المؤلفون: Feng, Christine H, Cornell, Mariel, Moore, Kevin L, Karunamuni, Roshan, Seibert, Tyler M

المصدر: Radiation Oncology. 15(1)

مصطلحات موضوعية: Cancer, Neurosciences, Clinical Research, Adult, Artificial Intelligence, Brain Neoplasms, Cranial Irradiation, Hippocampus, Humans, Organs at Risk, Radiotherapy Planning, Computer-Assisted, Retrospective Studies, Brain metastases, Hippocampal-avoidant whole-brain radiotherapy, Artificial intelligence, Radiotherapy automation, Brain segmentation, Knowledge-based planning, Oncology and Carcinogenesis, Oncology & Carcinogenesis

الوصف: BackgroundWhole-brain radiotherapy (WBRT) remains an important treatment for over 200,000 cancer patients in the United States annually. Hippocampal-avoidant WBRT (HA-WBRT) reduces neurocognitive toxicity compared to standard WBRT, but HA-WBRT contouring and planning are more complex and time-consuming than standard WBRT. We designed and evaluated a workflow using commercially available artificial intelligence tools for automated hippocampal segmentation and treatment planning to efficiently generate clinically acceptable HA-WBRT radiotherapy plans.MethodsWe retrospectively identified 100 consecutive adult patients treated for brain metastases outside the hippocampal region. Each patient's T1 post-contrast brain MRI was processed using NeuroQuant, an FDA-approved software that provides segmentations of brain structures in less than 8 min. Automated hippocampal segmentations were reviewed for accuracy, then converted to files compatible with a commercial treatment planning system, where hippocampal avoidance regions and planning target volumes (PTV) were generated. Other organs-at-risk (OARs) were previously contoured per clinical routine. A RapidPlan knowledge-based planning routine was applied for a prescription of 30 Gy in 10 fractions using volumetric modulated arc therapy (VMAT) delivery. Plans were evaluated based on NRG CC001 dose-volume objectives (Brown et al. in J Clin Oncol, 2020).ResultsOf the 100 cases, 99 (99%) had acceptable automated hippocampi segmentations without manual intervention. Knowledge-based planning was applied to all cases; the median processing time was 9 min 59 s (range 6:53-13:31). All plans met per-protocol dose-volume objectives for PTV per the NRG CC001 protocol. For comparison, only 65.5% of plans on NRG CC001 met PTV goals per protocol, with 26.1% within acceptable variation. In this study, 43 plans (43%) met OAR constraints, and the remaining 57 (57%) were within acceptable variation, compared to 42.5% and 48.3% on NRG CC001, respectively. No plans in this study had unacceptable dose to OARs, compared to 0.8% of manually generated plans from NRG CC001. 8.4% of plans from NRG CC001 were not scored or unable to be evaluated.ConclusionsAn automated pipeline harnessing the efficiency of commercially available artificial intelligence tools can generate clinically acceptable VMAT HA-WBRT plans with minimal manual intervention. This process could improve clinical efficiency for a treatment established to improve patient outcomes over standard WBRT.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/0p6360mhTest

المؤلفون: Karunamuni, Roshan, Tringale, Kathryn R, Burkeen, Jeffrey, Tibbs, Michelle D, Huynh-Le, Minh-Phuong, Bahrami, Naeim, Marshall, Deborah, Seibert, Tyler M, McDonald, Carrie R, Hattangadi-Gluth, Jona A

المصدر: Journal of Neuro-Oncology. 146(1)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Brain Disorders, Neurosciences, Mental Health, Behavioral and Social Science, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), Clinical Research, Cancer, Mental health, Adult, Brain Neoplasms, Executive Function, Female, Follow-Up Studies, Humans, Male, Memory Disorders, Middle Aged, Neurocognitive Disorders, Neuropsychological Tests, Prognosis, Prospective Studies, Radiotherapy, Neurocognitive function, Primary brain tumors, Global deficit score, Oncology & Carcinogenesis, Oncology and carcinogenesis

الوصف: IntroductionWe investigated multi-domain baseline neurocognition of primary brain tumor patients prior to radiotherapy (RT), including clinical predictors of function and association between pre-RT and post-RT impairment on a prospective trial.MethodsA multi-domain neuropsychological battery (memory, executive functioning, language, attention, processing) was performed on 37 patients, pre-RT and 3-(n = 21), 6-(n = 22) and 12-(n = 14) months post-RT. Impairment rate was the proportion of patients with standardized T-scores ≤ 1.5 standard deviations below normative means. Per-patient impairment across all domains was calculated using a global deficit score (GDS; higher value indicates more impairment). Associations between baseline GDS and clinical variables were tested. Global GDS impairment rate at each time point was the fraction of patients with GDS scores > 0.5.ResultsStatistically significant baseline neurocognitive impairments were identified on 4 memory (all p ≤ 0.03) and 2 out of 3 (p = 0.01, p = 0.027) executive functioning tests. Per-patient baseline GDS was significantly associated with tumor volume (p = 0.048), tumor type (p = 0.043), seizure history (p = 0.007), and use of anti-epileptics (p = 0.009). The percentage of patients with the same impairment status at 3-, 6-, and 12-months as at baseline were 88%, 85%, and 85% respectively.ConclusionsMemory and executive functioning impairment were the most common cognitive deficits prior to RT. Patients with larger tumors, more aggressive histology, and use of anti-epileptics had higher baseline GDS values. GDS is a promising tool to encompass multi-domain neurocognitive function, and baseline GDS can identify those at risk of cognitive impairment.

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الوصول الحر: https://escholarship.org/uc/item/9w72f1x1Test

المؤلفون: Tringale, Kathryn R, Nguyen, Tanya T, Karunamuni, Roshan, Seibert, Tyler, Huynh-Le, Minh-Phuong, Connor, Michael, Moiseenko, Vitali, Gorman, Mary Kay, Marshall, Anisa, Tibbs, Michelle Devereux, Farid, Nikdokht, Simpson, Daniel, Sanghvi, Parag, McDonald, Carrie R, Hattangadi-Gluth, Jona A

المصدر: International Journal of Radiation Oncology • Biology • Physics. 105(4)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Cancer, Acquired Cognitive Impairment, Neurosciences, Biomedical Imaging, Clinical Research, Brain Disorders, Mental health, Adult, Aged, Agnosia, Anisotropy, Antineoplastic Agents, Brain Neoplasms, Cranial Irradiation, Diffusion Magnetic Resonance Imaging, Dose Fractionation, Radiation, Entorhinal Cortex, Female, Functional Neuroimaging, Hippocampus, Humans, Male, Memory, Memory Disorders, Mental Recall, Middle Aged, Neuropsychological Tests, Prospective Studies, Radiation Injuries, Seizures, Temporal Lobe, White Matter, Young Adult, Other Physical Sciences, Clinical Sciences, Oncology & Carcinogenesis, Oncology and carcinogenesis, Theoretical and computational chemistry, Medical and biological physics

الوصف: PurposeWe used quantitative magnetic resonance imaging to prospectively analyze the association between microstructural damage to memory-associated structures within the medial temporal lobe and longitudinal memory performance after brain radiation therapy (RT).Methods and materialsPatients with a primary brain tumor receiving fractionated brain RT were enrolled on a prospective trial (n = 27). Patients underwent high-resolution volumetric brain magnetic resonance imaging, diffusion-weighted imaging, and neurocognitive testing before and 3, 6, and 12 months post-RT. Medial temporal lobe regions (hippocampus; entorhinal, parahippocampal, and temporal pole white matter [WM]) were autosegmented, quantifying volume and diffusion biomarkers of WM integrity (mean diffusivity [MD]; fractional anisotropy [FA]). Reliable change indices measured changes in verbal (Hopkins Verbal Learning Test-Revised) and visuospatial (Brief Visuospatial Memory Test-Revised [BVMT-R]) memory. Linear mixed-effects models assessed longitudinal associations between imaging parameters and memory.ResultsVisuospatial memory significantly declined at 6 months post-RT (mean reliable change indices, -1.3; P = .012). Concurrent chemotherapy and seizures trended toward a significant association with greater decline in visuospatial memory (P = .053 and P = .054, respectively). Higher mean dose to the left temporal pole WM was significantly associated with decreased FA (r = -0.667; P = .002). Over all time points, smaller right hippocampal volume (P = .021), lower right entorhinal FA (P = .023), greater right entorhinal MD (P = .047), and greater temporal pole MD (BVMT-R total recall, P = .003; BVMT-R delayed recall, P = .042) were associated with worse visuospatial memory. The interaction between right entorhinal MD (BVMT-R total recall, P = .021; BVMT-R delayed recall, P = .004) and temporal pole FA (BVMT-R delayed recall, P = .024) significantly predicted visuospatial memory performance.ConclusionsBrain tumor patients exhibited visuospatial memory decline post-RT. Microstructural damage to critical memory regions, including the hippocampus and medial temporal lobe WM, were associated with post-RT memory decline. The integrity of medial temporal lobe structures is critical to memory performance post-RT, representing possible avoidance targets for memory preservation.

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الوصول الحر: https://escholarship.org/uc/item/3rk9f19nTest

المؤلفون: Huynh-Le, Minh-Phuong, Karunamuni, Roshan, Moiseenko, Vitali, Farid, Nikdokht, McDonald, Carrie R, Hattangadi-Gluth, Jona A, Seibert, Tyler M

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Brain Cancer, Brain Disorders, Cancer, Neurosciences, Biomedical Imaging, Rare Diseases, Radiation Oncology, Evaluation of treatments and therapeutic interventions, 6.5 Radiotherapy and other non-invasive therapies, Adult, Aged, Amygdala, Atrophy, Brain Neoplasms, Cranial Irradiation, Female, Humans, Magnetic Resonance Imaging, Male, Memory, Middle Aged, Radiation Injuries, Retrospective Studies, Young Adult, Brain radiotherapy, Quantitative MRI, Other Physical Sciences, Oncology & Carcinogenesis, Clinical sciences, Oncology and carcinogenesis, Medical and biological physics

الوصف: Background and purposeThe amygdalae are deep brain nuclei critical to emotional processing and the creation and storage of memory. It is not known whether the amygdalae are affected by brain radiotherapy (RT). We sought to quantify dose-dependent amygdala change one year after brain RT.Materials and methods52 patients with primary brain tumors were retrospectively identified. Study patients underwent high-resolution, volumetric magnetic resonance imaging before RT and 1 year afterward. Images were processed using FDA-cleared software for automated segmentation of amygdala volume. Tumor, surgical changes, and segmentation errors were manually censored. Mean amygdala RT dose was tested for correlation with amygdala volume change 1 year after RT via the Pearson correlation coefficient. A linear mixed-effects model was constructed to evaluate potential predictors of amygdala volume change, including age, tumor hemisphere, sex, seizure history, and bevacizumab treatment during the study period. As 51 of 52 patients received chemotherapy, possible chemotherapy effects could not be studied. A two-tailed p-value

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الوصول الحر: https://escholarship.org/uc/item/95q626t1Test
https://escholarship.org/content/qt95q626t1/qt95q626t1.pdfTest

المؤلفون: Tringale, Kathryn R, Nguyen, Tanya, Bahrami, Naeim, Marshall, Deborah C, Leyden, Kelly M, Karunamuni, Roshan, Seibert, Tyler M, Gorman, Mary Kay, Connor, Michael, Burkeen, Jeff, Piccioni, David E, Farid, Nikdokht, Hattangadi-Gluth, Jona A, McDonald, Carrie R

مصطلحات موضوعية: Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Cancer, Neurosciences, Acquired Cognitive Impairment, Brain Disorders, Clinical Research, Neurological, Biomarkers, Brain, Brain Neoplasms, Diffusion Tensor Imaging, Executive Function, Female, Humans, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Radiation Injuries, White Matter, Brain tumors, Radiation therapy, Neurocognition, Executive function, Neuroimaging, Other Physical Sciences, Oncology & Carcinogenesis, Clinical sciences, Oncology and carcinogenesis, Medical and biological physics

الوصف: Background and purposeExecutive function (EF) decline is common after brain radiation therapy (RT), yet the etiology is unclear. We analyzed the association between longitudinal changes in frontal lobe white matter microstructure and decline in EF following RT in brain tumor patients on a prospective clinical trial.Materials and methodsDiffusion tensor imaging was obtained on 22 patients with brain tumors prior to RT, as well as 3- and 6-months post-RT, in a prospective, observational trial. Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were calculated within the superficial white matter (SWM) of the anterior cingulate (AC) and dorsolateral prefrontal cortex. Measures of cognitive flexibility, verbal fluency, and verbal set-shifting were obtained pre- and post-RT. Reliable change indices were calculated to determine significant baseline to 6-month EF changes.ResultsDecreases in FA and increases in MD were observed in the caudal AC (CAC) at 3-months post-RT. CAC changes were characterized by increased RD bilaterally. From baseline to 6-months post-RT, decreased FA and increased MD and RD of the CAC was associated with decline in verbal set-shifting ability, whereas increased MD in the CAC was associated with a decline in cognitive flexibility.ConclusionWhite matter underlying the AC may be particularly vulnerable to radiation effects. Early microstructural loss within AC SWM represents an important biomarker for EF decline, and dose reduction in this region may represent a possibility for cognitive preservation for patients receiving radiotherapy.

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الوصول الحر: https://escholarship.org/uc/item/9vs405k7Test

المؤلفون: Bahrami, Naeim, Hartman, Stephen J, Chang, Yu-Hsuan, Delfanti, Rachel, White, Nathan S, Karunamuni, Roshan, Seibert, Tyler M, Dale, Anders M, Hattangadi-Gluth, Jona A, Piccioni, David, Farid, Nikdokht, McDonald, Carrie R

المصدر: Journal of Neuro-Oncology. 139(3)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Rare Diseases, Neurosciences, Brain Cancer, Biomedical Imaging, Cancer, Brain Disorders, Clinical Research, Detection, screening and diagnosis, 4.2 Evaluation of markers and technologies, Adult, Aged, Brain Neoplasms, DNA Methylation, DNA Modification Methylases, DNA Repair Enzymes, Female, Glioma, Humans, Imaging, Three-Dimensional, Isocitrate Dehydrogenase, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasm Grading, Retrospective Studies, Tumor Suppressor Proteins, Young Adult, Grade II, III gliomas, Texture analysis, IDH, 1p/19q, Magnetic resonance imaging, Grade II/III gliomas, Oncology & Carcinogenesis, Oncology and carcinogenesis

الوصف: BackgroundMolecular markers of WHO grade II/III glioma are known to have important prognostic and predictive implications and may be associated with unique imaging phenotypes. The purpose of this study is to determine whether three clinically relevant molecular markers identified in gliomas-IDH, 1p/19q, and MGMT status-show distinct quantitative MRI characteristics on FLAIR imaging.MethodsSixty-one patients with grade II/III gliomas who had molecular data and MRI available prior to radiation were included. Quantitative MRI features were extracted that measured tissue heterogeneity (homogeneity and pixel correlation) and FLAIR border distinctiveness (edge contrast; EC). T-tests were conducted to determine whether patients with different genotypes differ across the features. Logistic regression with LASSO regularization was used to determine the optimal combination of MRI and clinical features for predicting molecular subtypes.ResultsPatients with IDH wildtype tumors showed greater signal heterogeneity (p = 0.001) and lower EC (p = 0.008) within the FLAIR region compared to IDH mutant tumors. Among patients with IDH mutant tumors, 1p/19q co-deleted tumors had greater signal heterogeneity (p = 0.002) and lower EC (p = 0.005) compared to 1p/19q intact tumors. MGMT methylated tumors showed lower EC (p = 0.03) compared to the unmethylated group. The combination of FLAIR border distinctness, heterogeneity, and pixel correlation optimally classified tumors by IDH status.ConclusionQuantitative imaging characteristics of FLAIR heterogeneity and border pattern in grade II/III gliomas may provide unique information for determining molecular status at time of initial diagnostic imaging, which may then guide subsequent surgical and medical management.

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الوصول الحر: https://escholarship.org/uc/item/2cc358xxTest

المؤلفون: Murzin, Vyacheslav L, Woods, Kaley, Moiseenko, Vitali, Karunamuni, Roshan, Tringale, Kathryn R, Seibert, Tyler M, Connor, Michael J, Simpson, Daniel R, Sheng, Ke, Hattangadi-Gluth, Jona A

المصدر: Radiotherapy and Oncology. 127(1)

مصطلحات موضوعية: Medical and Biological Physics, Biomedical and Clinical Sciences, Clinical Sciences, Physical Sciences, Oncology and Carcinogenesis, Neurosciences, Cancer, Clinical Research, Brain Disorders, Evaluation of treatments and therapeutic interventions, 6.5 Radiotherapy and other non-invasive therapies, Adult, Aged, Brain Neoplasms, Cerebral Cortex, Female, Hippocampus, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Organs at Risk, Probability, Radiation Injuries, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Radiotherapy, Intensity-Modulated, Retrospective Studies, Intracranial radiotherapy, Non-coplanar IMRT, Brain sparing, NTCP, Cortical atrophy, Other Physical Sciences, Oncology & Carcinogenesis, Clinical sciences, Oncology and carcinogenesis, Medical and biological physics

الوصف: Background and purposeIncidental irradiation of normal brain tissue during radiotherapy is linked to cognitive decline, and may be mediated by damage to healthy cortex. Non-coplanar techniques may be used for cortical sparing. We compared normal brain sparing and probability of cortical atrophy using 4π radiation therapy planning vs. standard fixed gantry intensity-modulated radiotherapy (IMRT).Material and methodsPlans from previously irradiated brain tumor patients ("original IMRT", n = 13) were re-planned to spare cortex using both 4π optimization ("4π") and IMRT optimization ("optimized IMRT"). Homogeneity index (HI), gradient measure, doses to cortex and white matter (excluding tumor), brainstem, optics, and hippocampus were compared with matching PTV coverage. Probability of three grades of post-treatment cortical atrophy was modeled based on previously established dose response curves.ResultsWith matching PTV coverage, 4π significantly improved HI by 27% (p = 0.005) and gradient measure by 8% (p = 0.001) compared with optimized IMRT. 4π optimization reduced mean and equivalent uniform doses (EUD) to all standard OARs, with 14-15% reduction in hippocampal EUD (p ≤ 0.003) compared with the other two plans. 4π significantly reduced dose to fractional cortical volumes (V50, V40 and V30) compared with the original IMRT plans, and reduced cortical V30 by 7% (p = 0.008) compared with optimized IMRT. White matter EUD, mean dose, and fractional volumes V50, V40 and V30 were also significantly lower with 4π (p ≤ 0.001). With 4π, probability of grade 1, 2 and 3 cortical atrophy decreased by 12%, 21% and 26% compared with original IMRT and by 8%, 14% and 3% compared with optimized IMRT, respectively (p ≤ 0.001).Conclusions4π radiotherapy significantly improved cortical sparing and reduced doses to standard brain OARs, white matter, and the hippocampus. This was achieved with superior PTV dose homogeneity. Such sparing could reduce the probability of cortical atrophy that may lead to cognitive decline.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/2ff0j9gtTest

المؤلفون: Murzin, Vyacheslav L, Woods, Kaley, Moiseenko, Vitali, Karunamuni, Roshan, Tringale, Kathryn R, Seibert, Tyler M, Connor, Michael J, Simpson, Daniel R, Sheng, Ke, Hattangadi-Gluth, Jona A

المصدر: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 127(1)

مصطلحات موضوعية: Hippocampus, Cerebral Cortex, Humans, Brain Neoplasms, Radiation Injuries, Magnetic Resonance Imaging, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Probability, Retrospective Studies, Adult, Aged, Middle Aged, Female, Male, Radiotherapy, Intensity-Modulated, Organs at Risk, Brain sparing, Cortical atrophy, Intracranial radiotherapy, NTCP, Non-coplanar IMRT, Brain Disorders, Clinical Research, Cancer, Neurosciences, Evaluation of treatments and therapeutic interventions, 6.5 Radiotherapy and other non-invasive therapies, Other Physical Sciences, Oncology and Carcinogenesis, Oncology & Carcinogenesis

الوصف: BACKGROUND AND PURPOSE:Incidental irradiation of normal brain tissue during radiotherapy is linked to cognitive decline, and may be mediated by damage to healthy cortex. Non-coplanar techniques may be used for cortical sparing. We compared normal brain sparing and probability of cortical atrophy using 4π radiation therapy planning vs. standard fixed gantry intensity-modulated radiotherapy (IMRT). MATERIAL AND METHODS:Plans from previously irradiated brain tumor patients ("original IMRT", n = 13) were re-planned to spare cortex using both 4π optimization ("4π") and IMRT optimization ("optimized IMRT"). Homogeneity index (HI), gradient measure, doses to cortex and white matter (excluding tumor), brainstem, optics, and hippocampus were compared with matching PTV coverage. Probability of three grades of post-treatment cortical atrophy was modeled based on previously established dose response curves. RESULTS:With matching PTV coverage, 4π significantly improved HI by 27% (p = 0.005) and gradient measure by 8% (p = 0.001) compared with optimized IMRT. 4π optimization reduced mean and equivalent uniform doses (EUD) to all standard OARs, with 14-15% reduction in hippocampal EUD (p ≤ 0.003) compared with the other two plans. 4π significantly reduced dose to fractional cortical volumes (V50, V40 and V30) compared with the original IMRT plans, and reduced cortical V30 by 7% (p = 0.008) compared with optimized IMRT. White matter EUD, mean dose, and fractional volumes V50, V40 and V30 were also significantly lower with 4π (p ≤ 0.001). With 4π, probability of grade 1, 2 and 3 cortical atrophy decreased by 12%, 21% and 26% compared with original IMRT and by 8%, 14% and 3% compared with optimized IMRT, respectively (p ≤ 0.001). CONCLUSIONS:4π radiotherapy significantly improved cortical sparing and reduced doses to standard brain OARs, white matter, and the hippocampus. This was achieved with superior PTV dose homogeneity. Such sparing could reduce the probability of cortical atrophy that may lead to cognitive decline.

الوصول الحر: https://escholarship.org/uc/item/4pq0v2htTest

المؤلفون: Delfanti, Rachel L, Piccioni, David E, Handwerker, Jason, Bahrami, Naeim, Krishnan, AnithaPriya, Karunamuni, Roshan, Hattangadi-Gluth, Jona A, Seibert, Tyler M, Srikant, Ashwin, Jones, Karra A, Snyder, Vivian S, Dale, Anders M, White, Nathan S, McDonald, Carrie R, Farid, Nikdokht

المصدر: Journal of Neuro-Oncology. 135(3)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Brain Cancer, Orphan Drug, Clinical Research, Rare Diseases, Brain Disorders, Cancer, Clinical Trials and Supportive Activities, Neurosciences, Biomedical Imaging, Adult, Brain, Brain Neoplasms, Chromosomes, Human, Pair 1, Disease-Free Survival, Female, Follow-Up Studies, Glioma, Humans, Isocitrate Dehydrogenase, Kaplan-Meier Estimate, Magnetic Resonance Imaging, Male, Middle Aged, Mutation, Neoplasm Grading, Proportional Hazards Models, Retrospective Studies, World Health Organization, X-linked Nuclear Protein, Lower grade gliomas, Grade II/III gliomas, IDH mutation, Neuroradiology, MRI, Radiogenomics, Oncology & Carcinogenesis, Oncology and carcinogenesis

الوصف: The 2016 World Health Organization Classification of Tumors of the Central Nervous System incorporates the use of molecular information into the classification of brain tumors, including grade II and III gliomas, providing new prognostic information that cannot be delineated based on histopathology alone. We hypothesized that these genomic subgroups may also have distinct imaging features. A retrospective single institution study was performed on 40 patients with pathologically proven infiltrating WHO grade II/III gliomas with a pre-treatment MRI and molecular data on IDH, chromosomes 1p/19q and ATRX status. Two blinded Neuroradiologists qualitatively assessed MR features. The relationship between each parameter and molecular subgroup (IDH-wildtype; IDH-mutant-1p/19q codeleted-ATRX intact; IDH-mutant-1p/19q intact-ATRX loss) was evaluated with Fisher's exact test. Progression free survival (PFS) was also analyzed. A border that could not be defined on FLAIR was most characteristic of IDH-wildtype tumors, whereas IDH-mutant tumors demonstrated either well-defined or slightly ill-defined borders (p = 0.019). Degree of contrast enhancement and presence of restricted diffusion did not distinguish molecular subgroups. Frontal lobe predominance was associated with IDH-mutant tumors (p = 0.006). The IDH-wildtype subgroup had significantly shorter PFS than the IDH-mutant groups (p

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الوصول الحر: https://escholarship.org/uc/item/1hv6852tTest

المؤلفون: Bahrami, Naeim, Seibert, Tyler M, Karunamuni, Roshan, Bartsch, Hauke, Krishnan, AnithaPriya, Farid, Nikdokht, Hattangadi-Gluth, Jona A, McDonald, Carrie R

المصدر: Brain Connectivity. 7(5)

مصطلحات موضوعية: Biological Psychology, Biomedical and Clinical Sciences, Psychology, Brain Disorders, Brain Cancer, Cancer, Neurosciences, Clinical Research, Rare Diseases, Neurological, Adaptation, Physiological, Adult, Aged, Brain, Brain Neoplasms, Connectome, Cranial Irradiation, Dose Fractionation, Radiation, Dose-Response Relationship, Radiation, Female, Humans, Male, Middle Aged, Nerve Net, Treatment Outcome, Young Adult, graph theory, radiotherapy, brain tumor, structural network connectivity, magnetic resonance imaging, Biological psychology

الوصف: Radiation therapy (RT) is a critical treatment modality for patients with brain tumors, although it can cause adverse effects. Recent data suggest that brain RT is associated with dose-dependent cortical atrophy, which could disrupt neocortical networks. This study examines whether brain RT affects structural network properties in brain tumor patients. We applied graph theory to MRI-derived cortical thickness estimates of 54 brain tumor patients before and after RT. Cortical surfaces were parcellated into 68 regions and correlation matrices were created for patients pre- and post-RT. Significant changes in graph network properties were tested using nonparametric permutation tests. Linear regressions were conducted to measure the association between dose and changes in nodal network connectivity. Increases in transitivity, modularity, and global efficiency (n = 54, p

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الوصول الحر: https://escholarship.org/uc/item/2xb0m9jhTest