INTRODUCTION: Glioblastoma (GBM) is the most common malignant primary brain tumor, and methods to improve the early detection of disease progression and evaluate treatment response are highly desirable. We therefore explored changes in whole-brain apparent diffusion coefficient (ADC) values with respect to survival (progression-free [PFS], overall [OS]) in a cohort of GBM patients followed at regular intervals until disease progression. METHODS: A total of 43 subjects met inclusion criteria and were analyzed retrospectively. Histogram data were extracted from standardized whole-brain ADC maps including skewness, kurtosis, entropy, median, mode, 15th percentile (p15) and 85th percentile (p85) values, and linear regression slopes (metrics versus time) were fitted. Regression slope directionality (positive/negative) was subjected to univariate Cox regression. The final model was determined by aLASSO on metrics above threshold. RESULTS: Skewness, kurtosis, median, p15 and p85 were all below threshold for both PFS and OS and were analyzed further. Median regression slope directionality best modeled PFS (p = 0.001; HR 3.3; 95% CI 1.6-6.7), while p85 was selected for OS (p = 0.002; HR 0.29; 95% CI 0.13-0.64). CONCLUSIONS: Our data show tantalizing potential in the use of whole-brain ADC measurements in the follow up of GBM patients, specifically serial median ADC values which correlated with PFS, and serial p85 values which correlated with OS. Whole-brain ADC measurements are fast and easy to perform, and free of ROI-placement bias.
- MeSH
- alkylační protinádorové látky terapeutické užití MeSH
- chemoradioterapie mortalita MeSH
- difuzní magnetická rezonance metody MeSH
- glioblastom mortalita patologie terapie MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- míra přežití MeSH
- nádory mozku mortalita patologie terapie MeSH
- následné studie MeSH
- počítačové zpracování obrazu metody MeSH
- prognóza MeSH
- progrese nemoci MeSH
- retrospektivní studie MeSH
- temozolomid terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: Multiple system atrophy (MSA) is a rare neurodegenerative disease that remains poorly understood, and the diagnosis of MSA continues to be challenging. We endeavored to improve the diagnostic process and understanding of in vivo characteristics of MSA by diffusion tensor imaging (DTI). MATERIALS AND METHODS: Twenty MSA subjects, ten parkinsonian dominant (MSA-P), ten cerebellar dominant (MSA-C), and 20 healthy volunteer subjects were recruited. Fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity maps were processed using tract-based spatial statistics. Diffusion data were additionally evaluated in the basal ganglia. A support vector machine was used to assess diagnostic utility, leave-one-out cross-validation in the evaluation of classification schemes, and receiver operating characteristic analyses to determine cutoff values. RESULTS: We detected widespread changes in the brain white matter of MSA subjects; however, no group-wise differences were found between MSA-C and MSA-P subgroups. Altered DTI metrics in the putamen and middle cerebellar peduncles were associated with a positive parkinsonian and cerebellar phenotype, respectively. Concerning clinical applicability, we achieved high classification performance on mean diffusivity data in the combined bilateral putamen and middle cerebellar peduncle (accuracy 90.3%±9%, sensitivity 86.5%±11%, and specificity 99.3%±4%). CONCLUSION: DTI in the middle cerebellar peduncle and putamen may be used in the diagnosis of MSA with a high degree of accuracy.
- Publikační typ
- časopisecké články MeSH
PURPOSE: To characterize the relationship between superparamagnetic ferritin-bound iron and diffusion tensor scalars in vitro, and validate the results in vivo. MATERIALS AND METHODS: The in vitro model consisted of a series of 40-mL 1.1% agarose gels doped with ferritin covering and exceeding those concentrations normally found within healthy human gray matter. Additionally, regions of interest were placed in the caudate, putamen, and globus pallidus of 29 healthy volunteer subjects 19-80 years of age. Carr-Purcell-Meiboom-Gill sequence (CPMG) and diffusion tensor imaging (DTI) data were collected at 1.5 Tesla (T) and 3T in vitro, and at 1.5T in vivo. RESULTS: In vitro, linear relationships were observed between ferritin-bound iron concentration, R2 (1/T2 ) and 1/SNR. Eigenvalue repulsion with increasing R2 (decreasing SNR) was reflected in an artifactual increase of fractional anisotropy. In vivo, similar relationships were observed, with mean diffusivity also decreasing linearly with increasing R2 . Lambda 3 showed the strongest correlation with R2 both in vitro and in vivo. CONCLUSION: The observation that DTI metrics correlate with ferritin-bound iron is an important consideration in the design and interpretation of studies exploring the diffusion characteristics of gray matter regions, especially in studies focused on adolescence as well as diseases associated with altered brain-iron load such as pantothenate kinase-associated neurodegeneration, Huntington disease and multiple system atrophy.
- MeSH
- dospělí MeSH
- fantomy radiodiagnostické MeSH
- ferritiny metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mozek cytologie metabolismus MeSH
- neurony cytologie metabolismus MeSH
- reprodukovatelnost výsledků MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- techniky in vitro MeSH
- železo metabolismus MeSH
- zobrazování difuzních tenzorů přístrojové vybavení metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Glioblastoma multiforme (GBM) is the most common and malignant primary intracranial tumor, and has a median survival of only 10 to 14 months with only 3 to 5% of patients surviving more than three years. Recurrence (RGBM) is nearly universal, and further decreases the median survival to only five to seven months with optimal therapy. Tumor-treating fields (TTField) therapy is a novel treatment technique that has recently received CE and FDA approval for the treatment of RGBM, and is based on the principle that low intensity, intermediate frequency electric fields (100 to 300 kHz) may induce apoptosis in specific cell types. Our center was the first to apply TTField treatment to histologically proven GBM in a small pilot study of 20 individuals in 2004 and 2005, and four of those original 20 patients are still alive today. We report two cases of GBM and two cases of RGBM treated by TTField therapy, all in good health and no longer receiving any treatment more than seven years after initiating TTField therapy, with no clinical or radiological evidence of recurrence.
- MeSH
- dospělí MeSH
- elektrostimulační terapie * MeSH
- glioblastom mortalita patologie terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru mortalita patologie terapie MeSH
- magnetická rezonanční tomografie MeSH
- míra přežití MeSH
- nádory mozku mortalita patologie terapie MeSH
- pilotní projekty MeSH
- prognóza MeSH
- senioři MeSH
- stupeň nádoru MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
Kalcifikující pseudoneoplazmata nervového systému (CAPNONA) jsou vzácné léze, které byly popsány v intra- i extraaxiálních lokalizacích intrakraniálně a v extraaxiálních lokalizacích ve spinální oblasti. Charakteriským znakem na magnetické rezonanci je centrální výpadek signálu na T1 a T 2 vážených obrazech s postkontrastním zvýrazněním po aplikaci kontrastní látky. Nicméně histologická skladba může být různorodá, což se v zobrazení může odrazit. Předkládáme tři kazuistiky CAPNONA, které byly detekovány pomocí MR a potvrzeny histologicky. Kazuistiky jsou doplněny rozsáhlým přehledem literatury s MR charakteristikami těchto lézí, jak byly dosud popsány.
Calcifying pseudoneoplasms of the neural axis (CAPNONA) are rare lesions that have been reported in both intra/extra-axial locations intracranially, and in extra-axial locations in the spinal region. Central loss of signal on T1/T2-weighted images with enhancement following contrast administration is most commonly observed on magnetic resonance imaging, however, the histopathological composition of CAPNONA is diverse which may be reflected in the imaging findings. We present three cases of CAPNONA detected by MRI and confirmed by histological evaluation, and the largest review of the MRI characteristics of these lesions to date.
- Klíčová slova
- CAPNONA, fibro-oseozní léze, kalcifikace,
- MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- financování organizované MeSH
- histologické techniky využití MeSH
- kalcinóza diagnóza MeSH
- kontrastní látky diagnostické užití MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody využití MeSH
- metaplazie diagnóza etiologie MeSH
- nádory nervového systému diagnóza etiologie komplikace MeSH
- nádory podle histologického typu MeSH
- neurochirurgické výkony metody využití MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
