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Diffuse Low Grade Glioma

Tamara Ius, Luca Turella, Giada Pauletto, Miriam Isola, Marta Maieron, Giovanni Sciacca, Riccardo Budai, Serena D'Agostini, Roberto Eleopra, Miran Skrap
BACKGROUND: Pre-operative diffusion tensor tractography (DTT) has recently been utilized to aid in the mapping of functional pathways in order to limit damage associated with resection of low-grade gliomas. OBJECTIVE: To assess the predictive capacity of DTT as a biomarker of post-operative motor outcomes in patients with low-grade gliomas (LGGs) involving the corticospinal tract (CST). CST parameters obtained using a quantitative fiber-tracking approach were used to investigate the reliability of the DTT biomarker by comparing their values in the tumoral (Tcst) and healthy (Hcst) hemispheres...
October 12, 2016: World Neurosurgery
Martin T Freitag, Klaus H Maier-Hein, Francisczek Binczyk, Frederik B Laun, Christian Weber, David Bonekamp, Rafal Tarnawski, Barbara Bobek-Billewicz, Joanna Polanska, Henryk Majchrzak, Bram Stieltjes
OBJECTIVE: Here, we retrospectively investigate the value of voxel-wisely plotted diffusion tensor-derived (DTI) axial, radial and mean diffusivity for the early detection of malignant transformation (MT) in WHO II glioma compared to contrast-enhanced images. MATERIALS AND METHODS: Forty-seven patients underwent brain magnetic resonance imaging follow-up between 2006-2014 after gross-tumor resection of intra-axial WHO II glioma. Axial/Mean/Radial diffusivity maps (AD/MD/RD) were generated from DTI data...
2016: PloS One
Tong Ren, Shide Lin, Zhongfeng Wang, Aijia Shang
Astrocytoma is one of the most common types of brain tumor, which is histologically and clinically classified into four grades (I-IV): I (pilocytic astrocytoma), II (diffuse astrocytoma), III (anaplastic astrocytoma), and IV (glioblastoma multiforme). A higher grade astrocytoma represents a worse prognosis and is more aggressive. In this study, we compared the differential proteome profile of astrocytoma from grades I to IV. The protein samples from clinical specimens of grades I, II, III, and IV astrocytoma were analyzed by two-dimensional liquid chromatography-tandem mass spectrometry and isobaric tags for relative and absolute quantitation and quantification...
2016: OncoTargets and Therapy
Andrew L Lin, Michael White, Michelle M Miller-Thomas, Robert S Fulton, Christina I Tsien, Keith M Rich, Robert E Schmidt, David D Tran, Sonika Dahiya
During the 6 month period following chemoradiotherapy, gliomas frequently develop new areas of contrast enhancement, which are due to treatment effect rather than tumor progression. We sought to characterize this phenomenon in oligodendrogliomas (OG) and mixed oligoastrocytomas (MOA). We reviewed the imaging findings from 143 patients with a WHO grade II or III OG or MOA for evidence of pseudoprogression (PsP) or early tumor progression. We characterized these cases for 1p/19q codeletions by FISH, IDH1 R132H mutation by immunohistochemistry, and TP53, ATRX, and EGFR mutations by next generation sequencing...
October 4, 2016: Journal of Neuro-oncology
Jason C H Chiang, David W Ellison
Advances in our understanding of the biology of paediatric central nervous system (CNS) tumours have encouraged pathologists to use molecular markers alongside histopathological analysis for disease classification or prognostication and treatment stratification. In this article, we review molecular genetic alterations in paediatric CNS tumours, including those in low-grade and high-grade gliomas, ependymomas, and embryonal tumours. Some of these molecular changes with clinicopathological utility have been used for the first time in the most recent edition of the World Health Organization (WHO) classification of CNS tumours to define entities like ependymoma, RELA fusion-positive or diffuse midline glioma, H3 K27M-mutant...
October 4, 2016: Journal of Pathology
Sara Giovanna Romeo, Alfredo Conti, Francesca Polito, Chiara Tomasello, Valeria Barresi, Domenico La La Torre, Maria Cucinotta, Flavio Filippo Angileri, Marcello Bartolotta, Rosa Maria Di Giorgio, M'Hammed Aguennouz
Sirtuins are a family of 7 histone deacetylases largely involved in the regulation of cell proliferation, survival and death. The role of sirtuins in tumorigenesis and cancer progression has been previously studied in certain cancer types. Few studies have investigated sirtuin expression in gliomas, with controversial results. The aim of the present study was to investigate the expression of sirtuin-1 (Sirt-1) in diffuse astrocytoma [low grade astrocytoma (LGA)], anaplastic astrocytoma (AA) and glioblastoma multiforme (GBM) and in primary glioma cell lines: PLGAC (primary LGA cells); PAAC (primary AA cells); and PGBMC (primary GBM cells)...
October 2016: Oncology Letters
Jaap C Reijneveld, Martin J B Taphoorn, Corneel Coens, Jacoline E C Bromberg, Warren P Mason, Khê Hoang-Xuan, Gail Ryan, Mohamed Ben Hassel, Roelien H Enting, Alba A Brandes, Antje Wick, Olivier Chinot, Michele Reni, Guy Kantor, Brian Thiessen, Martin Klein, Eugenie Verger, Christian Borchers, Peter Hau, Michael Back, Anja Smits, Vassilis Golfinopoulos, Thierry Gorlia, Andrew Bottomley, Roger Stupp, Brigitta G Baumert
BACKGROUND: Temozolomide chemotherapy versus radiotherapy in patients with a high-risk low-grade glioma has been shown to have no significant effect on progression-free survival. If these treatments have a different effect on health-related quality of life (HRQOL), it might affect the choice of therapy. We postulated that temozolomide compromises HRQOL and global cognitive functioning to a lesser extent than does radiotherapy. METHODS: We did a prospective, phase 3, randomised controlled trial at 78 medical centres and large hospitals in 19 countries...
September 26, 2016: Lancet Oncology
Jessica K R Boult, Marco Borri, Alexa Jury, Sergey Popov, Gary Box, Lara Perryman, Suzanne A Eccles, Chris Jones, Simon P Robinson
High grade and metastatic brain tumours exhibit considerable spatial variations in proliferation, angiogenesis, invasion, necrosis and oedema. Vascular heterogeneity arising from vascular co-option in regions of invasive growth (in which the blood-brain barrier remains intact) and neoangiogenesis is a major challenge faced in the assessment of brain tumours by conventional MRI. A multiparametric MRI approach, incorporating native measurements and both Gd-DTPA (Magnevist) and ultrasmall superparamagnetic iron oxide (P904)-enhanced imaging, was used in combination with histogram and unsupervised cluster analysis using a k-means algorithm to examine the spatial distribution of vascular parameters, water diffusion characteristics and invasion in intracranially propagated rat RG2 gliomas and human MDA-MB-231 LM2-4 breast adenocarcinomas in mice...
September 27, 2016: NMR in Biomedicine
Zulma Tovar-Spinoza, Hoon Choi
BACKGROUND: Pediatric low-grade gliomas (LGGs) account for approximately half of all pediatric central nervous system tumors. The low-grade gliomas' first line of treatment is gross total resection. However, when gross total resection is not possible, options for adjuvant therapy are limited. MRI-guided laser ablation (magnetic resonance-guided laser interstitial thermal therapy (MRgLITT)) offers a new option for treatment in selected cases. We present a description of the current MRgLITT technology and an exemplary case-series review of our experience in its use in LGGs...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Mario Giordano, Cinta Arraez, Amir Samii, Madjid Samii, Concezio Di Rocco
INTRODUCTION: The treatment of low-grade gliomas (LGGs) in pediatric age is still controversial. However, most authors report longer life expectancy in case of completely removed cerebral gliomas. Intraoperative magnetic resonance imaging (iMRI) is increasingly utilized in the surgical management of intra-axial tumor in adults following the demonstration of its effectiveness. In this article, we analyze the management of LGG using iMRI focusing on its impact on resection rate and its limits in the pediatric population...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Tai-Tong Wong, Hsin-Hung Chen, Muh-Lii Liang, Kevin Li-Chun Hsieh, Yi-Shan Yang, Donald Ming-Tak Ho, Kai-Ping Chang, Yi-Yen Lee, Shih-Chieh Lin, Ting-Rong Hsu, Yi-Wei Chen, Sang-Hue Yen, Feng-Chi Chang, Wan-You Guo, Kuo-Wei Chen, Wei-Kang Kwang, Wu-Yu Hou, Chung-Yih Wang
BACKGROUND: Tumors with epicenter in the thalamus occur in about 4 % of pediatric brain tumors. The histological diagnosis is mainly gliomas. Among them, low-grade glioma (LGG) constituted of a significant entity of the tumors (Cuccia et al., Childs Nerv Syst 13:514-521, 1997; Puget et al., J Neurosurg 106:354-362, 2007; Bernstein et al., J Neurosurg 61:649-656, 1984; Bilginer et al., Childs Nerv Syst 30:1493-1498, 2014). Since Kelly's report in 1989, >90 % resection of thalamic tumors were achieved in reported series (Ozek and Ture, Childs Nerv Syst 18:450-6, 2002; Villarejo et al...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Gianluca Trevisi, Thomas Roujeau, Hugues Duffau
INTRODUCTION: Brain mapping through a direct cortical and subcortical electrical stimulation during an awake craniotomy has gained an increasing popularity as a powerful tool to prevent neurological deficit while increasing extent of resection of hemispheric diffuse low-grade gliomas in adults. However, few case reports or very limited series of awake surgery in children are currently available in the literature. METHODS: In this paper, we review the oncological and functional differences between pediatric and adult populations, and the methodological specificities that may limit the use of awake mapping in pediatric low-grade glioma surgery...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Simona Gaudino, Rosellina Russo, Tommaso Verdolotti, Massimo Caulo, Cesare Colosimo
INTRODUCTION: Advanced magnetic resonance imaging (MRI) techniques is an umbrella term that includes diffusion (DWI) and diffusion tensor (DTI), perfusion (PWI), spectroscopy (MRS), and functional (fMRI) imaging. These advanced modalities have improved the imaging of brain tumors and provided valuable additional information for treatment planning. Despite abundant literature on advanced MRI techniques in adult brain tumors, few reports exist for pediatric brain ones, potentially because of technical challenges...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Alvaro Lassaletta, Michal Zapotocky, Eric Bouffet, Cynthia Hawkins, Uri Tabori
Hemispheric low-grade gliomas account for the second most common location in pediatric low-grade gliomas (PLGGs) after the cerebellum. The pathological spectrum includes gangliogliomas, dysembryoplastic neuroepithelial tumors (DNETs), diffuse astrocytomas, pilocytic astrocytomas, and pleomorphic xanthoastrocytomas (PXAs), among others. Clinically, hemispheric PLGGs represent a well-recognized cause of intractable epilepsy in children and adolescents. With an excellent long-term outcome, surgery remains the cornerstone and patients with gross total resection typically do not need any further therapies...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Ernesto Roldan-Valadez, Camilo Rios, Daniel Motola-Kuba, Juan Matus-Santos, Antonio R Villa, Sergio Moreno-Jimenez
OBJECTIVE: A long-lasting concern has prevailed for the identification of predictive biomarkers for high-grade gliomas (HGGs) using MRI. However, a consensus of which imaging parameters assemble a significant survival model is still missing in the literature; we investigated the significant positive or negative contribution of several MR biomarkers in this tumour prognosis. METHODS: A retrospective cohort of supratentorial HGGs [11 glioblastoma multiforme (GBM) and 17 anaplastic astrocytomas] included 28 patients (9 females and 19 males, respectively, with a mean age of 50...
November 2016: British Journal of Radiology
Guillaume Herbet, Sylvie Moritz-Gasser, Morgane Boiseau, Sophie Duvaux, Jérôme Cochereau, Hugues Duffau
Neurological insults that damage the left hemisphere are frequently associated with a variety of language disorders. Of these, lexical retrieval impairments are the most commonly observed, and often constitute the residual but lasting disturbance in patients with good functional outcomes. The current study was specifically designed to understand the anatomical factors that prevent full recovery of lexical retrieval in patients having undergone a neurosurgery for a left diffuse low-grade glioma, with a special focus on white matter disconnection...
September 6, 2016: Brain: a Journal of Neurology
Roland Roelz, David Strohmaier, Ramazan Jabbarli, Rainer Kraeutle, Karl Egger, Volker A Coenen, Astrid Weyerbrock, Peter C Reinacher
Diffuse low grade gliomas (DLGG) are continuously progressive primary brain neoplasms that lead to neurological deficits and death. Treatment strategies are controversial. Randomized trials establishing the prognostic value of surgery do not exist. Here, we report the results of a nine-year near-randomized patient distribution between resection and biopsy. Until 2012, the Department of Neurosurgery and the Department of Stereotactic Neurosurgery at the University Medical Center Freiburg were organized as separate administrative units both coordinating DLGG patient treatment independently...
2016: Scientific Reports
Lamiaa El-Serougy, Ahmed Abdel Khalek Abdel Razek, Amani Ezzat, Hany Eldawoody, Ahmad El-Morsy
AIM: The aim of this article is to assess diffusion tensor imaging (DTI) metrics in differentiating low-grade from high-grade gliomas. PATIENTS AND METHODS: A prospective study was conducted on 35 patients with gliomas who underwent DTI. Gliomas were classified into low-grade and high-grade gliomas. The fractional anisotropy (FA), mean diffusivity (MD), linear coefficient (CL), planar coefficient (CP) and spherical coefficient (CS) of the solid tumoral part and peri-tumoral regions were calculated...
October 2016: Neuroradiology Journal
Xu Han, Shiteng Suo, Yawen Sun, Jinyan Zu, Jianxun Qu, Yan Zhou, Zengai Chen, Jianrong Xu
PURPOSE: To compare four methods of region-of-interest (ROI) placement for apparent diffusion coefficient (ADC) measurements in distinguishing low-grade gliomas (LGGs) from high-grade gliomas (HGGs). MATERIALS AND METHODS: Two independent readers measured ADC parameters using four ROI methods (single-slice [single-round, five-round and freehand] and whole-volume) on 43 patients (20 LGGs, 23 HGGs) who had undergone 3.0 Tesla diffusion-weighted imaging and time required for each method of ADC measurements was recorded...
August 16, 2016: Journal of Magnetic Resonance Imaging: JMRI
Maria C Rossi Espagnet, Andrea Romano, Valeria Mancuso, Francesco Cicone, Antonio Napolitano, Claudia Scaringi, Giuseppe Minniti, Alessandro Bozzao
OBJECTIVE: To compare MRI using perfusion and diffusion techniques with 6-[(18)F]-fluoro-L-3,4-dihydroxyphenylalanine ((18)F-FDOPA) positron emission tomography (PET) in the follow-up of low-grade gliomas (LGGs) and to identify the best imaging parameter to differentiate patients with different prognosis. METHODS: Between 2010 and 2015, 12 patients with a pathology-proven diagnosis of LGG and MR (with perfusion and diffusion sequences) and a PET study during their follow-up were retrospectively included in our study...
October 2016: British Journal of Radiology
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