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Gihr G, Horvath-Rizea D, Kohlhof-Meinecke P, Ganslandt O, Henkes H, Härtig W, Donitza A, Skalej M, Schob S. Diffusion Weighted Imaging in Gliomas: A Histogram-Based Approach for Tumor Characterization. Cancers (Basel) 2022; 14:cancers14143393. [PMID: 35884457 PMCID: PMC9321540 DOI: 10.3390/cancers14143393] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary Glioma represent approximately one-third of all brain tumors. Although they differ clinically, histologically and genetically, they often are not distinguishable by morphological magnetic resonance imaging (MRI) diagnostics. We therefore investigated in this retrospective study whether diffusion weighted imaging (DWI) using a radiomic approach could provide complementary information with respect to tumor differentiation and cell proliferation, as well as the underlying genetic and epigenetic tumor profile. We identified several histogram features that could facilitate presurgical tumor grading and potentially enable one to draw conclusions about tumor characteristics on a cellular and subcellular scale. Abstract (1) Background: Astrocytic gliomas present overlapping appearances in conventional MRI. Supplementary techniques are necessary to improve preoperative diagnostics. Quantitative DWI via the computation of apparent diffusion coefficient (ADC) histograms has proven valuable for tumor characterization and prognosis in this regard. Thus, this study aimed to investigate (I) the potential of ADC histogram analysis (HA) for distinguishing low-grade gliomas (LGG) and high-grade gliomas (HGG) and (II) whether those parameters are associated with Ki-67 immunolabelling, the isocitrate-dehydrogenase-1 (IDH1) mutation profile and the methylguanine-DNA-methyl-transferase (MGMT) promoter methylation profile; (2) Methods: The ADC-histograms of 82 gliomas were computed. Statistical analysis was performed to elucidate associations between histogram features and WHO grade, Ki-67 immunolabelling, IDH1 and MGMT profile; (3) Results: Minimum, lower percentiles (10th and 25th), median, modus and entropy of the ADC histogram were significantly lower in HGG. Significant differences between IDH1-mutated and IDH1-wildtype gliomas were revealed for maximum, lower percentiles, modus, standard deviation (SD), entropy and skewness. No differences were found concerning the MGMT status. Significant correlations with Ki-67 immunolabelling were demonstrated for minimum, maximum, lower percentiles, median, modus, SD and skewness; (4) Conclusions: ADC HA facilitates non-invasive prediction of the WHO grade, tumor-proliferation rate and clinically significant mutations in case of astrocytic gliomas.
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Affiliation(s)
- Georg Gihr
- Katharinenhospital Stuttgart, Clinic for Neuroradiology, 70174 Stuttgart, Germany; (D.H.-R.); (H.H.)
- Correspondence: (G.G.); (S.S.); Tel.: +49-711-2785-4454 (G.G.); +49-345-557-2342 (S.S.)
| | - Diana Horvath-Rizea
- Katharinenhospital Stuttgart, Clinic for Neuroradiology, 70174 Stuttgart, Germany; (D.H.-R.); (H.H.)
| | | | - Oliver Ganslandt
- Katharinenhospital Stuttgart, Clinic for Neurosurgery, 70174 Stuttgart, Germany;
| | - Hans Henkes
- Katharinenhospital Stuttgart, Clinic for Neuroradiology, 70174 Stuttgart, Germany; (D.H.-R.); (H.H.)
| | - Wolfgang Härtig
- Paul Flechsig Institute for Brain Research, University of Leipzig, 04103 Leipzig, Germany;
| | - Aneta Donitza
- Department for Neuroradiology, Clinic and Policlinic for Radiology, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (A.D.); (M.S.)
| | - Martin Skalej
- Department for Neuroradiology, Clinic and Policlinic for Radiology, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (A.D.); (M.S.)
| | - Stefan Schob
- Department for Neuroradiology, Clinic and Policlinic for Radiology, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (A.D.); (M.S.)
- Correspondence: (G.G.); (S.S.); Tel.: +49-711-2785-4454 (G.G.); +49-345-557-2342 (S.S.)
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Gihr G, Horvath-Rizea D, Hekeler E, Ganslandt O, Henkes H, Hoffmann KT, Scherlach C, Schob S. Diffusion weighted imaging in high-grade gliomas: A histogram-based analysis of apparent diffusion coefficient profile. PLoS One 2021; 16:e0249878. [PMID: 33857203 PMCID: PMC8049265 DOI: 10.1371/journal.pone.0249878] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 03/26/2021] [Indexed: 12/15/2022] Open
Abstract
Purpose Glioblastoma and anaplastic astrocytoma represent the most commonly encountered high-grade-glioma (HGG) in adults. Although both neoplasms are very distinct entities in context of epidemiology, clinical course and prognosis, their appearance in conventional magnetic resonance imaging (MRI) is very similar. In search for additional information aiding the distinction of potentially confusable neoplasms, histogram analysis of apparent diffusion coefficient (ADC) maps recently proved to be auxiliary in a number of entities. Therefore, our present exploratory retrospective study investigated whether ADC histogram profile parameters differ significantly between anaplastic astrocytoma and glioblastoma, reflect the proliferation index Ki-67, or are associated with the prognostic relevant MGMT (methylguanine-DNA methyl-transferase) promotor methylation status. Methods Pre-surgical ADC volumes of 56 HGG patients were analyzed by histogram-profiling. Association between extracted histogram parameters and neuropathology including WHO-grade, Ki-67 expression and MGMT promotor methylation status was investigated due to comparative and correlative statistics. Results Grade IV gliomas were more heterogeneous than grade III tumors. More specifically, ADCmin and the lowest percentile ADCp10 were significantly lower, whereas ADCmax, ADC standard deviation and Skewness were significantly higher in the glioblastoma group. ADCmin, ADCmax, ADC standard deviation, Kurtosis and Entropy of ADC histogram were significantly correlated with Ki-67 expression. No significant difference could be revealed by comparison of ADC histogram parameters between MGMT promotor methylated and unmethylated HGG. Conclusions ADC histogram parameters differ significantly between glioblastoma and anaplastic astrocytoma and show distinct associations with the proliferative activity in both HGG. Our results suggest ADC histogram profiling as promising biomarker for differentiation of both, however, further studies with prospective multicenter design are wanted to confirm and further elaborate this hypothesis.
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Affiliation(s)
- Georg Gihr
- Clinic for Neuroradiology, Katharinenhospital Stuttgart, Stuttgart, Germany
- * E-mail:
| | | | - Elena Hekeler
- Department for Pathology, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Oliver Ganslandt
- Clinic for Neurosurgery, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Hans Henkes
- Clinic for Neuroradiology, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Karl-Titus Hoffmann
- Department for Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | - Cordula Scherlach
- Department for Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | - Stefan Schob
- Department for Radiology, University Hospital Halle (Saale), Halle (Saale), Germany
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Gihr GA, Horvath-Rizea D, Hekeler E, Ganslandt O, Henkes H, Hoffmann KT, Scherlach C, Schob S. Histogram Analysis of Diffusion Weighted Imaging in Low-Grade Gliomas: in vivo Characterization of Tumor Architecture and Corresponding Neuropathology. Front Oncol 2020; 10:206. [PMID: 32158691 PMCID: PMC7051987 DOI: 10.3389/fonc.2020.00206] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 02/06/2020] [Indexed: 02/01/2023] Open
Abstract
Background: Low-grade gliomas (LGG) in adults are usually slow growing and frequently asymptomatic brain tumors, originating from glial cells of the central nervous system (CNS). Although regarded formally as “benign” neoplasms, they harbor the potential of malignant transformation associated with high morbidity and mortality. Their complex and unpredictable tumor biology requires a reliable and conclusive presurgical magnetic resonance imaging (MRI). A promising and emerging MRI approach in this context is histogram based apparent diffusion coefficient (ADC) profiling, which recently proofed to be capable of providing prognostic relevant information in different tumor entities. Therefore, our study investigated whether histogram profiling of ADC distinguishes grade I from grade II glioma, reflects the proliferation index Ki-67, as well as the IDH (isocitrate dehydrogenase) mutation and MGMT (methylguanine-DNA methyl-transferase) promotor methylation status. Material and Methods: Pre-treatment ADC volumes of 26 LGG patients were used for histogram-profiling. WHO-grade, Ki-67 expression, IDH mutation, and MGMT promotor methylation status were evaluated. Comparative and correlative statistics investigating the association between histogram-profiling and neuropathology were performed. Results: Almost the entire ADC profile (p25, p75, p90, mean, median) was significantly lower in grade II vs. grade I gliomas. Entropy, as second order histogram parameter of ADC volumes, was significantly higher in grade II gliomas compared with grade I gliomas. Mean, maximum value (ADCmax) and the percentiles p10, p75, and p90 of ADC histogram were significantly correlated with Ki-67 expression. Furthermore, minimum ADC value (ADCmin) was significantly associated with MGMT promotor methylation status as well as ADC entropy with IDH-1 mutation status. Conclusions: ADC histogram-profiling is a valuable radiomic approach, which helps differentiating tumor grade, estimating growth kinetics and probably prognostic relevant genetic as well as epigenetic alterations in LGG.
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Affiliation(s)
| | | | - Elena Hekeler
- Department for Pathology, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Oliver Ganslandt
- Katharinenhospital Stuttgart, Clinic for Neurosurgery, Stuttgart, Germany
| | - Hans Henkes
- Katharinenhospital Stuttgart, Clinic for Neuroradiology, Stuttgart, Germany
| | - Karl-Titus Hoffmann
- Department for Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | - Cordula Scherlach
- Department for Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | - Stefan Schob
- Department for Neuroradiology, University Hospital Leipzig, Leipzig, Germany
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Hamerla G, Meyer HJ, Schob S, Ginat DT, Altman A, Lim T, Gihr GA, Horvath-Rizea D, Hoffmann KT, Surov A. Comparison of machine learning classifiers for differentiation of grade 1 from higher gradings in meningioma: A multicenter radiomics study. Magn Reson Imaging 2019; 63:244-249. [DOI: 10.1016/j.mri.2019.08.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 07/14/2019] [Accepted: 08/15/2019] [Indexed: 01/05/2023]
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Surov A, Ginat DT, Lim T, Cabada T, Baskan O, Schob S, Meyer HJ, Gihr GA, Horvath-Rizea D, Hamerla G, Hoffmann KT, Wienke A. Histogram Analysis Parameters Apparent Diffusion Coefficient for Distinguishing High and Low-Grade Meningiomas: A Multicenter Study. Transl Oncol 2018; 11:1074-1079. [PMID: 30005209 PMCID: PMC6067084 DOI: 10.1016/j.tranon.2018.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/23/2018] [Accepted: 06/25/2018] [Indexed: 01/11/2023] Open
Abstract
Low grade meningiomas have better prognosis than high grade meningiomas. The aim of this study was to measure apparent diffusion coefficient (ADC) histogram analysis parameters in different meningiomas in a large multicenter sample and to analyze the possibility of several parameters for predicting tumor grade and proliferation potential. Overall, 148 meningiomas from 7 institutions were evaluated in this retrospective study. Grade 1 lesions were diagnosed in 101 (68.2%) cases, grade 2 in 41 (27.7%) patients, and grade 3 in 6 (4.1%) patients. All tumors were investigated by MRI (1.5 T scanner) by using diffusion weighted imaging (b values of 0 and 1000 s/mm2). For every lesion, the following parameters were calculated: mean ADC, maximum ADC, minimum ADC, median ADC, mode ADC, ADC percentiles P10, P25, P75, P90, kurtosis, skewness, and entropy. The comparison of ADC values was performed by Mann–Whitney-U test. Correlation between different ADC parameters and KI 67 was calculated by Spearman's rank correlation coefficient. Grade 2/3 meningiomas showed statistically significant lower ADC histogram analysis parameters in comparison to grade 1 tumors, especially ADC median. A threshold value of 0.82 for ADC median to predict tumor grade was estimated (sensitivity = 82.2%, specificity = 63.8%, accuracy = 76.4%, positive and negative predictive values were 83% and 62.5%, respectively). All ADC parameters except maximum ADC showed weak significant correlations with KI 67, especially ADC P25 (P = −.340, P = .0001).
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Affiliation(s)
- Alexey Surov
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Germany; Department of Diagnostic and Interventional Radiology, University of Leipzig, Germany.
| | - Daniel T Ginat
- University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Tchoyoson Lim
- Department of Neuroradiology, National Neuroscience Institute, Singapore
| | - Teresa Cabada
- Servicio de Radiologia, Hospital de Navarra, Pamplona, Spain
| | - Ozdil Baskan
- Department of Radiology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Stefan Schob
- Department of Neuroradiology, University of Leipzig
| | - Hans Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Germany
| | | | | | | | | | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther University Halle-Wittenberg, Halle, Germany
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Gihr GA, Horvath-Rizea D, Kohlhof-Meinecke P, Ganslandt O, Henkes H, Richter C, Hoffmann KT, Surov A, Schob S. Histogram Profiling of Postcontrast T1-Weighted MRI Gives Valuable Insights into Tumor Biology and Enables Prediction of Growth Kinetics and Prognosis in Meningiomas. Transl Oncol 2018; 11:957-961. [PMID: 29909365 PMCID: PMC6008484 DOI: 10.1016/j.tranon.2018.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 05/24/2018] [Accepted: 05/24/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND: Meningiomas are the most frequently diagnosed intracranial masses, oftentimes requiring surgery. Especially procedure-related morbidity can be substantial, particularly in elderly patients. Hence, reliable imaging modalities enabling pretherapeutic prediction of tumor grade, growth kinetic, realistic prognosis, and—as a consequence—necessity of surgery are of great value. In this context, a promising diagnostic approach is advanced analysis of magnetic resonance imaging data. Therefore, our study investigated whether histogram profiling of routinely acquired postcontrast T1-weighted images is capable of separating low-grade from high-grade lesions and whether histogram parameters reflect Ki-67 expression in meningiomas. MATERIAL AND METHODS: Pretreatment T1-weighted postcontrast volumes of 44 meningioma patients were used for signal intensity histogram profiling. WHO grade, tumor volume, and Ki-67 expression were evaluated. Comparative and correlative statistics investigating the association between histogram profile parameters and neuropathology were performed. RESULTS: None of the investigated histogram parameters revealed significant differences between low-grade and high-grade meningiomas. However, significant correlations were identified between Ki-67 and the histogram parameters skewness and entropy as well as between entropy and tumor volume. CONCLUSIONS: Contrary to previously reported findings, pretherapeutic postcontrast T1-weighted images can be used to predict growth kinetics in meningiomas if whole tumor histogram analysis is employed. However, no differences between distinct WHO grades were identifiable in out cohort. As a consequence, histogram analysis of postcontrast T1-weighted images is a promising approach to obtain quantitative in vivo biomarkers reflecting the proliferative potential in meningiomas.
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Affiliation(s)
| | | | | | - Oliver Ganslandt
- Katharinenhospital Stuttgart, Neurosurgical Clinic, Stuttgart, Germany
| | - Hans Henkes
- Katharinenhospital Stuttgart, Clinic for Neuroradiology, Stuttgart, Germany
| | - Cindy Richter
- University Hospital Leipzig, Department for Neuroradiology, Leipzig, Germany
| | - Karl-Titus Hoffmann
- University Hospital Leipzig, Department for Neuroradiology, Leipzig, Germany
| | - Alexey Surov
- University Hospital Leipzig, Clinic for Diagnostic and Interventional Radiology, Leipzig, Germany
| | - Stefan Schob
- University Hospital Leipzig, Department for Neuroradiology, Leipzig, Germany
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Horvath-Rizea D, Surov A, Hoffmann KT, Garnov N, Vörkel C, Kohlhof-Meinecke P, Ganslandt O, Bäzner H, Gihr GA, Kalman M, Henkes E, Henkes H, Schob S. The value of whole lesion ADC histogram profiling to differentiate between morphologically indistinguishable ring enhancing lesions-comparison of glioblastomas and brain abscesses. Oncotarget 2018; 9:18148-18159. [PMID: 29719596 PMCID: PMC5915063 DOI: 10.18632/oncotarget.24454] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 01/30/2018] [Indexed: 12/17/2022] Open
Abstract
Background Morphologically similar appearing ring enhancing lesions in the brain parenchyma can be caused by a number of distinct pathologies, however, they consistently represent life-threatening conditions. The two most frequently encountered diseases manifesting as such are glioblastoma multiforme (GBM) and brain abscess (BA), each requiring disparate therapeutical approaches. As a result of their morphological resemblance, essential treatment might be significantly delayed or even ommited, in case results of conventional imaging remain inconclusive. Therefore, our study aimed to investigate, whether ADC histogram profiling reliably can distinguish between both entities, thus enhancing the differential diagnostic process and preventing treatment failure in this highly critical context. Methods 103 patients (51 BA, 52 GBM) with histopathologically confirmed diagnosis were enrolled. Pretreatment diffusion weighted imaging (DWI) was obtained in a 1.5T system using b values of 0, 500, and 1000 s/mm2. Whole lesion ADC volumes were analyzed using a histogram-based approach. Statistical analysis was performed using SPSS version 23. Results All investigated parameters were statistically different in comparison of both groups. Most importantly, ADCp10 was able to differentiate reliably between BA and GBM with excellent accuracy (0.948) using a cutpoint value of 70 × 10−5 mm2 × s−1. Conclusions ADC whole lesion histogram profiling provides a valuable tool to differentiate between morphologically indistinguishable mass lesions. Among the investigated parameters, the 10th percentile of the ADC volume distinguished best between GBM and BA.
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Affiliation(s)
| | - Alexey Surov
- Clinic for Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
| | - Karl-Titus Hoffmann
- Department for Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | | | - Cathrin Vörkel
- Clinic for Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
| | | | - Oliver Ganslandt
- Clinic for Neurosurgery, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Hansjörg Bäzner
- Clinic for Neurology, Katherinenhospital Stuttgart, Stuttgart, Germany
| | | | - Marcell Kalman
- Clinic for Neuroradiology, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Elina Henkes
- Clinic for Neuroradiology, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Hans Henkes
- Clinic for Neuroradiology, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Stefan Schob
- Department for Neuroradiology, University Hospital Leipzig, Leipzig, Germany
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Gihr GA, Horvath-Rizea D, Garnov N, Kohlhof-Meinecke P, Ganslandt O, Henkes H, Meyer HJ, Hoffmann KT, Surov A, Schob S. Diffusion Profiling via a Histogram Approach Distinguishes Low-grade from High-grade Meningiomas, Can Reflect the Respective Proliferative Potential and Progesterone Receptor Status. Mol Imaging Biol 2018; 20:632-640. [DOI: 10.1007/s11307-018-1166-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schob S, Weiß A, Surov A, Dieckow J, Richter C, Pirlich M, Horvath-Rizea D, Härtig W, Hoffmann KT, Krause M, Quäschling U. Elevated Surfactant Protein Levels and Increased Flow of Cerebrospinal Fluid in Cranial Magnetic Resonance Imaging. Mol Neurobiol 2017; 55:6227-6236. [PMID: 29282698 DOI: 10.1007/s12035-017-0835-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/08/2017] [Indexed: 12/14/2022]
Abstract
Surfactant proteins (SPs) are a multifunctional group of proteins, responsible for the regulation of rheological properties of body fluids, host defense, and cellular waste clearance. Their concentrations are changed in cerebrospinal fluid (CSF) of patients suffering from communicating hydrocephalus. Hydrocephalic conditions are accompanied by altered CSF flow dynamics; however, the association of CSF-SP concentrations and CSF flow has not yet been investigated. Hence, the aim of this study was to evaluate the association between SP concentrations in the CSF and marked CSF flow phenomena at different anatomical landmarks of CSF spaces. Sixty-one individuals (15 healthy subjects and 46 hydrocephalus patients) were included in this study. CSF specimens were analyzed for SP-A, SP-B, SP-C, and SP-D concentrations by the use of enzyme-linked immunosorbent assays (ELISA). CSF flow was evaluated in axial T2_turbo inversion recovery magnitude (TIRM)-weighted and sagittal T2-weighted magnetic resonance imaging sections using a 4-grade scale (1-no flow, 2-subtle flow, 3-moderate flow, and 4-strong flow). CSF-SP concentrations (mean ± standard deviation) of the overall collective were as follows: SP-A = 0.73 ± 0.58 ng/ml, SP-B = 0.17 ± 0.93 ng/ml, SP-C = 0.95 ± 0.75 ng/ml, and SP-D = 7.43 ± 5.17 ng/ml. The difference between healthy controls and hydrocephalic patients regarding CSF concentrations of SP-A (0.34 ± 0.22 vs. 0.81 ± 0.59 ng/ml) and SP-C (0.48 ± 0.29 vs. 1.10 ± 0.79 ng/ml) revealed to be statistically significant as calculated by means of ANOVA (p values of 0.022 and 0.007, respectively). CSF flow voids were detectable at all investigated landmarks of the CSF spaces (foramina of Monro, third ventricle, mesencephalic aqueduct, prepontine cistern, fourth ventricle, cisterna magna, and craniocervical junction). CSF flow voids, reported as mean ± standard deviation, revealed to be significantly increased in hydrocephalic patients compared to controls as calculated by means of ANOVA (respective p values are given in brackets following values of descriptive statistics) at the following sites: foramina of Monro (1.60 ± 0.91 vs. 2.37 ± 0.99, p = 0.01), fourth ventricle (1.67 ± 0.98 vs. 2.52 ± 1.05, p = 0.007), and the cisterna magna (1.93 ± 1.10 vs. 2.72 ± 1.13, p = 0.022). Spearman's rank order calculation identified significant correlations for CSF flow voids at the foramina of Monro and the third ventricle with SP-A (r = 0.429, p = 0.001 and r = 0.464, p < 0.001) and CSF flow void at the mesencephalic duct with SP-D (r = - 0.371, p = 0.039). Furthermore, SP-C showed a moderate inverse correlation with age (r = - 0.302, p = 0.022). The present study confirmed statistically significant differences in SP-CSF concentrations between healthy controls and hydrocephalic patients. Additionally, significant correlations between SP concentrations in CSF with increased CSF flow were identified. These findings underline the role of SPs as regulators of CSF rheology.
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Affiliation(s)
- Stefan Schob
- Department for Neuroradiology, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
| | - Alexander Weiß
- Department for Neuroradiology, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany
| | - Alexey Surov
- Department for Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
| | - Julia Dieckow
- Department for Ophthalmology, University Hospital Leipzig, Leipzig, Germany
| | - Cindy Richter
- Department for Neuroradiology, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.,Institute for Anatomy, University Hospital Leipzig, Leipzig, Germany
| | - Mandy Pirlich
- Department for Neurology, University Hospital Leipzig, Leipzig, Germany
| | | | - Wolfgang Härtig
- Paul Flechsig Institute for Brain Research, Medical Faculty / University Hospital Leipzig, Leipzig, Germany
| | - Karl-Titus Hoffmann
- Department for Neuroradiology, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany
| | - Matthias Krause
- Department for Neurosurgery, University Hospital Leipzig, Leipzig, Germany
| | - Ulf Quäschling
- Department for Neuroradiology, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany
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Schob S, Meyer HJ, Dieckow J, Pervinder B, Pazaitis N, Höhn AK, Garnov N, Horvath-Rizea D, Hoffmann KT, Surov A. Histogram Analysis of Diffusion Weighted Imaging at 3T is Useful for Prediction of Lymphatic Metastatic Spread, Proliferative Activity, and Cellularity in Thyroid Cancer. Int J Mol Sci 2017; 18:ijms18040821. [PMID: 28417929 PMCID: PMC5412405 DOI: 10.3390/ijms18040821] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/09/2017] [Accepted: 04/10/2017] [Indexed: 01/11/2023] Open
Abstract
Pre-surgical diffusion weighted imaging (DWI) is increasingly important in the context of thyroid cancer for identification of the optimal treatment strategy. It has exemplarily been shown that DWI at 3T can distinguish undifferentiated from well-differentiated thyroid carcinoma, which has decisive implications for the magnitude of surgery. This study used DWI histogram analysis of whole tumor apparent diffusion coefficient (ADC) maps. The primary aim was to discriminate thyroid carcinomas which had already gained the capacity to metastasize lymphatically from those not yet being able to spread via the lymphatic system. The secondary aim was to reflect prognostically important tumor-biological features like cellularity and proliferative activity with ADC histogram analysis. Fifteen patients with follicular-cell derived thyroid cancer were enrolled. Lymph node status, extent of infiltration of surrounding tissue, and Ki-67 and p53 expression were assessed in these patients. DWI was obtained in a 3T system using b values of 0, 400, and 800 s/mm2. Whole tumor ADC volumes were analyzed using a histogram-based approach. Several ADC parameters showed significant correlations with immunohistopathological parameters. Most importantly, ADC histogram skewness and ADC histogram kurtosis were able to differentiate between nodal negative and nodal positive thyroid carcinoma. Conclusions: histogram analysis of whole ADC tumor volumes has the potential to provide valuable information on tumor biology in thyroid carcinoma. However, further studies are warranted.
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Affiliation(s)
- Stefan Schob
- Department for Neuroradiology, University Hospital Leipzig, Leipzig 04103, Germany.
| | - Hans Jonas Meyer
- Department for Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig 04103, Germany.
| | - Julia Dieckow
- Department for Ophthalmology, University Hospital Leipzig, Leipzig 04103, Germany.
| | - Bhogal Pervinder
- Department for Diagnostic and Interventional Neuroradiology, Katharinenhospital Stuttgart, Stuttgart 70174, Germany.
| | - Nikolaos Pazaitis
- Institute for Pathology, University Hospital Halle-Wittenberg, Martin-Luther-University Halle-Wittenberg, Halle 06112, Germany.
| | - Anne Kathrin Höhn
- Institute for Pathology, University Hospital Leipzig, Leipzig 04103, Germany.
| | - Nikita Garnov
- Department for Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig 04103, Germany.
| | - Diana Horvath-Rizea
- Department for Diagnostic and Interventional Neuroradiology, Katharinenhospital Stuttgart, Stuttgart 70174, Germany.
| | - Karl-Titus Hoffmann
- Department for Neuroradiology, University Hospital Leipzig, Leipzig 04103, Germany.
| | - Alexey Surov
- Department for Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig 04103, Germany.
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Coburger J, Musahl C, Henkes H, Horvath-Rizea D, Bittl M, Weissbach C, Hopf N. Comparison of navigated transcranial magnetic stimulation and functional magnetic resonance imaging for preoperative mapping in rolandic tumor surgery. Neurosurg Rev 2012; 36:65-75; discussion 75-6. [DOI: 10.1007/s10143-012-0413-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Revised: 05/21/2012] [Accepted: 06/16/2012] [Indexed: 10/28/2022]
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