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Blandin AF, Giglio R, Graham MS, Garcia G, Malinowski S, Woods JK, Ramkissoon S, Ramkissoon L, Dubois F, Schoolcraft K, Tsai J, Wang D, Jones R, Vogelzang J, Pelton K, Becker S, Watkinson F, Sinai C, Cohen EF, Booker MA, Tolstorukov MY, Haemels V, Goumnerova L, Wright K, Kieran M, Fehnel K, Reardon D, Tauziede-Espariat A, Lulla R, Carcamo B, Chaleff S, Charest A, DeSmet F, Ligon AH, Dubuc A, Pages M, Varlet P, Wen PY, Alexander BM, Chi S, Alexandrescu S, Kittler R, Bachoo R, Bandopadhayay P, Beroukhim R, Ligon KL. ALK Amplification and Rearrangements Are Recurrent Targetable Events in Congenital and Adult Glioblastoma. Clin Cancer Res 2023; 29:2651-2667. [PMID: 36780194 PMCID: PMC10363218 DOI: 10.1158/1078-0432.ccr-21-3521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/31/2022] [Accepted: 02/07/2023] [Indexed: 02/14/2023]
Abstract
PURPOSE Anaplastic lymphoma kinase (ALK) aberrations have been identified in pediatric-type infant gliomas, but their occurrence across age groups, functional effects, and treatment response has not been broadly established. EXPERIMENTAL DESIGN We performed a comprehensive analysis of ALK expression and genomic aberrations in both newly generated and retrospective data from 371 glioblastomas (156 adult, 205 infant/pediatric, and 10 congenital) with in vitro and in vivo validation of aberrations. RESULTS ALK aberrations at the protein or genomic level were detected in 12% of gliomas (45/371) in a wide age range (0-80 years). Recurrent as well as novel ALK fusions (LRRFIP1-ALK, DCTN1-ALK, PRKD3-ALK) were present in 50% (5/10) of congenital/infant, 1.4% (3/205) of pediatric, and 1.9% (3/156) of adult GBMs. ALK fusions were present as the only candidate driver in congenital/infant GBMs and were sometimes focally amplified. In contrast, adult ALK fusions co-occurred with other oncogenic drivers. No activating ALK mutations were identified in any age group. Novel and recurrent ALK rearrangements promoted STAT3 and ERK1/2 pathways and transformation in vitro and in vivo. ALK-fused GBM cellular and mouse models were responsive to ALK inhibitors, including in patient cells derived from a congenital GBM. Relevant to the treatment of infant gliomas, we showed that ALK protein appears minimally expressed in the forebrain at perinatal stages, and no gross effects on perinatal brain development were seen in pregnant mice treated with the ALK inhibitor ceritinib. CONCLUSIONS These findings support use of brain-penetrant ALK inhibitors in clinical trials across infant, pediatric, and adult GBMs. See related commentary by Mack and Bertrand, p. 2567.
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Affiliation(s)
- Anne-Florence Blandin
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Broad institute of Harvard and MIT, Cambridge, MA, USA
| | - Ross Giglio
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | | | - Jared K. Woods
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Broad institute of Harvard and MIT, Cambridge, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | | | | | - Frank Dubois
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Broad institute of Harvard and MIT, Cambridge, MA, USA
| | | | - Jessica Tsai
- Dana-Farber Cancer Institute, Boston, MA, USA
- Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Dayle Wang
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | | | | | | | | | - Elizabeth F Cohen
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Matthew A Booker
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Veerle Haemels
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research Unit, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | | | - Karen Wright
- Dana-Farber Cancer Institute, Boston, MA, USA
- Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Mark Kieran
- Day One Biopharmaceuticals, Brisbane, CA 94005
| | - Katie Fehnel
- Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | | | | | - Rishi Lulla
- Hasbro Children's Hospital, Providence, RI, USA
| | - Benjamin Carcamo
- Texas Tech University, Health Science Center, Paul L. Foster School of Medicine, El Paso, TX, USA
- El Paso Children's Hospital, El Paso, TX, USA
| | | | - Alain Charest
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Frederik DeSmet
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research Unit, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Azra H. Ligon
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
- Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Adrian Dubuc
- Dana-Farber Cancer Institute, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - Melanie Pages
- Department of Genetics, Institute Curie, Paris, France. INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Institute Curie, Paris, France
| | | | - Patrick Y. Wen
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Brian M. Alexander
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - Susan Chi
- Dana-Farber Cancer Institute, Boston, MA, USA
- Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Sanda Alexandrescu
- Dana-Farber Cancer Institute, Boston, MA, USA
- Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Ralf Kittler
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Robert Bachoo
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Pratiti Bandopadhayay
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Broad institute of Harvard and MIT, Cambridge, MA, USA
- Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Rameen Beroukhim
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Broad institute of Harvard and MIT, Cambridge, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - Keith L. Ligon
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Broad institute of Harvard and MIT, Cambridge, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
- Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
- Dana-Farber Cancer Institute, Center for Patient Derived Models (CPDM), Boston, MA, USA
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Moradi B, Hamidian Y, Soltanghoraee H, Katouli FS. Prenatally detected congenital medulloblastoma. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:432-435. [PMID: 35930477 DOI: 10.1002/jcu.23278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/11/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
We describe a congenital cerebellar mass in a fetus at 30 weeks GA. The lesion is detected at the prenatal third-trimester ultrasound, confirmed by fetal MRI, and determined as medulloblastoma in postmortem pathologic evaluation.
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Affiliation(s)
- Behnaz Moradi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Hamidian
- Fetal Health Research Center, Hope generation Foundation, Tehran, Iran
| | - Haleh Soltanghoraee
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Fatemeh Shakki Katouli
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Korostyshevskaya AM, Stankevich JA, Vasilkiv LM, Bogomyakova OB, Korobko DS, Gornostaeva AM, Tulupov AА. CLIPPERS: Multiparametric and quantitative MRI features. Radiol Case Rep 2022; 18:368-376. [PMID: 36411846 PMCID: PMC9674504 DOI: 10.1016/j.radcr.2022.10.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/18/2022] Open
Abstract
Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a rare chronic central-nervous-system inflammatory disorder that became known only recently, and the pathogenesis of CLIPPERS remains poorly understood. This report presents clinical and radiological features of a rare case: a young female patient who rapidly died of suspected CLIPPERS. Helpful multiparametric MRI diagnostic criteria are proposed that can help discriminate CLIPPERS from non-CLIPPERS pathologies. We reviewed clinical history, symptoms, quantitative data from brain multiparametric MRI before and after treatment, and histopathological data. Perfusion-weighted imaging revealed a decrease in regional cerebral blood flow by 31% and in cerebral blood volume by 64%, with a moderate increase in transit time and in time to peak by up to 23% in affected pontine and cerebral white matter. As estimated by diffusion tensor imaging, there was elevated density of tracts (n/mm2) and a decrease of fraction anisotropy (×10-3 mm/s2) in the patient's pons as compared to a healthy control: density of tracts = 13.5 vs 12.4 and fraction anisotropy = 0.32 vs 0.45, respectively. Macromolecular proton fraction values proved to be reduced (15.8% and 14.5% in the control, respectively) in the patient's cerebral peduncles by 3% and in the pons by 4.1% and in a periventricular white matter lesion by 6.4% (11.3% in the normal-looking contralateral hemisphere). Based on our findings, we argue that quantitative MRI techniques may be a valuable source of biomarkers and reliable diagnostic criteria and can shed light on the pathogenesis and exact nosological position of this disorder.
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Key Words
- ADC, apparent diffusion coefficient
- CBF, cerebral blood flow
- CLIPPERS
- CNS, central nervous system
- CSF, cerebrospinal fluid
- DOT, density of tracts
- DTI, diffusion tensor imaging
- DWI, diffusion-weighted imaging
- Diffusion tensor imaging
- FLAIR, fluid attenuated inversion recovery
- ITC, International Tomography Center
- MPF, macromolecular proton fraction
- MS, multiple sclerosis
- Macromolecular proton fraction mapping
- PWI, perfusion-weighted imaging
- Perfusion-weighted imaging
- Quantitative MRI
- SWI, susceptibility-weighted imaging
- WI, weighted image
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Affiliation(s)
- Alexandra M. Korostyshevskaya
- The Institute International Tomography Center of the Russian Academy of Sciences, Institutskaya str., Bldg. 3а, Novosibirsk, 630090, Russian Federation
- Federal State Budgetary Scientific Institution «The Federal Research Center of Fundamental and Translational Medicine», 2 Timakova str., Novosibirsk, 630060, Russian Federation
| | - Julia A. Stankevich
- The Institute International Tomography Center of the Russian Academy of Sciences, Institutskaya str., Bldg. 3а, Novosibirsk, 630090, Russian Federation
- Novosibirsk State University, 1, Pirogova str., Novosibirsk, 630090, Russian Federation
| | - Liubov M. Vasilkiv
- The Institute International Tomography Center of the Russian Academy of Sciences, Institutskaya str., Bldg. 3а, Novosibirsk, 630090, Russian Federation
- Novosibirsk State University, 1, Pirogova str., Novosibirsk, 630090, Russian Federation
| | - Olga B. Bogomyakova
- The Institute International Tomography Center of the Russian Academy of Sciences, Institutskaya str., Bldg. 3а, Novosibirsk, 630090, Russian Federation
- Novosibirsk State University, 1, Pirogova str., Novosibirsk, 630090, Russian Federation
- Lavrentyev Institute of Hydrodynamics, 15, Akademika Lavrent'yeva pr., Novosibirsk, 630090, Russian Federation
| | - Denis S. Korobko
- Regional Center for Multiple Sclerosis and other autoimmune diseases of the nervous system, State Budgetary Healthcare Institution of the Novosibirsk Region "State Novosibirsk Regional Clinical Hospital" (GBUZ NSO GNOKB); 126, Nemirovich – Danchenko str., Novosibirsk, 630087, Russian Federation
- Novosibirsk State Medical University; 52, Krasny prospect av., Novosibirsk, 630091, Russian Federation
| | - Alyona M. Gornostaeva
- The Institute International Tomography Center of the Russian Academy of Sciences, Institutskaya str., Bldg. 3а, Novosibirsk, 630090, Russian Federation
- Corresponding author.
| | - Andrey А. Tulupov
- The Institute International Tomography Center of the Russian Academy of Sciences, Institutskaya str., Bldg. 3а, Novosibirsk, 630090, Russian Federation
- Novosibirsk State University, 1, Pirogova str., Novosibirsk, 630090, Russian Federation
- Lavrentyev Institute of Hydrodynamics, 15, Akademika Lavrent'yeva pr., Novosibirsk, 630090, Russian Federation
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Chen Y, Zhang H, Zhao Y, Ma J. Congenital medulloblastoma in two brothers with SUFU-mutated Gorlin-Goltz syndrome: Case reports and literature review. Front Oncol 2022; 12:988798. [PMID: 36313636 PMCID: PMC9603755 DOI: 10.3389/fonc.2022.988798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundCongenital medulloblastoma is very rare, and many cases involve germline mutations that can lead to inherited syndromes. Here, we first report two brothers with congenital medulloblastoma who were diagnosed with Gorlin-Goltz syndrome caused by SUFU mutation.Clinical presentationMedulloblastoma was detected in two brothers at 2 and 3 months of age, with very similar imaging features. Genetic testing revealed that both children and their mother carried SUFU gene germline mutations, and both brothers were diagnosed with Gorlin-Goltz syndrome.ConclusionGorlin-Goltz syndrome-associated congenital medulloblastoma with SUFU germline mutation is very rare. Pathological types mostly involve desmoplastic/nodular or extensive nodularity; chemotherapy is the main treatment, and studies revealing prognostic data are scarce.
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Affiliation(s)
| | | | - Yang Zhao
- *Correspondence: Jie Ma, ; Yang Zhao,
| | - Jie Ma
- *Correspondence: Jie Ma, ; Yang Zhao,
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5
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Role of Demyelination in the Persistence of Neurological and Mental Impairments after COVID-19. Int J Mol Sci 2022; 23:ijms231911291. [PMID: 36232592 PMCID: PMC9569975 DOI: 10.3390/ijms231911291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
Long-term neurological and mental complications of COVID-19, the so-called post-COVID syndrome or long COVID, affect the quality of life. The most persistent manifestations of long COVID include fatigue, anosmia/hyposmia, insomnia, depression/anxiety, and memory/attention deficits. The physiological basis of neurological and psychiatric disorders is still poorly understood. This review summarizes the current knowledge of neurological sequelae in post-COVID patients and discusses brain demyelination as a possible mechanism of these complications with a focus on neuroimaging findings. Numerous reviews, experimental and theoretical studies consider brain demyelination as one of the mechanisms of the central neural system impairment. Several factors might cause demyelination, such as inflammation, direct effect of the virus on oligodendrocytes, and cerebrovascular disorders, inducing myelin damage. There is a contradiction between the solid fundamental basis underlying demyelination as the mechanism of the neurological injuries and relatively little published clinical evidence related to demyelination in COVID-19 patients. The reason for this probably lies in the fact that most clinical studies used conventional MRI techniques, which can detect only large, clearly visible demyelinating lesions. A very limited number of studies use specific methods for myelin quantification detected changes in the white matter tracts 3 and 10 months after the acute phase of COVID-19. Future research applying quantitative MRI assessment of myelin in combination with neurological and psychological studies will help in understanding the mechanisms of post-COVID complications associated with demyelination.
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6
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Kisel AA, Naumova AV, Yarnykh VL. Macromolecular Proton Fraction as a Myelin Biomarker: Principles, Validation, and Applications. Front Neurosci 2022; 16:819912. [PMID: 35221905 PMCID: PMC8863973 DOI: 10.3389/fnins.2022.819912] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/17/2022] [Indexed: 12/16/2022] Open
Abstract
Macromolecular proton fraction (MPF) is a quantitative MRI parameter describing the magnetization transfer (MT) effect and defined as a relative amount of protons bound to biological macromolecules with restricted molecular motion, which participate in magnetic cross-relaxation with water protons. MPF attracted significant interest during past decade as a biomarker of myelin. The purpose of this mini review is to provide a brief but comprehensive summary of MPF mapping methods, histological validation studies, and MPF applications in neuroscience. Technically, MPF maps can be obtained using a variety of quantitative MT methods. Some of them enable clinically reasonable scan time and resolution. Recent studies demonstrated the feasibility of MPF mapping using standard clinical MRI pulse sequences, thus substantially enhancing the method availability. A number of studies in animal models demonstrated strong correlations between MPF and histological markers of myelin with a minor influence of potential confounders. Histological studies validated the capability of MPF to monitor both demyelination and re-myelination. Clinical applications of MPF have been mainly focused on multiple sclerosis where this method provided new insights into both white and gray matter pathology. Besides, several studies used MPF to investigate myelin role in other neurological and psychiatric conditions. Another promising area of MPF applications is the brain development studies. MPF demonstrated the capabilities to quantitatively characterize the earliest stage of myelination during prenatal brain maturation and protracted myelin development in adolescence. In summary, MPF mapping provides a technically mature and comprehensively validated myelin imaging technology for various preclinical and clinical neuroscience applications.
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Affiliation(s)
- Alena A. Kisel
- Department of Radiology, University of Washington, Seattle, WA, United States
- Laboratory of Neurobiology, Tomsk State University, Tomsk, Russia
| | - Anna V. Naumova
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Vasily L. Yarnykh
- Department of Radiology, University of Washington, Seattle, WA, United States
- Laboratory of Neurobiology, Tomsk State University, Tomsk, Russia
- *Correspondence: Vasily L. Yarnykh,
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7
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Yarnykh VL, Korostyshevskaya AM, Savelov AA, Isaeva YO, Gornostaeva AM, Tulupov AA, Sagdeev RZ. Macromolecular proton fraction mapping in magnetic resonance imaging: physicochemical principles and biomedical applications. Russ Chem Bull 2022. [DOI: 10.1007/s11172-021-3343-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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8
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Yarnykh VL. Data-Driven Retrospective Correction of B 1 Field Inhomogeneity in Fast Macromolecular Proton Fraction and R 1 Mapping. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:3473-3484. [PMID: 34110989 PMCID: PMC8711232 DOI: 10.1109/tmi.2021.3088258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Correction of B1 field non-uniformity is critical for many quantitative MRI methods including variable flip angle (VFA) T1 mapping and single-point macromolecular proton fraction (MPF) mapping. The latter method showed promising results as a fast and robust quantitative myelin imaging approach and involves VFA-based R1=1/T1 map reconstruction as an intermediate processing step. The need for B1 correction restricts applications of the above methods, since B1 mapping sequences increase the examination time and are not commonly available in clinics. A new algorithm was developed to enable retrospective data-driven simultaneous B1 correction in VFA R1 and single-point MPF mapping. The principle of the algorithm is based on different mathematical dependences of B1 -related errors in R1 and MPF allowing extraction of a surrogate B1 field map from uncorrected R1 and MPF maps. To validate the method, whole-brain R1 and MPF maps with isotropic 1.25 mm3 resolution were obtained on a 3 T MRI scanner from 11 volunteers. Mean parameter values in segmented brain tissues were compared between three reconstruction options including the absence of correction, actual B1 correction, and surrogate B1 correction. Surrogate B1 maps closely reproduced actual patterns of B1 inhomogeneity. Without correction, B1 non-uniformity caused highly significant biases in R1 and MPF ( ). Surrogate B1 field correction reduced the biases in both R1 and MPF to a non-significant level ( 0.1 ≤ P ≤ 0.8 ). The described algorithm obviates the use of dedicated B1 mapping sequences in fast single-point MPF mapping and provides an alternative solution for correction of B1 non-uniformities in VFA R1 mapping.
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9
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Khodanovich MY, Gubskiy IL, Kudabaeva MS, Namestnikova DD, Kisel AA, Anan’ina TV, Tumentceva YA, Mustafina LR, Yarnykh VL. Long-term monitoring of chronic demyelination and remyelination in a rat ischemic stroke model using macromolecular proton fraction mapping. J Cereb Blood Flow Metab 2021; 41:2856-2869. [PMID: 34107787 PMCID: PMC8756474 DOI: 10.1177/0271678x211020860] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 12/23/2022]
Abstract
Remyelination is a key process enabling post-stroke brain tissue recovery and plasticity. This study aimed to explore the feasibility of demyelination and remyelination monitoring in experimental stroke from the acute to chronic stage using an emerging myelin imaging biomarker, macromolecular proton fraction (MPF). After stroke induction by transient middle cerebral artery occlusion, rats underwent repeated MRI examinations during 85 days after surgery with histological endpoints for the animal subgroups on the 7th, 21st, 56th, and 85th days. MPF maps revealed two sub-regions within the infarct characterized by distinct temporal profiles exhibiting either a persistent decrease by 30%-40% or a transient decrease followed by return to nearly normal values after one month of observation. Myelin histology confirmed that these sub-regions had nearly similar extent of demyelination in the sub-acute phase and then demonstrated either chronic demyelination or remyelination. The remyelination zones also exhibited active axonal regrowth, reconstitution of compact fiber bundles, and proliferation of neuronal and oligodendroglial precursors. The demyelination zones showed more extensive astrogliosis from the 21st day endpoint. Both sub-regions had substantially depleted neuronal population over all endpoints. These results histologically validate MPF mapping as a novel approach for quantitative assessment of myelin damage and repair in ischemic stroke.
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Affiliation(s)
| | - Ilya L Gubskiy
- Research Institute of Cerebrovascular Pathology and Stroke, Pirogov Russian Medical University, Moscow, Russian Federation
| | - Marina S Kudabaeva
- Laboratory of Neurobiology, Tomsk State University, Tomsk, Russian Federation
| | - Darya D Namestnikova
- Research Institute of Cerebrovascular Pathology and Stroke, Pirogov Russian Medical University, Moscow, Russian Federation
| | - Alena A Kisel
- Laboratory of Neurobiology, Tomsk State University, Tomsk, Russian Federation
- Department of Radiology, University of Washington, Seattle, USA
| | - Tatyana V Anan’ina
- Laboratory of Neurobiology, Tomsk State University, Tomsk, Russian Federation
| | - Yana A Tumentceva
- Laboratory of Neurobiology, Tomsk State University, Tomsk, Russian Federation
| | - Lilia R Mustafina
- Department of histology, embriology, and cytology, Siberian State Medical University, Tomsk, Russian Federation
| | - Vasily L Yarnykh
- Laboratory of Neurobiology, Tomsk State University, Tomsk, Russian Federation
- Department of Radiology, University of Washington, Seattle, USA
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10
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García-Espinosa P, Molina-Ayala M, Botello-Hernández E, Villareal-Garza E, Barbosa-Quintana Á. Congenital medulloblastoma presented in the neonatal period. AUTOPSY AND CASE REPORTS 2021; 11:e2021258. [PMID: 33968829 PMCID: PMC8087391 DOI: 10.4322/acr.2021.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Congenital medulloblastoma is a rare brain tumor that appears in less than 1% of pediatric patients. Congenital medulloblastoma has a poor prognosis and should be suspected in patients with clinical manifestations of hyporeactivity, slow suction reflexes, and the presence of hydrocephalus. Herein we present the case of a 12-day-old female newborn who developed non-communicative hydrocephalus, hyporeactivity, and hyporeflexia. Magnetic resonance imaging of her brain showed a heterogeneous and cystic mass on the posterior cranial fossa. A suboccipital craniotomy was performed. The histopathologic analysis reported a congenital medulloblastoma. She remained in hospital until her death at 112 days old. This is one of the first case reports with clinical-radiological and pathological documentation. Awareness of this diagnosis can allow prenatal intervention, rendering a better prognosis. This case report exemplifies the importance of good prenatal follow-up.
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Affiliation(s)
- Patricio García-Espinosa
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Departamento de Neurología Monterrey, México
| | - Max Molina-Ayala
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Departamento de Patología y Citología, Monterrey, México
| | - Edgar Botello-Hernández
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Hospital Universitario "Dr. José Eleuterio González", Monterrey, México
| | - Estefania Villareal-Garza
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Departamento de Neurología Monterrey, México
| | - Álvaro Barbosa-Quintana
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Departamento de Patología y Citología, Monterrey, México
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Yang J, Kim SK, Wang KC, Kim KH, Park SH, Phi JH. A boy with a congenital cerebellar mass. Childs Nerv Syst 2021; 37:983-987. [PMID: 32613423 DOI: 10.1007/s00381-020-04767-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Tumorigenesis of medulloblastoma is believed to be associated with granule cell progenitor neurogenesis of the cerebellum. Nevertheless, congenital medulloblastomas are rarely found. Here, we report a case of congenital medulloblastoma that showed spontaneous albeit transient regression. METHODS A one-month-old baby presented with abnormal antenatal and postnatal imaging findings. Upon ultrasonography at 26 weeks of gestational age, Dandy-Walker malformation with vermian hypoplasia and cystic change was suspected. Brain MRI at 1 week after birth revealed gadolinium-enhancing lesions in the cerebellum with apparent infiltrative features along the cerebellar folia accompanied by three independent cysts in the upper and inferolateral sides of the lesion. Serial MRIs taken up to 5 months of age showed a decrease in the size and extent of enhancing solid portions. The baby did not show any abnormal signs or developmental delay. MRI at the age of 7 months showed enlargement of the lesion, and surgery was performed. RESULTS The lesion was diagnosed as medulloblastoma with histologically extensive nodularity (MBEN), genetically SHH-activated and TP53-wildtype. CONCLUSION This case provides an unusual chance of observing an early phase of medulloblastoma development and raises a suspicion that medulloblastoma may initiate itself very early in cerebellar organogenesis and progress later at a certain time of postnatal development.
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Affiliation(s)
- Jeyul Yang
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Neuro-oncology clinic, National Cancer Center, Goyang, South Korea
| | - Seung-Ki Kim
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyu-Chang Wang
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Neuro-oncology clinic, National Cancer Center, Goyang, South Korea
| | - Ki-Hong Kim
- Department of Neurosurgery, Daegu Catholic University School of Medicine, Daegu, South Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Ji Hoon Phi
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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12
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Cornejo P, Feygin T, Vaughn J, Pfeifer CM, Korostyshevska A, Patel M, Bardo DME, Miller J, Goncalves LF. Imaging of fetal brain tumors. Pediatr Radiol 2020; 50:1959-1973. [PMID: 33252762 DOI: 10.1007/s00247-020-04777-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 05/13/2020] [Accepted: 07/08/2020] [Indexed: 12/12/2022]
Abstract
Congenital brain tumors, defined as those diagnosed prenatally or within the first 2 months of age, represent less than 2% of pediatric brain tumors. Their location, prevalence and pathophysiology differ from those of tumors that develop later in life. Imaging plays a crucial role in diagnosis, tumor characterization and treatment planning. The most common lesions diagnosed in utero are teratomas, followed by gliomas, choroid plexus papillomas and craniopharyngiomas. In this review, we summarize the pathogenesis, diagnosis, management and prognosis of the most frequent fetal brain tumors.
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Affiliation(s)
- Patricia Cornejo
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA. .,Department of Neuroradiology, Barrows Neurological Institute, Phoenix, AZ, USA. .,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA. .,Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ, USA. .,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA.
| | - Tamara Feygin
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jennifer Vaughn
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA.,Department of Neuroradiology, Barrows Neurological Institute, Phoenix, AZ, USA.,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA.,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA
| | - Cory M Pfeifer
- Department of Radiology, UT Southwestern, Dallas, TX, USA
| | - Alexandra Korostyshevska
- International Tomography Center of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Mittun Patel
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA.,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA.,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA
| | - Dianna M E Bardo
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA.,Department of Neuroradiology, Barrows Neurological Institute, Phoenix, AZ, USA.,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA.,Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ, USA.,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA
| | - Jeffrey Miller
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA.,Department of Neuroradiology, Barrows Neurological Institute, Phoenix, AZ, USA.,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA.,Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ, USA.,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA
| | - Luis F Goncalves
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA.,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA.,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA
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13
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Anisimov NV, Pavlova OS, Pirogov YA, Yarnykh VL. Three-dimensional fast single-point macromolecular proton fraction mapping of the human brain at 0.5 Tesla. Quant Imaging Med Surg 2020; 10:1441-1449. [PMID: 32676363 DOI: 10.21037/qims-19-1057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fast single-point macromolecular proton fraction (MPF) mapping is a recent magnetic resonance imaging (MRI) method enabling quantitative assessment of myelin content in neural tissues. To date, the reported technical implementations of MPF mapping utilized high-field MRI equipment (1.5 T or higher), while low-field applications might pose challenges due to signal-to-noise ratio (SNR) limitations and short T1 . This study aimed to evaluate the feasibility of MPF mapping of the human brain at 0.5 T. The three-dimensional MPF mapping protocol was implemented according to the single-point synthetic-reference method, which includes three spoiled gradient-echo sequences providing proton density, T1 , and magnetization transfer contrast weightings. Whole-brain MPF maps were obtained from three healthy volunteers with spatial resolution of 1.5×1.5×2 mm3 and the total scan time of 19 minutes. MPF values were measured in a series of white and gray matter structures and compared with literature data for 3 T magnetic field. MPF maps enabled high contrast between white and gray matter with notable insensitivity to paramagnetic effects in iron-rich structures, such as globus pallidus, substantia nigra, and dentate nucleus. MPF values at 0.5 T appeared in close agreement with those at 3 T. This study demonstrates the feasibility of fast MPF mapping with low-field MRI equipment and the independence of brain MPF values of magnetic field. The presented results confirm the utility of MPF as an absolute scale for MRI-based myelin content measurements across a wide range of magnetic field strengths and extend the applicability of fast MPF mapping to inexpensive low-field MRI hardware.
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Affiliation(s)
- Nikolay V Anisimov
- Faculty of Fundamental Medicine, Lomonosov Moscow State University, 117192, Moscow, Lomonosovsky Prospekt, 31-5, Russian Federation
| | - Olga S Pavlova
- Faculty of Fundamental Medicine, Lomonosov Moscow State University, 117192, Moscow, Lomonosovsky Prospekt, 31-5, Russian Federation.,Faculty of Physics, Lomonosov Moscow State University, 119991, Moscow, GSP-1, Leninskie Gory, 1-2, Russian Federation
| | - Yury A Pirogov
- Faculty of Physics, Lomonosov Moscow State University, 119991, Moscow, GSP-1, Leninskie Gory, 1-2, Russian Federation.,Institute for Physical and Chemical Fundamentals of Artificial Intelligence, Lomonosov Moscow State University, 119991, Moscow, GSP-1, Leninskie Gory, 1-11, Russian Federation
| | - Vasily L Yarnykh
- Department of Radiology, University of Washington, Seattle, WA 98109, USA.,Research Institute of Biology and Biophysics, Tomsk State University, 634050, Tomsk, Russian Federation
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14
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Feygin T, Khalek N, Moldenhauer JS. Fetal brain, head, and neck tumors: Prenatal imaging and management. Prenat Diagn 2020; 40:1203-1219. [PMID: 32350893 DOI: 10.1002/pd.5722] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 02/06/2020] [Accepted: 04/03/2020] [Indexed: 12/21/2022]
Abstract
Fetal tumors represent an infrequent pathology when compared to congenital malformations, although their true incidence may be underestimated. A variety of benign and malignant neoplasms may occur anywhere in the neural axis. Imaging plays an important role in the fetal tumor diagnosis and evaluation of their resultant complications. Discovery of a fetal mass on obstetric ultrasound necessitates further evaluation with prenatal magnetic resonance imaging (MRI). New MR sequences and new applications of existing techniques have been successfully implemented in prenatal imaging. A detailed assessment may be performed using a variety of MR. Fetal tumors may be histologically benign or malignant, but their prognosis generally remains poor, especially for intracranial lesions. Unfavorable tumor location or heightened metabolic demands on a developing fetus may result in severe complications and a fatal outcome, even in cases of benign lesions. Nowadays, prenatal treatment focuses mainly on alleviation of secondary complications caused by the tumors. In this article we review congenital tumors of the brain, face, and neck encountered in prenatal life, and discuss diagnostic clues for appropriate diagnosis.
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Affiliation(s)
- Tamara Feygin
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Nahla Khalek
- The Center for fetal diagnosis and treatment, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Julie S Moldenhauer
- The Center for fetal diagnosis and treatment, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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15
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Yarnykh VL, Kisel AA, Khodanovich MY. Scan-Rescan Repeatability and Impact of B 0 and B 1 Field Nonuniformity Corrections in Single-Point Whole-Brain Macromolecular Proton Fraction Mapping. J Magn Reson Imaging 2019; 51:1789-1798. [PMID: 31737961 DOI: 10.1002/jmri.26998] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/26/2019] [Accepted: 10/26/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Single-point macromolecular proton fraction (MPF) mapping is a recent quantitative MRI method for fast assessment of brain myelination. Information about reproducibility and sensitivity of MPF mapping to magnetic field nonuniformity is important for clinical applications. PURPOSE To assess scan-rescan repeatability and a value of B0 and B1 field inhomogeneity corrections in single-point synthetic-reference MPF mapping. STUDY TYPE Prospective. POPULATION Eight healthy adult volunteers underwent two scans with 11.5 ± 2.3 months interval. FIELD STRENGTH/SEQUENCE 3T; whole-brain 3D MPF mapping protocol included three spoiled gradient-echo sequences providing T1 , proton density, and magnetization transfer contrasts with 1.25 × 1.25 × 1.25 mm3 resolution and B0 and B1 mapping sequences. ASSESSMENT MPF maps were reconstructed with B0 and B1 field nonuniformity correction, B0 - and B1 -only corrections, and without corrections. Mean MPF values were measured in automatically segmented white matter (WM) and gray matter (GM). STATISTICAL TESTS Within-subject coefficient of variation (CV), intraclass correlation coefficient (ICC), Bland-Altman plots, and paired t-tests to assess scan-rescan repeatability. Repeated-measures analysis of variance (ANOVA) to compare field corrections. RESULTS Maximal relative local MPF errors without correction in the areas of largest field nonuniformities were about 5% and 27% for B0 and B1 , respectively. The effect of B0 correction was insignificant for whole-brain WM (P > 0.25) and GM (P > 0.98) MPF. The absence of B1 correction caused a positive relative bias of 4-5% (P < 0.001) in both tissues. Scan-rescan agreement was similar for all field correction options with ICCs 0.80-0.81 for WM and 0.89-0.92 for GM. CVs were 1.6-1.7% for WM and 0.7-1.0% for GM. DATA CONCLUSION The single-point method enables high repeatability of MPF maps obtained with the same equipment. Correction of B0 inhomogeneity may be disregarded to shorten the examination time. B1 nonuniformity correction improves accuracy of MPF measurements at 3T. Reliability of whole-brain MPF measurements in WM and GM is not affected by B0 and B1 field corrections. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:1789-1798.
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Affiliation(s)
- Vasily L Yarnykh
- Department of Radiology, University of Washington, Seattle, Washington, USA.,Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russian Federation
| | - Alena A Kisel
- Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russian Federation
| | - Marina Y Khodanovich
- Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russian Federation
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16
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Khodanovich M, Pishchelko A, Glazacheva V, Pan E, Akulov A, Svetlik M, Tyumentseva Y, Anan'ina T, Yarnykh V. Quantitative Imaging of White and Gray Matter Remyelination in the Cuprizone Demyelination Model Using the Macromolecular Proton Fraction. Cells 2019; 8:cells8101204. [PMID: 31590363 PMCID: PMC6830095 DOI: 10.3390/cells8101204] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 02/07/2023] Open
Abstract
Macromolecular proton fraction (MPF) has been established as a quantitative clinically-targeted MRI myelin biomarker based on recent demyelination studies. This study aimed to assess the capability of MPF to quantify remyelination using the murine cuprizone-induced reversible demyelination model. MPF was measured in vivo using the fast single-point method in three animal groups (control, cuprizone-induced demyelination, and remyelination after cuprizone withdrawal) and compared to quantitative immunohistochemistry for myelin basic protein (MBP), myelinating oligodendrocytes (CNP-positive cells), and oligodendrocyte precursor cells (OPC, NG2-positive cells) in the corpus callosum, caudate putamen, hippocampus, and cortex. In the demyelination group, MPF, MBP-stained area, and oligodendrocyte count were significantly reduced, while OPC count was significantly increased as compared to both control and remyelination groups in all anatomic structures (p < 0.05). All variables were similar in the control and remyelination groups. MPF and MBP-stained area strongly correlated in each anatomic structure (Pearson’s correlation coefficients, r = 0.80–0.90, p < 0.001). MPF and MBP correlated positively with oligodendrocyte count (r = 0.70–0.84, p < 0.01 for MPF; r = 0.81–0.92, p < 0.001 for MBP) and negatively with OPC count (r = −0.69–−0.77, p < 0.01 for MPF; r = −0.72–−0.89, p < 0.01 for MBP). This study provides immunohistological validation of fast MPF mapping as a non-invasive tool for quantitative assessment of de- and remyelination in white and gray matter and indicates the feasibility of using MPF as a surrogate marker of reparative processes in demyelinating diseases.
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Affiliation(s)
- Marina Khodanovich
- Laboratory of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, Tomsk 634050, Russia.
| | - Anna Pishchelko
- Laboratory of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, Tomsk 634050, Russia.
| | - Valentina Glazacheva
- Laboratory of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, Tomsk 634050, Russia.
| | - Edgar Pan
- Laboratory of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, Tomsk 634050, Russia.
| | - Andrey Akulov
- Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk 630090, Russia.
| | - Mikhail Svetlik
- Laboratory of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, Tomsk 634050, Russia.
| | - Yana Tyumentseva
- Laboratory of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, Tomsk 634050, Russia.
| | - Tatyana Anan'ina
- Laboratory of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, Tomsk 634050, Russia.
| | - Vasily Yarnykh
- Laboratory of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, Tomsk 634050, Russia.
- Department of Radiology, University of Washington, Seattle, WA 98109, USA.
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17
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Korostyshevskaya AM, Prihod'ko IY, Savelov AA, Yarnykh VL. Direct comparison between apparent diffusion coefficient and macromolecular proton fraction as quantitative biomarkers of the human fetal brain maturation. J Magn Reson Imaging 2019; 50:52-61. [PMID: 30635965 DOI: 10.1002/jmri.26635] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/15/2018] [Accepted: 12/17/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Apparent diffusion coefficient (ADC) is known as a quantitative biomarker of prenatal brain maturation. Fast macromolecular proton fraction (MPF) mapping is an emerging method for quantitative assessment of myelination that was recently adapted to fetal MRI. PURPOSE To compare the capability of ADC and MPF to quantify the normal fetal brain development. STUDY TYPE Prospective. POPULATION Forty-two human fetuses in utero (gestational age [GA] = 27.7 ± 6.0, range 20-38 weeks). FIELD STRENGTH/SEQUENCE 1.5 T; diffusion-weighted single-shot echo-planar spin-echo with five b-values for ADC mapping; spoiled multishot echo-planar gradient-echo with T1 , proton density, and magnetization transfer contrast weightings for single-point MPF mapping. ASSESSMENT Two operators measured ADC and MPF in the medulla, pons, cerebellum, thalamus, and frontal, occipital, and temporal cerebral white matter (WM). STATISTICAL TESTS Mixed repeated-measures analysis of variance (ANOVA) with the factors of pregnancy trimester and brain structure; Pearson correlation coefficient (r); Hotelling-Williams test to compare strengths of correlations. RESULTS From the 2nd to 3rd trimester, ADC significantly decreased in the thalamus and cerebellum (P < 0.005). MPF significantly increased in the medulla, pons, thalamus, and cerebellum (P < 0.005). Cerebral WM had significantly higher ADC and lower MPF compared with the medulla and pons in both trimesters. MPF (r range 0.83, 0.89, P < 0.001) and ADC (r range -0.43, -0.75, P ≤ 0.004) significantly correlated with GA and each other (r range -0.32, -0.60, P ≤ 0.04) in the medulla, pons, thalamus, and cerebellum. No significant correlations or distinctions between regions and trimesters were observed for cerebral WM (P range 0.1-0.75). Correlations with GA were significantly stronger for MPF compared with ADC in the medulla, pons, and cerebellum (Hotelling-Williams test, P < 0.003) and similar in the thalamus. Structure-averaged MPF and ADC values strongly correlated (r = 0.95, P < 0.001). DATA CONCLUSION MPF and ADC demonstrated qualitatively similar but quantitatively different spatiotemporal patterns. MPF appeared more sensitive to changes in the brain structures with prenatal onset of myelination. LEVEL OF EVIDENCE 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:52-61.
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Affiliation(s)
- Alexandra M Korostyshevskaya
- Institute "International Tomography Center" of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Irina Yu Prihod'ko
- Institute "International Tomography Center" of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Andrey A Savelov
- Institute "International Tomography Center" of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Vasily L Yarnykh
- University of Washington, Department of Radiology, Seattle, Washington, USA.,Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russian Federation
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