immediate result of coronary angioplasty in relation to balloon inflation time]. Arch Mal Coeur Vaiss 1994; 87:721-7. [PMID: 7702414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The aim of this study was to assess the effects of coronary angioplasty on the intima with respect to the duration of balloon inflation by percutaneous angioplasty. Twenty-seven patients were randomized according to the total duration of balloon inflation: Group I "standard" duration (total duration < or = 3 min, N = 13) and Group II: prolonged duration (total duration > or = 12 min, N = 14); the type and distribution of the lesions were comparable in the two groups. The results of angioplasty were evaluated immediately after dilatation by angiography and angioscopy. Angioscopy was performed without failure or complications with perfect definition of the images in all cases. Angioscopy showed 1) intimal tears, 2) thrombi, 3) longitudinal dissections. A classification in three grades was used taking the apparent gravity of the lesions into consideration. The mean duration of balloon inflation in Group I was 205 +/- 45 s and 958 +/- 129 s in Group II. The residual stenosis was 36 +/- 8% in Group I and 26 +/- 10% in Group II (p < 0.05). Angioscopy showed the frequency of intimal tears to be twice greater in Group I (9 cases) than in Group II (4 cases) (p = 0.05). Intravascular thrombi were observed in 13 cases, 6 in Group I and 7 in Group II. One case of longitudinal dissection was observed in each group: only one of these two cases was detected at angiography. The authors conclude that repeated and prolonged balloon inflations improve the immediate results of angioplasty with less residual stenosis at angiography and a lower incidence of intimal tears at angioscopy.
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Affiliation(s)
- H Eltchaninoff
- Service de cardiologie, hôpital Charles-Nicolle, CHU de Rouen
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Abstract
Splenoportography was performed upon 195 pediatric patients, including 137 by conventional technique and 58 by digital subtraction technique. The results obtained were compared, and it was found that the percentage of diagnosis of spontaneous splenorenal shunt was higher with digital than with conventional technique. In conclusion digital technique is a more sensitive and safer method than the conventional method.
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Affiliation(s)
- N Farid
- Radiology Department, Hacettepe University School of Medicine, Ankara, Turkey
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Senaati S, Farid N, Guran S, Balkanci F. Pericardiac extravasation during intravenous digital subtraction angiography: a case report. Angiology 1991; 42:426-8. [PMID: 2035897 DOI: 10.1177/000331979104200513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The authors reported a case, pericardiac extravasation of contract medium during an intravenous angiographic (IV DSA) procedure. To their knowledge this is the first such case in the literature. They suggest modifications of the IV DSA method to avoid this complication.
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Affiliation(s)
- S Senaati
- Department of Radiology, Hacettepe University Medical Center, Sehhiye, Ankara, Turkey
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Abstract
The technique of digital splenoportography with thin flexible needles and small amounts of dilute contrast medium is described as one particularly suitable for use in paediatric patients. The authors report a high incidence of spontaneous splenorenal shunting revealed in their patients by this technique.
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Affiliation(s)
- F Balkanci
- Hacettepe University, Medical Faculty, Department of Radiology, Ankara, Turkey
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Parfrey PS, Griffiths SM, Barrett BJ, Paul MD, Genge M, Withers J, Farid N, McManamon PJ. Contrast material-induced renal failure in patients with diabetes mellitus, renal insufficiency, or both. A prospective controlled study. N Engl J Med 1989; 320:143-9. [PMID: 2643041 DOI: 10.1056/nejm198901193200303] [Citation(s) in RCA: 652] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
To determine the risk of nephrotoxicity induced by the infusion of radiographic contrast material, we undertook a prospective study of consecutive patients undergoing radiographic procedures with intravascular contrast material. There were three study groups: patients with diabetes mellitus and normal renal function (n = 85), patients with preexisting renal insufficiency (serum creatinine level, greater than or equal to 150 mumol per liter) without diabetes (n = 101), and patients with both diabetes and renal insufficiency (n = 34). The control group consisted of patients undergoing CT scanning or abdominal imaging procedures without the infusion of contrast material who had diabetes mellitus (n = 59), preexisting renal insufficiency (n = 145), or both (n = 64). Clinically important acute renal failure (defined as an increase of greater than 50 percent in the serum creatinine level) attributable to the contrast material did not occur in nondiabetic patients with preexisting renal insufficiency or in diabetics with normal renal function. The incidence of clinically important contrast-induced renal failure among the diabetic patients with preexisting renal insufficiency was 8.8 percent (95 percent confidence interval, 1.9 to 23.7 percent), as compared with 1.6 percent for the controls. The incidence of acute renal insufficiency, more broadly defined as an increase of greater than 25 percent in the serum creatinine level after the infusion of contrast material, was 11.8 percent among all patients with preexisting renal insufficiency. After the exclusion of patients whose acute renal insufficiency could be attributed to other causes, the incidence was 7.0 percent (95 percent confidence interval, 3.2 to 12.8 percent), as compared with 1.5 percent in the control group. The risk of acute renal insufficiency attributable to the contrast material was therefore 5.5 percent, and the relative risk associated with the infusion of contrast material was 4.7. These rates were similar whether the osmolarity of the contrast material was high or low. We conclude that there is little risk of clinically important nephrotoxicity attributable to contrast material for patients with diabetes and normal renal function or for nondiabetic patients with preexisting renal insufficiency. The risk for those with both diabetes and preexisting renal insufficiency is about 9 percent, which is lower than previously reported.
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Affiliation(s)
- P S Parfrey
- Division of Nephrology, Health Sciences Centre, Memorial University, St. John's, Canada
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Cramer B, Green J, Harnett J, Johnson GJ, McManamon P, Farid N, Pryse-Phillips W, Parfrey PS. Sonographic and urographic correlation in Bardet-Biedl syndrome (formerly Laurence-Moon-Biedl syndrome). Urol Radiol 1988; 10:176-80. [PMID: 3072750 DOI: 10.1007/bf02926564] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
To determine the spectrum of urologic disease and the value of ultrasound as a screening mechanism, renal imaging was performed on 23 patients with Bardet-Biedl syndrome. On intravenous urography (IVU), abnormal calices were present in 22 patients, with communicating cortical cysts/diverticula in 17. Ultrasound detected caliceal or cystic changes in 70%. On IVU, 21 patients had fetal-type lobular outlines that were detected on sonography in 95%. Renal structural abnormalities are characteristic of the Bardet-Biedl syndrome, and are still best imaged by urography.
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Affiliation(s)
- B Cramer
- Department of Radiology, Memorial University, St. John's, Newfoundland, Canada
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Skanes VM, Barnard J, Farid N, Marshall WH, Murphy L, Rideout D, Taylor R, Xidos G, Larsen B. Class III alleles and high-risk MHC haplotypes in type I diabetes mellitus, Graves' disease and Hashimoto's thyroiditis. Mol Biol Med 1986; 3:143-57. [PMID: 3461234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
By typing a large quantity of family-based material for HLA-B, HLA-DR, C4, C2 and factor B, we were able to derive four-gene complement haplotypes (C4A, C4B, C2, BF) and six-gene MHC haplotypes (HLA-B, complement, HLA-DR). Fourteen six-gene MHC haplotypes showed linkage disequilibrium but exact frequencies could not be determined because it was not always possible to assign null C4 alleles in families where null genes were not clearly seen to segregate. Comparison of unrelated type I diabetes, Graves' disease and Hashimoto's thyroiditis patients with healthy unrelated controls revealed the following MHC allele associations: C4B*3, HLA-DR3 and HLA-DR4 with type I diabetes; BF*F1 and HLA-DR3 with Graves' disease; HLA-DR4 with Hashimoto's thyroiditis. By typing families of type I diabetes and Graves' disease patients we were able to derive two high-risk DR3+ MHC haplotypes for both type I diabetes and Graves' disease. These are HLA-B8 C4A*Q0 C4B*1 BF*S HLA-DR3 and HLA-B18 C4A*3 C4B*Q0 BF*F1 HLA-DR3, and these haplotypes account for most of the associations between these diseases and HLA-DR3. The MHC haplotype HLA-B15 C4A*3 C4B*3 BF*S HLA-DR4 also carries high risk for type I diabetes in this group of patients. Our data suggest that other DR4+ haplotypes, probably containing C4A*3 C4B*1, carry increased risk for type I diabetes whereas haplotypes containing DR4 and C4 C4A*3 C4B*Q0 do not. Our phenotype data suggest that DR4 in Hashimoto's thyroiditis is frequently associated with HLA-B44, C4A*3, C4B*1 and BF*S.
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Zerbe RL, Rowe H, Enas GG, Wong D, Farid N, Lemberger L. Clinical pharmacology of tomoxetine, a potential antidepressant. J Pharmacol Exp Ther 1985; 232:139-43. [PMID: 3965689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Tomoxetine (LY139603) selectively inhibits norepinephrine uptake in animals and has activity in animal models of depression. Tomoxetine was administered in single oral doses up to 90 mg to healthy normal volunteers. In addition, normal human subjects received either 20 or 40 mg of tomoxetine b.i.d. for 1 week to evaluate the safety and pharmacologic activity of the compound in humans. At these doses, no serious drug-related adverse effects were encountered. Activity of the compound at the lower dose (20 mg b.i.d.) was evaluated by examining changes in the pressor responses to infused norepinephrine and tyramine and by determining [3H]serotonin uptake in platelets harvested from subjects receiving the compound. Pressor sensitivity to norepinephrine was increased by 261 +/- 69% of control, and pressor sensitivity to tyramine was decreased by 51 +/- 6% of control during treatment. Changes in the pressor sensitivity to norepinephrine in individual subjects were positively correlated with drug levels. There were no statistically significant changes in platelet [3H]serotonin uptake. These results indicate that tomoxetine selectively inhibits norepinephrine uptake in humans at doses which are clinically well tolerated and suggest that tomoxetine has potential clinical use as an antidepressant.
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Lemberger L, Bergstrom R, Aronoff G, Farid N, Wolen R. SPECIFIC SEROTONIN UPTAKE BLOCKERS. Clin Neuropharmacol 1984. [DOI: 10.1097/00002826-198406001-00160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pruzanski W, Farid N, Keystone E, Armstrong M, Greaves MF. The influence of homogeneous cold agglutinins on human B and T lymphocytes. Clin Immunol Immunopathol 1975; 4:248-57. [PMID: 806408 DOI: 10.1016/0090-1229(75)90060-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Farid N. A CASE OF RIGHT HOMONYMOUS HEMIANOPIA. Br J Ophthalmol 1929; 13:67-8. [DOI: 10.1136/bjo.13.2.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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