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Kurokawa R, Baba A, Kano R, Kaneko Y, Kurokawa M, Gonoi W, Abe O. Radiological Imaging Findings of Adrenal Abnormalities in TAFRO Syndrome: A Systematic Review. Biomedicines 2024; 12:837. [PMID: 38672191 DOI: 10.3390/biomedicines12040837] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 03/22/2024] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
This systematic review article aims to investigate the clinical and radiological imaging characteristics of adrenal abnormalities in patients with thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly (TAFRO) syndrome. We searched the literature in PubMed, the Cochrane Library, and the Web of Science Core Collection. Ultimately, we analyzed 11 studies with 22 patients plus our 1 patient, totaling 23 patients. The mean age was 47.0 ± 12.6 years. There were 20 male and 3 female patients, respectively. The histopathological analysis of lymph nodes was conducted in 15 patients (65.2%), and the diagnosis was consistent with TAFRO syndrome in all 15 patients. Among the 23 patients, 11 patients (18 adrenal glands) showed adrenal ischemia/infarction, 9 patients (13 adrenal glands) showed adrenal hemorrhage, and 4 patients (7 adrenal glands) showed adrenomegaly without evidence of concurrent ischemia/infarction or hemorrhage. One patient demonstrated unilateral adrenal hemorrhage and contralateral adrenomegaly. In patients with adrenal ischemia/infarction, the adrenal glands displayed poor enhancement through contrast-enhanced computed tomography (CT). In patients with adrenal hemorrhage, the adrenal glands revealed high attenuation through non-enhanced CT and hematoma through magnetic resonance imaging. Adrenomegaly, with or without adrenal ischemia/infarction or hemorrhage, was observed in all patients (23/23, 100%). The subsequent calcification of the affected adrenal glands was frequently observed (9/14, 64.3%) when a follow-up CT was performed. Abdominal pain was frequent (15/23, 65.2%), all of which occurred after the disease's onset, suggesting the importance of considering TAFRO syndrome as a cause of acute abdomen. Given the absence of evidence of adrenal abnormalities in non-TAFRO-idiopathic multicentric Castleman disease (iMCD), they may serve as diagnostic clues for differentiating TAFRO syndrome from non-TAFRO-iMCD.
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Affiliation(s)
- Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Akira Baba
- Department of Radiology, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Rui Kano
- Department of Radiology, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Yo Kaneko
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu City 501-1194, Japan
| | - Mariko Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Wataru Gonoi
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Kato S, Kurokawa R, Suzuki F, Amemiya S, Shinozaki T, Takanezawa D, Kohashi R, Abe O. White and Gray Matter Abnormality in Burning Mouth Syndrome Evaluated with Diffusion Tensor Imaging and Neurite Orientation Dispersion and Density Imaging. Magn Reson Med Sci 2024; 23:204-213. [PMID: 36990741 PMCID: PMC11024709 DOI: 10.2463/mrms.mp.2022-0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 03/02/2023] [Indexed: 03/30/2023] Open
Abstract
PURPOSE Burning mouth syndrome (BMS) is defined by a burning sensation or pain in the tongue or other oral sites despite the presence of normal mucosa on inspection. Both psychiatric and neuroimaging investigations have examined BMS; however, there have been no analyses using the neurite orientation dispersion and density imaging (NODDI) model, which provides detailed information of intra- and extracellular microstructures. Therefore, we performed voxel-wise analyses using both NODDI and diffusion tensor imaging (DTI) models and compared the results to better comprehend the pathology of BMS. METHODS Fourteen patients with BMS and 11 age- and sex-matched healthy control subjects were prospectively scanned using a 3T-MRI machine using 2-shell diffusion imaging. Diffusion tensor metrics (fractional anisotropy [FA], mean diffusivity [MD], axial diffusivity [AD], and radial diffusivity [RD]) and neurite orientation and dispersion index metrics (intracellular volume fraction [ICVF], isotropic volume fraction [ISO], and orientation dispersion index [ODI]) were retrieved from diffusion MRI data. These data were analyzed using tract-based spatial statistics (TBSS) and gray matter-based spatial statistics (GBSS). RESULTS TBSS analysis showed that patients with BMS had significantly higher FA and ICVF and lower MD and RD than the healthy control subjects (family-wise error [FWE] corrected P < 0.05). Changes in ICVF, MD, and RD were observed in widespread white matter areas. Fairly small areas with different FA were included. GBSS analysis showed that patients with BMS had significantly higher ISO and lower MD and RD than the healthy control subjects (FWE-corrected P < 0.05), mainly limited to the amygdala. CONCLUSION The increased ICVF in the BMS group may represent myelination and/or astrocytic hypertrophy, and microstructural changes in the amygdala in GBSS analysis indicate the emotional-affective profile of BMS.
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Affiliation(s)
- Shimpei Kato
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Fumio Suzuki
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shiori Amemiya
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takahiro Shinozaki
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | - Daiki Takanezawa
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | - Ryutaro Kohashi
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, Tokyo, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Fujita N, Yasaka K, Hatano S, Sakamoto N, Kurokawa R, Abe O. Deep learning reconstruction for high-resolution computed tomography images of the temporal bone: comparison with hybrid iterative reconstruction. Neuroradiology 2024:10.1007/s00234-024-03330-1. [PMID: 38514472 DOI: 10.1007/s00234-024-03330-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/07/2023] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE We investigated whether the quality of high-resolution computed tomography (CT) images of the temporal bone improves with deep learning reconstruction (DLR) compared with hybrid iterative reconstruction (HIR). METHODS This retrospective study enrolled 36 patients (15 men, 21 women; age, 53.9 ± 19.5 years) who had undergone high-resolution CT of the temporal bone. Axial and coronal images were reconstructed using DLR, HIR, and filtered back projection (FBP). In qualitative image analyses, two radiologists independently compared the DLR and HIR images with FBP in terms of depiction of structures, image noise, and overall quality, using a 5-point scale (5 = better than FBP, 1 = poorer than FBP) to evaluate image quality. The other two radiologists placed regions of interest on the tympanic cavity and measured the standard deviation of CT attenuation (i.e., quantitative image noise). Scores from the qualitative and quantitative analyses of the DLR and HIR images were compared using, respectively, the Wilcoxon signed-rank test and the paired t-test. RESULTS Qualitative and quantitative image noise was significantly reduced in DLR images compared with HIR images (all comparisons, p ≤ 0.016). Depiction of the otic capsule, auditory ossicles, and tympanic membrane was significantly improved in DLR images compared with HIR images (both readers, p ≤ 0.003). Overall image quality was significantly superior in DLR images compared with HIR images (both readers, p < 0.001). CONCLUSION Compared with HIR, DLR provided significantly better-quality high-resolution CT images of the temporal bone.
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Affiliation(s)
- Nana Fujita
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Koichiro Yasaka
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
| | - Sosuke Hatano
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Naoya Sakamoto
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
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Baba A, Kurokawa R, Kurokawa M, Rivera-de Choudens R, Srinivasan A. Apparent diffusion coefficient for differentiation between extra-nodal lymphoma and squamous cell carcinoma in the head and neck: a systematic review and meta-analysis. Acta Radiol 2024:2841851241228487. [PMID: 38377681 DOI: 10.1177/02841851241228487] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 02/22/2024]
Abstract
BACKGROUND Radiological differentiation between extra-nodal lymphoma and squamous cell carcinoma in the head and neck is often difficult due to their similarities. PURPOSE To evaluate the diagnostic benefit of apparent diffusion coefficient (ADC) calculated from diffusion-weighted imaging (DWI) in differentiating the two. MATERIAL AND METHODS A systematic review was performed by searching the MEDLINE, Scopus, and Embase databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Forest plots and the pooled mean difference of ADC values were calculated to describe the relationship between extra-nodal lymphoma and squamous cell carcinoma in the head and neck. Heterogeneity among studies was evaluated using the Cochrane Q test and I2 statistic. RESULTS The review identified eight studies with 440 patients (441 lesions) eligible for meta-analysis. Among all studies, the mean ADC values of squamous cell carcinoma was 0.88 × 10-3mm2/s and that of lymphoma was 0.64 × 10-3mm2/s. In the meta-analysis, the ADC value of lymphoma was significantly lower than that of squamous cell carcinoma (pooled mean difference = 0.235, 95% confidence interval [CI] = 0.168-0.302, P <0.0001). The Cochrane Q test (chi-square = 55.7, P <0.0001) and I2 statistic (I2 = 87.4%, 95% CI = 77.4-93.0%) revealed significant heterogeneity. CONCLUSION This study highlights the value of quantitative assessment of ADC for objective and reliable differentiation between extra-nodal lymphoma and squamous cell carcinoma in the head and neck. Conclusions should be interpreted with caution due to heterogeneity in the study data.
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Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Department of Radiology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Department of Radiology, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Department of Radiology, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | | | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
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Baba A, Matsushima S, Kessoku H, Omura K, Kurokawa R, Fukasawa N, Takeshita Y, Yamauchi H, Ogino N, Kayama R, Uchihara K, Yoshimatsu L, Ojiri H. Radiological features of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: case series and systematic review. Neuroradiology 2024; 66:249-259. [PMID: 38103083 DOI: 10.1007/s00234-023-03254-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE To comprehensively summarize the clinical data and CT/MRI characteristics of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA). METHODS Twenty-seven lesions from 25 study articles identified through a systematic review and three lesions from our institution associated with TL-LGNPPA were evaluated. RESULTS The mean age of the patients at diagnosis was 35.7 years, and the male-to-female ratio was nearly half. The chief complaint was nasal obstruction, followed by epistaxis. All patients underwent excision. None of the patients had neck nodes or distant metastases. All patients survived with no locoregional/distant recurrence during 3-93 months of follow-up. All lesions were located at the posterior edge of the nasal septum, attached to the nasopharyngeal parietal wall, and showed no laterality. The mean lesion diameter was 1.7 cm. The margins of lesions were well-defined and lobulated, followed by well-defined smooth margins. None of lesions were associated with parapharyngeal space or skull base destruction. All lesions were iso- and low-density on non-contrast CT. Adjacent skull base sclerosis was detected in 63.6% of lesions. High signal intensity on T2-weighted imaging and mostly iso-signal intensity on T1-weighted imaging compared to muscle tissue. Most lesions were heterogeneous and exhibited moderate contrast enhancement. Relatively large lesions (≥1.4 cm) tended to be more lobulated than smooth margins compared to relatively small lesions (<1.4 cm) (p = 0.016). CONCLUSION We summarized the clinical and radiological features of TL-LGNPPA to facilitate accurate diagnosis and appropriate management.
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Affiliation(s)
- Akira Baba
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Satoshi Matsushima
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hisashi Kessoku
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryo Kurokawa
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Nei Fukasawa
- Department of Pathology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yuhei Takeshita
- Department of Radiology, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Hideomi Yamauchi
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Nobuhiro Ogino
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Reina Kayama
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kimiyuki Uchihara
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Lynn Yoshimatsu
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
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Kurokawa R, Hagiwara A, Kurokawa M, Ellingson BM, Baba A, Moritani T. Diffusion histogram profiles predict molecular features of grade 4 in histologically lower-grade adult diffuse gliomas following WHO classification 2021. Eur Radiol 2024; 34:1367-1375. [PMID: 37581661 PMCID: PMC10853353 DOI: 10.1007/s00330-023-10071-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVES In the latest World Health Organization classification 2021, grade 4 adult diffuse gliomas can be diagnosed with several molecular features even without histological evidence of necrosis or microvascular proliferation. We aimed to explore whole tumor histogram-derived apparent diffusion coefficient (ADC) histogram profiles for differentiating between the presence (Mol-4) and absence (Mol-2/3) of grade 4 molecular features in histologically lower-grade gliomas. METHODS Between June 2019 and October 2022, 184 adult patients with diffuse gliomas underwent MRI. After excluding 121 patients, 18 (median age, 64.5 [range, 37-84 years]) Mol-4 and 45 (median 40 [range, 18-73] years) Mol-2/3 patients with histologically lower-grade gliomas were enrolled. Whole tumor volume-of-interest-derived ADC histogram profiles were calculated and compared between the two groups. Stepwise logistic regression analysis with Akaike's information criterion using the ADC histogram profiles with p values < 0.01 and age at diagnosis was used to identify independent variables for predicting the Mol-4 group. RESULTS The 90th percentile (p < 0.001), median (p < 0.001), mean (p < 0.001), 10th percentile (p = 0.014), and entropy (p < 0.001) of normalized ADC were lower, and kurtosis (p < 0.001) and skewness (p = 0.046) were higher in the Mol-4 group than in the Mol-2/3 group. Multivariate logistic regression analysis revealed that the entropy of normalized ADC and age at diagnosis were independent predictive parameters for the Mol-4 group with an area under the curve of 0.92. CONCLUSION ADC histogram profiles may be promising preoperative imaging biomarkers to predict molecular grade 4 among histologically lower-grade adult diffuse gliomas. CLINICAL RELEVANCE STATEMENT This study highlighted the diagnostic usefulness of ADC histogram profiles to differentiate histologically lower grade adult diffuse gliomas with the presence of molecular grade 4 features and those without. KEY POINTS • ADC histogram profiles to predict molecular CNS WHO grade 4 status among histologically lower-grade adult diffuse gliomas were evaluated. • Entropy of ADC and age were independent predictive parameters for molecular grade 4 status. • ADC histogram analysis is useful for predicting molecular grade 4 among histologically lower-grade gliomas.
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Affiliation(s)
- Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA.
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Akifumi Hagiwara
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Department of Radiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
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Ohizumi Y, Kurokawa R, Amemiya S, Ito T, Sato M, Abe O. Restrictive Allograft Syndrome After COVID-19 Pneumonia: A Case Report. Cureus 2024; 16:e54583. [PMID: 38384867 PMCID: PMC10879649 DOI: 10.7759/cureus.54583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 02/23/2024] Open
Abstract
Chronic lung allograft dysfunction (CLAD) continues to be the leading cause of death in the long term after lung transplantation (LTx). CLAD has the following two main subtypes: bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS). BOS features obstructive lung dysfunction, while RAS features restrictive lung dysfunction. Overall, RAS has a worse prognosis. The pathophysiology of CLAD is not fully understood; however, pulmonary infections can trigger CLAD, including coronavirus disease 2019 (COVID-19) pneumonia. Here, we describe a case of a 55-year-old female who received LTx about seven years ago and developed RAS after COVID-19 pneumonia. RAS was ultimately diagnosed based on the clinical course and imaging findings. Steroid pulse therapy and empirical antimicrobial therapy were initiated, but respiratory failure progressed, and the patient died 139 days after COVID-19 diagnosis, and 83 days after dyspnea progression. Clinicians should be aware of unusual stair-step clinical courses and imaging features in a given setting of pulmonary infection including COVID-19 to suspect CLAD in lung transplant patients.
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Affiliation(s)
- Yuji Ohizumi
- Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, JPN
| | - Ryo Kurokawa
- Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, JPN
| | - Shiori Amemiya
- Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, JPN
| | - Tatsuya Ito
- Respiratory Medicine, Ome Municipal General Hospital, Tokyo, JPN
| | - Masaaki Sato
- Thoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, JPN
| | - Osamu Abe
- Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, JPN
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Enokizono M, Kurokawa R, Yagishita A, Nakata Y, Koyasu S, Nihira H, Kuwashima S, Aida N, Kono T, Mori H. Clinical and neuroimaging review of monogenic cerebral small vessel disease from the prenatal to adolescent developmental stage. Jpn J Radiol 2024; 42:109-125. [PMID: 37847489 PMCID: PMC10810974 DOI: 10.1007/s11604-023-01493-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 10/18/2023]
Abstract
Cerebral small vessel disease (cSVD) refers to a group of pathological processes with various etiologies affecting the small vessels of the brain. Most cases are sporadic, with age-related and hypertension-related sSVD and cerebral amyloid angiopathy being the most prevalent forms. Monogenic cSVD accounts for up to 5% of causes of stroke. Several causative genes have been identified. Sporadic cSVD has been widely studied whereas monogenic cSVD is still poorly characterized and understood. The majority of cases of both the sporadic and monogenic types, including cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), typically have their onset in adulthood. Types of cSVD with infantile and childhood onset are rare, and their diagnosis is often challenging. The present review discusses the clinical and neuroimaging findings of monogenic cSVD from the prenatal to adolescent period of development. Early diagnosis is crucial to enabling timely interventions and family counseling.
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Affiliation(s)
- Mikako Enokizono
- Department of Radiology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.
| | - Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Akira Yagishita
- Department of Neuroradiology, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
| | - Yasuhiro Nakata
- Department of Neuroradiology, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
| | - Sho Koyasu
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Hiroshi Nihira
- Department of Pediatrics, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Shigeko Kuwashima
- Department of Radiology, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
| | - Noriko Aida
- Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Tatsuo Kono
- Department of Radiology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan
| | - Harushi Mori
- Department of Radiology, School of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
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Akaiwa M, Matsuda Y, Kurokawa R, Sugawara Y, Kosuge R, Saito H, Shibata E, Sasaki T, Sugawara K, Kozuka N. Does 20 Hz Transcranial Alternating Current Stimulation over the Human Primary Motor Cortex Modulate Beta Rebound Following Voluntary Movement? Brain Sci 2024; 14:74. [PMID: 38248289 PMCID: PMC10813667 DOI: 10.3390/brainsci14010074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Beta frequency oscillations originating from the primary motor cortex increase in amplitude following the initiation of voluntary movement, a process termed beta rebound. The strength of beta rebound has been reported to predict the recovery of motor function following stroke, suggesting therapeutic applications of beta rebound modulation. The present study examined the effect of 20 Hz transcranial alternating current stimulation (tACS) on the beta rebound induced by self-paced voluntary movement. Electroencephalograms (EEGs) and electromyograms (EMGs) were recorded from 16 healthy adults during voluntary movements performed before and after active or sham tACS. There was no significant change in average beta rebound after active tACS. However, the beta rebound amplitude was significantly enhanced in a subset of participants, and the magnitude of the increase across all participants was negatively correlated with the difference between individual peak beta frequency and tACS frequency. Thus, matching the stimulus frequency of tACS with individual beta frequency may facilitate therapeutic enhancement for motor rehabilitation.
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Affiliation(s)
- Mayu Akaiwa
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Yuya Matsuda
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Ryo Kurokawa
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Yasushi Sugawara
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Rin Kosuge
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Hidekazu Saito
- Department of Occupational Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Eriko Shibata
- Major of Physical Therapy, Department of Rehabilitation, Faculty of Healthcare and Science, Hokkaido Bunkyo University, Eniwa 061-1449, Japan;
| | - Takeshi Sasaki
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan; (T.S.); (K.S.); (N.K.)
| | - Kazuhiro Sugawara
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan; (T.S.); (K.S.); (N.K.)
| | - Naoki Kozuka
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan; (T.S.); (K.S.); (N.K.)
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Toyohara Y, Sone K, Noda K, Yoshida K, Kato S, Kaiume M, Taguchi A, Kurokawa R, Osuga Y. The automatic diagnosis artificial intelligence system for preoperative magnetic resonance imaging of uterine sarcoma. J Gynecol Oncol 2023; 35:35.e24. [PMID: 38246183 DOI: 10.3802/jgo.2024.35.e24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 10/12/2023] [Accepted: 10/26/2023] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE Magnetic resonance imaging (MRI) is efficient for the diagnosis of preoperative uterine sarcoma; however, misdiagnoses may occur. In this study, we developed a new artificial intelligence (AI) system to overcome the limitations of requiring specialists to manually process datasets and a large amount of computer resources. METHODS The AI system comprises a tumor image filter, which extracts MRI slices containing tumors, and sarcoma evaluator, which diagnoses uterine sarcomas. We used 15 types of MRI patient sequences to train deep neural network (DNN) models used by tumor filter and sarcoma evaluator with 8 cross-validation sets. We implemented tumor filter and sarcoma evaluator using ensemble prediction technique with 9 DNN models. Ten tumor filters and sarcoma evaluator sets were developed to evaluate fluctuation accuracy. Finally, AutoDiag-AI was used to evaluate the new validation dataset, including 8 cases of sarcomas and 24 leiomyomas. RESULTS Tumor image filter and sarcoma evaluator accuracies were 92.68% and 90.50%, respectively. AutoDiag-AI with the original dataset accuracy was 89.32%, with 90.47% sensitivity and 88.95% specificity, whereas AutoDiag-AI with the new validation dataset accuracy was 92.44%, with 92.25% sensitivity and 92.50% specificity. CONCLUSION Our newly established AI system automatically extracts tumor sites from MRI images and diagnoses them as uterine sarcomas without human intervention. Its accuracy is comparable to that of a radiologist. With further validation, the system could be applied for diagnosis of other diseases. Further improvement of the system's accuracy may enable its clinical application in the future.
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Affiliation(s)
- Yusuke Toyohara
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenbun Sone
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | | | | | - Shimpei Kato
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masafumi Kaiume
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayumi Taguchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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11
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Baba A, Kurokawa R, Kurokawa M, Rivera-de Choudens R, Srinivasan A. Dual-energy computed tomography for improved visualization of internal jugular chain neck lymph node metastasis and nodal necrosis in head and neck squamous cell carcinoma. Jpn J Radiol 2023; 41:1351-1358. [PMID: 37347457 PMCID: PMC10687157 DOI: 10.1007/s11604-023-01460-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE To evaluate and compare the utility of 40-keV virtual monochromatic imaging (VMI) reconstructed from dual-energy computed tomography (DECT) in the assessment of neck lymph node metastasis with 70-keV VMI, which is reportedly equivalent to conventional 120-kVp single-energy computed tomography. MATERIALS AND METHODS Patients with head and neck squamous cell carcinoma who had neck lymph node metastasis in contact with the sternocleidomastoid muscle (SCM) and underwent contrast-enhanced DECT were included. In 40- and 70-keV VMI, contrast differences and contrast noise ratio (CNR) between the solid component of neck lymph node metastasis (SC) and the SCM and between SC and nodal necrosis (NN) were calculated. Two board-certified radiologists independently and qualitatively evaluated the boundary discrimination between SC and SCM and the diagnostic certainty of NN. RESULTS We evaluated 45 neck lymph node metastases. The contrast difference between SC and SCM and SC and NN were significantly higher at 40-keV VMI than at 70-keV VMI (p < 0.001). The CNR between SC and SCM was significantly higher at 40-keV VMI than at 70-keV VMI (p < 0.001). Scoring of the boundary discrimination between SC and SCM as well as the diagnostic certainty of NN at 40-keV VMI was significantly higher than that at 70-keV VMI (p < 0.001). The inter-rater agreements for these scores were higher at 40-keV VMI than at 70-keV VMI. CONCLUSION Additional employing 40-keV VMI in routine clinical practice may be useful in the diagnosis of head and neck lymph node metastases and nodal necrosis.
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Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Roberto Rivera-de Choudens
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
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12
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Venneti S, Kawakibi AR, Ji S, Waszak SM, Sweha SR, Mota M, Pun M, Deogharkar A, Chung C, Tarapore RS, Ramage S, Chi A, Wen PY, Arrillaga-Romany I, Batchelor TT, Butowski NA, Sumrall A, Shonka N, Harrison RA, de Groot J, Mehta M, Hall MD, Daghistani D, Cloughesy TF, Ellingson BM, Beccaria K, Varlet P, Kim MM, Umemura Y, Garton H, Franson A, Schwartz J, Jain R, Kachman M, Baum H, Burant CF, Mottl SL, Cartaxo RT, John V, Messinger D, Qin T, Peterson E, Sajjakulnukit P, Ravi K, Waugh A, Walling D, Ding Y, Xia Z, Schwendeman A, Hawes D, Yang F, Judkins AR, Wahl D, Lyssiotis CA, de la Nava D, Alonso MM, Eze A, Spitzer J, Schmidt SV, Duchatel RJ, Dun MD, Cain JE, Jiang L, Stopka SA, Baquer G, Regan MS, Filbin MG, Agar NY, Zhao L, Kumar-Sinha C, Mody R, Chinnaiyan A, Kurokawa R, Pratt D, Yadav VN, Grill J, Kline C, Mueller S, Resnick A, Nazarian J, Allen JE, Odia Y, Gardner SL, Koschmann C. Clinical Efficacy of ONC201 in H3K27M-Mutant Diffuse Midline Gliomas Is Driven by Disruption of Integrated Metabolic and Epigenetic Pathways. Cancer Discov 2023; 13:2370-2393. [PMID: 37584601 PMCID: PMC10618742 DOI: 10.1158/2159-8290.cd-23-0131] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/30/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023]
Abstract
Patients with H3K27M-mutant diffuse midline glioma (DMG) have no proven effective therapies. ONC201 has recently demonstrated efficacy in these patients, but the mechanism behind this finding remains unknown. We assessed clinical outcomes, tumor sequencing, and tissue/cerebrospinal fluid (CSF) correlate samples from patients treated in two completed multisite clinical studies. Patients treated with ONC201 following initial radiation but prior to recurrence demonstrated a median overall survival of 21.7 months, whereas those treated after recurrence had a median overall survival of 9.3 months. Radiographic response was associated with increased expression of key tricarboxylic acid cycle-related genes in baseline tumor sequencing. ONC201 treatment increased 2-hydroxyglutarate levels in cultured H3K27M-DMG cells and patient CSF samples. This corresponded with increases in repressive H3K27me3 in vitro and in human tumors accompanied by epigenetic downregulation of cell cycle regulation and neuroglial differentiation genes. Overall, ONC201 demonstrates efficacy in H3K27M-DMG by disrupting integrated metabolic and epigenetic pathways and reversing pathognomonic H3K27me3 reduction. SIGNIFICANCE The clinical, radiographic, and molecular analyses included in this study demonstrate the efficacy of ONC201 in H3K27M-mutant DMG and support ONC201 as the first monotherapy to improve outcomes in H3K27M-mutant DMG beyond radiation. Mechanistically, ONC201 disrupts integrated metabolic and epigenetic pathways and reverses pathognomonic H3K27me3 reduction. This article is featured in Selected Articles from This Issue, p. 2293.
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Affiliation(s)
| | | | - Sunjong Ji
- University of Michigan, Ann Arbor, Michigan
| | - Sebastian M. Waszak
- University of California, San Francisco, San Francisco, California
- Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo and Oslo University Hospital, Oslo, Norway
- Laboratory of Computational Neuro-Oncology, Swiss Institute for Experimental Cancer Research, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Stefan R. Sweha
- University of Michigan, Ann Arbor, Michigan
- Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | | | - Chan Chung
- University of Michigan, Ann Arbor, Michigan
- Department of New Biology, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, Republic of Korea
| | | | | | | | - Patrick Y. Wen
- Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts
| | | | | | | | | | | | | | - John de Groot
- University of California, San Francisco, San Francisco, California
| | | | | | | | | | | | - Kevin Beccaria
- Department of Neurosurgery, Necker Sick Children's University Hospital and Paris Descartes University, Paris, France
| | - Pascale Varlet
- Department of Neuropathology, Sainte-Anne Hospital and Paris Descartes University, Paris, France
| | | | | | | | | | | | | | | | - Heidi Baum
- University of Michigan, Ann Arbor, Michigan
| | | | - Sophie L. Mottl
- Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo and Oslo University Hospital, Oslo, Norway
| | | | | | | | | | | | | | | | | | | | - Yujie Ding
- University of Michigan, Ann Arbor, Michigan
| | - Ziyun Xia
- University of Michigan, Ann Arbor, Michigan
| | | | - Debra Hawes
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Fusheng Yang
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Alexander R. Judkins
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | | | - Daniel de la Nava
- Health Research Institute of Navarra (IdiSNA), Pamplona, Spain
- Solid Tumor Program, Cima Universidad de Navarra, Pamplona, Spain
- Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain
| | - Marta M. Alonso
- Health Research Institute of Navarra (IdiSNA), Pamplona, Spain
- Solid Tumor Program, Cima Universidad de Navarra, Pamplona, Spain
- Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain
| | - Augustine Eze
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC
| | - Jasper Spitzer
- Institute of Innate Immunity, AG Immunogenomics, University Hospital Bonn, Bonn, Germany
- Institute of Clinical Chemistry and Clinical Pharmacology, AG Immunmonitoring and Genomics, University Hospital Bonn, Bonn, Germany
| | - Susanne V. Schmidt
- Institute of Innate Immunity, AG Immunogenomics, University Hospital Bonn, Bonn, Germany
- Institute of Clinical Chemistry and Clinical Pharmacology, AG Immunmonitoring and Genomics, University Hospital Bonn, Bonn, Germany
| | - Ryan J. Duchatel
- Cancer Signalling Research Group, School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Precision Medicine Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Paediatric Program, Mark Hughes Foundation Centre for Brain Cancer Research, College of Health, Medicine, and Wellbeing, Callaghan, NSW, Australia
| | - Matthew D. Dun
- Cancer Signalling Research Group, School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Precision Medicine Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Paediatric Program, Mark Hughes Foundation Centre for Brain Cancer Research, College of Health, Medicine, and Wellbeing, Callaghan, NSW, Australia
| | - Jason E. Cain
- Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Molecular and Translational Sciences, Monash University, Clayton, VIC, Australia
| | - Li Jiang
- Department of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorder Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Sylwia A. Stopka
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gerard Baquer
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michael S. Regan
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mariella G. Filbin
- Department of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorder Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Nathalie Y.R. Agar
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Lili Zhao
- University of Michigan, Ann Arbor, Michigan
| | | | - Rajen Mody
- University of Michigan, Ann Arbor, Michigan
| | | | - Ryo Kurokawa
- University of Michigan, Ann Arbor, Michigan
- The University of Tokyo, Tokyo, Japan
| | - Drew Pratt
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Viveka N. Yadav
- Department of Pediatrics at Children's Mercy Research Institute, Kansas City, Missouri
| | - Jacques Grill
- Department of Pediatric and Adolescent Oncology and INSERM Unit 981, Gustave Roussy and University Paris-Saclay, Villejuif, France
| | - Cassie Kline
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sabine Mueller
- University of California, San Francisco, San Francisco, California
- Department of Oncology, Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Adam Resnick
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Javad Nazarian
- Department of Pediatrics, Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- Research Center for Genetic Medicine, Children's National Hospital, Washington, DC
- George Washington University School of Medicine and Health Sciences, Washington, DC
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Ueda K, Yu T, Hirayama M, Kurokawa R, Nakajima T, Saito H, Kriener M, Hoshino M, Hashizume D, Arima TH, Arita R, Tokura Y. Colossal negative magnetoresistance in field-induced Weyl semimetal of magnetic half-Heusler compound. Nat Commun 2023; 14:6339. [PMID: 37816724 PMCID: PMC10564756 DOI: 10.1038/s41467-023-41982-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/26/2023] [Indexed: 10/12/2023] Open
Abstract
The discovery of topological insulators and semimetals triggered enormous interest in exploring emergent electromagnetic responses in solids. Particular attention has been focused on ternary half-Heusler compounds, whose electronic structure bears analogy to the topological zinc-blende compounds while also including magnetic rare-earth ions coupled to conduction electrons. However, most of the research in this system has been in band-inverted zero-gap semiconductors such as GdPtBi, which still does not fully exhaust the large potential of this material class. Here, we report a less-studied member of half-Heusler compounds, HoAuSn, which we show is a trivial semimetal or narrow-gap semiconductor at zero magnetic field but undergoes a field-induced transition to a Weyl semimetal, with a negative magnetoresistance exceeding four orders of magnitude at low temperatures. The combined study of Shubnikov-de Haas oscillations and first-principles calculation suggests that the exchange field from Ho 4f moments reconstructs the band structure to induce Weyl points which play a key role in the strong suppression of large-angle carrier scattering. Our findings demonstrate the unique mechanism of colossal negative magnetoresistance and provide pathways towards realizing topological electronic states in a large class of magnetic half-Heusler compounds.
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Affiliation(s)
- Kentaro Ueda
- Department of Applied Physics and Quantum Phase Electronics Center (QPEC), University of Tokyo, Tokyo, 113-8656, Japan.
| | - Tonghua Yu
- Department of Applied Physics and Quantum Phase Electronics Center (QPEC), University of Tokyo, Tokyo, 113-8656, Japan
| | - Motoaki Hirayama
- Department of Applied Physics and Quantum Phase Electronics Center (QPEC), University of Tokyo, Tokyo, 113-8656, Japan
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
| | - Ryo Kurokawa
- Department of Applied Physics and Quantum Phase Electronics Center (QPEC), University of Tokyo, Tokyo, 113-8656, Japan
| | - Taro Nakajima
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
- Institute of Solid State Physics, University of Tokyo, Kashiwa, 277-8561, Japan
| | - Hiraku Saito
- Institute of Solid State Physics, University of Tokyo, Kashiwa, 277-8561, Japan
| | - Markus Kriener
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
| | - Manabu Hoshino
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
| | - Daisuke Hashizume
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
| | - Taka-Hisa Arima
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
- Department of Advanced Material Science, University of Tokyo, Kashiwa, 277-8561, Japan
| | - Ryotaro Arita
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
- Research Center for Advanced Science and Technology, University of Tokyo, Komaba Meguro-ku, Tokyo, 153-8904, Japan
| | - Yoshinori Tokura
- Department of Applied Physics and Quantum Phase Electronics Center (QPEC), University of Tokyo, Tokyo, 113-8656, Japan
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
- Tokyo College, University of Tokyo, Tokyo, 113-8656, Japan
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Baba A, Kurokawa R, Kurokawa M, Yanagisawa T, Srinivasan A. Performance of Neck Imaging Reporting and Data System (NI-RADS) for Diagnosis of Recurrence of Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-analysis. AJNR Am J Neuroradiol 2023; 44:1184-1190. [PMID: 37709352 PMCID: PMC10549942 DOI: 10.3174/ajnr.a7992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/12/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND The Neck Imaging Reporting and Data System (NI-RADS) is a reporting template used in head and neck cancer posttreatment follow-up imaging. PURPOSE Our aim was to evaluate the pooled detection rates of the recurrence of head and neck squamous cell carcinoma based on each NI-RADS category and to compare the diagnostic accuracy between NI-RADS 2 and 3 cutoffs. DATA SOURCES The MEDLINE, Scopus, and EMBASE databases were searched. STUDY SELECTION This systematic review identified 7 studies with a total of 694 patients (1233 lesions) that were eligible for the meta-analysis. DATA ANALYSIS The meta-analysis of pooled recurrence detection rate estimates for each NI-RADS category and the diagnostic accuracy of recurrence with NI-RADS 3 or 2 as the cutoff was performed. DATA SYNTHESIS The estimated recurrence rates in each category for primary lesions were 74.4% for NI-RADS 3, 29.0% for NI-RADS 2, and 4.2% for NI-RADS 1. The estimated recurrence rates in each category for cervical lymph nodes were 73.3% for NI-RADS 3, 14.3% for NI-RADS 2, and 3.5% for NI-RADS 1. The area under the curve of the summary receiver operating characteristic for recurrence detection with NI-RADS 3 as the cutoff was 0.887 and 0.983, respectively, higher than 0.869 and 0.919 for the primary sites and cervical lymph nodes, respectively, with NI-RADS 2 as the cutoff. LIMITATIONS Given the heterogeneity of the data of the studies, the conclusions should be interpreted with caution. CONCLUSIONS This meta-analysis revealed estimated recurrence rates for each NI-RADS category for primary lesions and cervical lymph nodes and showed that NI-RADS 3 has a high diagnostic performance for detecting recurrence.
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Affiliation(s)
- Akira Baba
- From the Division of Neuroradiology (A.B., R.K., M.K., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
- Department of Radiology (A.B.), The Jikei University School of Medicine, Tokyo, Japan
| | - Ryo Kurokawa
- From the Division of Neuroradiology (A.B., R.K., M.K., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
- Department of Radiology (R.K., M.K.), The University of Tokyo, Tokyo, Japan
| | - Mariko Kurokawa
- From the Division of Neuroradiology (A.B., R.K., M.K., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
- Department of Radiology (R.K., M.K.), The University of Tokyo, Tokyo, Japan
| | - Takafumi Yanagisawa
- Department of Urology (T.Y.), The Jikei University School of Medicine, Tokyo, Japan
| | - Ashok Srinivasan
- From the Division of Neuroradiology (A.B., R.K., M.K., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
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15
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Baba A, Kurokawa R, Kurokawa M, Rivera-de Choudens R, Srinivasan A. Performance of axial diameter on MR imaging for identification of retropharyngeal lymph node metastases in head and neck cancer: a systematic review and meta-analysis. Neuroradiology 2023; 65:1363-1369. [PMID: 37522935 DOI: 10.1007/s00234-023-03205-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE To summarize previous studies' data and to calculate the diagnostic performance of minimum axial diameter (MIAD) and maximum axial diameter (MAAD) on each of the cutoff values in retropharyngeal lymph node (RPLNs) metastases in head and neck cancer. METHODS MEDLINE, Scopus, and Embase databases were searched for systematic review. Meta-analysis was performed to summarize estimates of sensitivity, specificity, and diagnostic odds ratio (DOR) and generate summary recipient operator characteristic (sROC). RESULTS The review identified 5 studies with a total of 634 patients (971 lesions) that were eligible for the meta-analysis. The estimated sensitivity, specificity, and DOR at MIAD 5 mm cutoff and MIAD 6 mm cutoff were 89.8% and 74.3%, 82.7% and 92.7%, and 39.1 and 57.9, respectively. The estimated sensitivity, specificity, and DOR at MAAD 7 mm cutoff and MAAD 8 mm cutoff were 90.3% and 84.7%, 62.7% and 79.9%, and 17.8 and 21.7, respectively. The AUCs of sROC at MIAD 5 mm cutoff and MIAD 6 mm cutoff were 0.922 and 0.943. At MAAD 7 mm and MAAD 8 mm, they were 0.840 and 0.888. CONCLUSION The diagnostic performance of the MIAD 6 mm cutoff in RPLN metastases from head and neck cancer was 2% higher than the MIAD 5 mm cutoff. The diagnostic performance of MIAD was higher than that of MAAD.
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Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Roberto Rivera-de Choudens
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
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Umemura Y, Orringer D, Junck L, Varela ML, West MEJ, Faisal SM, Comba A, Heth J, Sagher O, Leung D, Mammoser A, Hervey-Jumper S, Zamler D, Yadav VN, Dunn P, Al-Holou W, Hollon T, Kim MM, Wahl DR, Camelo-Piragua S, Lieberman AP, Venneti S, McKeever P, Lawrence T, Kurokawa R, Sagher K, Altshuler D, Zhao L, Muraszko K, Castro MG, Lowenstein PR. Combined cytotoxic and immune-stimulatory gene therapy for primary adult high-grade glioma: a phase 1, first-in-human trial. Lancet Oncol 2023; 24:1042-1052. [PMID: 37657463 DOI: 10.1016/s1470-2045(23)00347-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND High-grade gliomas have a poor prognosis and do not respond well to treatment. Effective cancer immune responses depend on functional immune cells, which are typically absent from the brain. This study aimed to evaluate the safety and activity of two adenoviral vectors expressing HSV1-TK (Ad-hCMV-TK) and Flt3L (Ad-hCMV-Flt3L) in patients with high-grade glioma. METHODS In this dose-finding, first-in-human trial, treatment-naive adults aged 18-75 years with newly identified high-grade glioma that was evaluated per immunotherapy response assessment in neuro-oncology criteria, and a Karnofsky Performance Status score of 70 or more, underwent maximal safe resection followed by injections of adenoviral vectors expressing HSV1-TK and Flt3L into the tumour bed. The study was conducted at the University of Michigan Medical School, Michigan Medicine (Ann Arbor, MI, USA). The study included six escalating doses of viral particles with starting doses of 1×1010 Ad-hCMV-TK viral particles and 1×109 Ad-hCMV-Flt3L viral particles (cohort A), and then 1×1011 Ad-hCMV-TK viral particles and 1×109 Ad-hCMV-Flt3L viral particles (cohort B), 1×1010 Ad-hCMV-TK viral particles and 1×1010 Ad-hCMV-Flt3L viral particles (cohort C), 1×1011 Ad-hCMV-TK viral particles and 1×1010 Ad-hCMV-Flt3L viral particles (cohort D), 1×1010 Ad-hCMV-TK viral particles and 1×1011 Ad-hCMV-Flt3L viral particles (cohort E), and 1×1011 Ad-hCMV-TK viral particles and 1×1011 Ad-hCMV-Flt3L viral particles (cohort F) following a 3+3 design. Two 1 mL tuberculin syringes were used to deliver freehand a mix of Ad-hCMV-TK and Ad-hCMV-Flt3L vectors into the walls of the resection cavity with a total injection of 2 mL distributed as 0·1 mL per site across 20 locations. Subsequently, patients received two 14-day courses of valacyclovir (2 g orally, three times per day) at 1-3 days and 10-12 weeks after vector administration and standad upfront chemoradiotherapy. The primary endpoint was the maximum tolerated dose of Ad-hCMV-Flt3L and Ad-hCMV-TK. Overall survival was a secondary endpoint. Recruitment is complete and the trial is finished. The trial is registered with ClinicalTrials.gov, NCT01811992. FINDINGS Between April 8, 2014, and March 13, 2019, 21 patients were assessed for eligibility and 18 patients with high-grade glioma were enrolled and included in the analysis (three patients in each of the six dose cohorts); eight patients were female and ten were male. Neuropathological examination identified 14 (78%) patients with glioblastoma, three (17%) with gliosarcoma, and one (6%) with anaplastic ependymoma. The treatment was well-tolerated, and no dose-limiting toxicity was observed. The maximum tolerated dose was not reached. The most common serious grade 3-4 adverse events across all treatment groups were wound infection (four events in two patients) and thromboembolic events (five events in four patients). One death due to an adverse event (respiratory failure) occurred but was not related to study treatment. No treatment-related deaths occurred during the study. Median overall survival was 21·3 months (95% CI 11·1-26·1). INTERPRETATION The combination of two adenoviral vectors demonstrated safety and feasibility in patients with high-grade glioma and warrants further investigation in a phase 1b/2 clinical trial. FUNDING Funded in part by Phase One Foundation, Los Angeles, CA, The Board of Governors at Cedars-Sinai Medical Center, Los Angeles, CA, and The Rogel Cancer Center at The University of Michigan.
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Affiliation(s)
- Yoshie Umemura
- Department of Neurology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Daniel Orringer
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Larry Junck
- Department of Neurology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Maria L Varela
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; Department of Cell and Developmental Biology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; The Rogel Cancer Center, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Molly E J West
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; Department of Cell and Developmental Biology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; The Rogel Cancer Center, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Syed M Faisal
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; Department of Cell and Developmental Biology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; The Rogel Cancer Center, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Andrea Comba
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; Department of Cell and Developmental Biology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; The Rogel Cancer Center, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Jason Heth
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Oren Sagher
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Denise Leung
- Department of Neurology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Aaron Mammoser
- Department of Neurology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Shawn Hervey-Jumper
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Daniel Zamler
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Viveka N Yadav
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Patrick Dunn
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Wajd Al-Holou
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Todd Hollon
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Michelle M Kim
- Department of Radiation Oncology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Daniel R Wahl
- Department of Radiation Oncology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Sandra Camelo-Piragua
- Department of Pathology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Andrew P Lieberman
- Department of Pathology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Sriram Venneti
- Department of Pathology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Paul McKeever
- Department of Pathology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Theodore Lawrence
- Department of Radiation Oncology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Ryo Kurokawa
- Department of Radiology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Karen Sagher
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - David Altshuler
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Lili Zhao
- Department of Biostatistics, The University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Karin Muraszko
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Maria G Castro
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; Department of Cell and Developmental Biology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; The Rogel Cancer Center, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Pedro R Lowenstein
- Department of Neurosurgery, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; Department of Cell and Developmental Biology, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; The Rogel Cancer Center, The University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; Department of Biomedical Engineering, University of Michigan School of Engineering, University of Michigan, Ann Arbor, MI, USA.
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Usui Y, Kurokawa R, Fukushima T, Fujita R, Hosoi R, Miyawaki E, Hayashi M, Kishisita S, Kurokawa M, Abe O, Yamada H. Ectopic pituitary neuroendocrine tumor arising in the sphenoid sinus with an avid 18F-fluorodeoxyglucose uptake masquerading as malignancy: A case report. Radiol Case Rep 2023; 18:2943-2947. [PMID: 37388528 PMCID: PMC10300046 DOI: 10.1016/j.radcr.2023.05.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/28/2023] [Indexed: 07/01/2023] Open
Abstract
Ectopic pituitary neuroendocrine tumors (PitNETs) are uncommon conditions that develop outside of the sella turcica. The sphenoid sinus is the most common site for ectopic PitNET, followed by the suprasellar region, clivus, and cavernous sinus. PitNETs, regardless of whether inside or outside sella, may display avid 18F-fluorodeoxyglucose (FDG) uptake and masquerade as malignant tumors. Herein, we report a case of ectopic PitNET arising in the sphenoid sinus, which was found as an FDG-avid mass during cancer screening. On magnetic resonance imaging, the tumor showed heterogeneous and intermediate signal intensity areas on T1- and T2-weighted images with cystic components, which was consistent with PitNET. The localization and the presence of empty sella were suggestive of ectopic PitNET, and the diagnosis of ectopic PitNET (prolactinoma) was confirmed by endoscopic biopsy. Ectopic PitNET should be considered in a mass similar in nature to an orthogonal PitNET in areas near the sella turcica especially in patients with empty sella.
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Affiliation(s)
- Yukiko Usui
- Department of Radiology, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ryo Kurokawa
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takahiro Fukushima
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Richi Fujita
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Reina Hosoi
- Department of Radiology, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
| | - Emi Miyawaki
- Department of Radiology, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
| | - Michio Hayashi
- Department of Diabetes and Endocrinology, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
| | - Sadahiro Kishisita
- Department of Otorhinolaryngology-Head and Neck Surgery, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
| | - Mariko Kurokawa
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Osamu Abe
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Haruyasu Yamada
- Department of Radiology, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
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Kurokawa R, Kurokawa M, Baba A, Nakaya M, Kato S, Bapuraj J, Nakata Y, Ota Y, Srinivasan A, Abe O, Moritani T. Neuroimaging of hypophysitis: etiologies and imaging mimics. Jpn J Radiol 2023; 41:911-927. [PMID: 37010787 PMCID: PMC10468747 DOI: 10.1007/s11604-023-01417-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/24/2023] [Indexed: 04/04/2023]
Abstract
Hypophysitis is an inflammatory disease affecting the pituitary gland. Hypophysitis can be classified into multiple types depending on the mechanisms (primary or secondary), histology (lymphocytic, granulomatous, xanthomatous, plasmacytic/IgG4 related, necrotizing, or mixed), and anatomy (adenohypophysitis, infundibulo-neurohypophysitis, or panhypophysitis). An appropriate diagnosis is vital for managing these potentially life-threatening conditions. However, physiological morphological alterations, remnants, and neoplastic and non-neoplastic lesions may masquerade as hypophysitis, both clinically and radiologically. Neuroimaging, as well as imaging findings of other sites of the body, plays a pivotal role in diagnosis. In this article, we will review the types of hypophysitis and summarize clinical and imaging features of both hypophysitis and its mimickers.
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Affiliation(s)
- Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA.
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Moto Nakaya
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shimpei Kato
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Jayapalli Bapuraj
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Yasuhiro Nakata
- Department Or Neuroradiology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042, Japan
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
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19
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Baba A, Kurokawa R, Kurokawa M, Srinivasan A. MRI features of sinonasal tract angiofibroma/juvenile nasopharyngeal angiofibroma: Case series and systematic review. J Neuroimaging 2023; 33:675-687. [PMID: 37164909 DOI: 10.1111/jon.13116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/30/2023] [Accepted: 05/01/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND AND PURPOSE To comprehensively summarize the radiological characteristics of sinonasal tract angiofibroma (STA) (commonly known as juvenile nasopharyngeal angiofibroma). METHODS Forty-four lesions from 41 cases provided by 33 study articles identified through a systematic review and 13 lesions from 13 cases from our institution associated with patients with STA who underwent MRI were included in the review study, carried out by two board-certified experienced radiologists. RESULTS The study participants were all male patients with a mean age of 15.6 years at the time of diagnosis. All of them presented with nasal cavity lesions (100%), predominantly in the nasopharynx (98.2%). The sphenopalatine foramen/pterygopalatine fossa was involved in 76.0%, and compressive shift of the posterolateral wall of the maxillary sinus was present in more than half (57.9%). T2-weighted imaging signal intensity was heterogeneous with mixed high and iso intensities as compared to skeletal muscle (100%). T1-weighted imaging showed partial high signal intensity in 61.1% of the cases. Flow void and intense enhancement were present in almost all cases. Cystic/nonenhancement changes on contrast-enhanced MRI were relatively common (40.8%). The mean apparent diffusion coefficient value (2.07 × 10-3 mm2 /second) and some quantitative dynamic contrast-enhanced MRI parameters were high. There was a significant difference in the frequency of residual/recurrent lesions based on the presence of MRI findings of skull base invasion (p = .017) and intracranial extension (p = .003). CONCLUSIONS We summarized the MRI findings of STA that can facilitate timely diagnosis and appropriate management.
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Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Radiology, The Jikei University School of Medicine, Minato-ku, Japan
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Radiology, The University of Tokyo, Bunkyo-ku, Japan
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Radiology, The University of Tokyo, Bunkyo-ku, Japan
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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20
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Lavrova A, Mishra S, Richardson J, Masotti M, Kurokawa R, Kurokawa M, Itriago-Leon P, Gulani V, McCracken B, Wright K, Hussain HK, Moritani T, Seiberlich N. Quality assessment of routine brain imaging at 0.55 T: initial experience in a clinical workflow. NMR Biomed 2023:e5017. [PMID: 37654047 DOI: 10.1002/nbm.5017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/20/2023] [Accepted: 07/16/2023] [Indexed: 09/02/2023]
Abstract
The purpose of this study was to assess the quality of clinical brain imaging in healthy subjects and patients on an FDA-approved commercial 0.55 T MRI scanner, and to provide information about the feasibility of using this scanner in a clinical workflow. In this IRB-approved study, brain examinations on the scanner were prospectively performed in 10 healthy subjects (February-April 2022) and retrospectively derived from 44 patients (February-July 2022). Images collected using the following pulse sequences were available for assessment: axial DWI (diffusion-weighted imaging), apparent diffusion coefficient maps, 2D axial fluid-attenuated inversion recovery images, axial susceptibility-weighted images (both magnitude and phase), sagittal T1 -weighted (T1w) Sampling Perfection with Application Optimized Contrast images, sagittal T1w MPRAGE (magnetization prepared rapid gradient echo) with contrast enhancement, axial T1w turbo spin echo (TSE) with and without contrast enhancement, and axial T2 -weighted TSE. Two readers retrospectively and independently evaluated image quality and specific anatomical features in a blinded fashion on a four-point Likert scale, with a score of 1 being unacceptable and 4 being excellent, and determined the ability to answer the clinical question in patients. For each category of image sequences, the mean, standard deviation, and percentage of unacceptable quality images (<2) were calculated. Acceptable (rating ≥ 2) image quality was achieved at 0.55 T in all sequences for patients and 85% of the sequences for healthy subjects. Radiologists were able to answer the clinical question in all patients scanned. In total, 50% of the sequences used in patients and about 60% of the sequences used in healthy subjects exhibited good (rating ≥ 3) image quality. Based on these findings, we conclude that diagnostic quality clinical brain images can be successfully collected on this commercial 0.55 T scanner, indicating that the routine brain imaging protocol may be deployed on this system in the clinical workflow.
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Affiliation(s)
- Anna Lavrova
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Shruti Mishra
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jacob Richardson
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Maria Masotti
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Ryo Kurokawa
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mariko Kurokawa
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Vikas Gulani
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Brendan McCracken
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Katherine Wright
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Hero K Hussain
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Toshio Moritani
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicole Seiberlich
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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Hagiwara A, Fujita S, Kurokawa R, Andica C, Kamagata K, Aoki S. Multiparametric MRI: From Simultaneous Rapid Acquisition Methods and Analysis Techniques Using Scoring, Machine Learning, Radiomics, and Deep Learning to the Generation of Novel Metrics. Invest Radiol 2023; 58:548-560. [PMID: 36822661 PMCID: PMC10332659 DOI: 10.1097/rli.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/10/2023] [Indexed: 02/25/2023]
Abstract
ABSTRACT With the recent advancements in rapid imaging methods, higher numbers of contrasts and quantitative parameters can be acquired in less and less time. Some acquisition models simultaneously obtain multiparametric images and quantitative maps to reduce scan times and avoid potential issues associated with the registration of different images. Multiparametric magnetic resonance imaging (MRI) has the potential to provide complementary information on a target lesion and thus overcome the limitations of individual techniques. In this review, we introduce methods to acquire multiparametric MRI data in a clinically feasible scan time with a particular focus on simultaneous acquisition techniques, and we discuss how multiparametric MRI data can be analyzed as a whole rather than each parameter separately. Such data analysis approaches include clinical scoring systems, machine learning, radiomics, and deep learning. Other techniques combine multiple images to create new quantitative maps associated with meaningful aspects of human biology. They include the magnetic resonance g-ratio, the inner to the outer diameter of a nerve fiber, and the aerobic glycolytic index, which captures the metabolic status of tumor tissues.
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Affiliation(s)
- Akifumi Hagiwara
- From theDepartment of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shohei Fujita
- From theDepartment of Radiology, Juntendo University School of Medicine, Tokyo, Japan
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Christina Andica
- From theDepartment of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Koji Kamagata
- From theDepartment of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- From theDepartment of Radiology, Juntendo University School of Medicine, Tokyo, Japan
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22
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Kurokawa R, Kurokawa M, Isshiki S, Harada T, Nakaya M, Baba A, Naganawa S, Kim J, Bapuraj J, Srinivasan A, Abe O, Moritani T. Dural and Leptomeningeal Diseases: Anatomy, Causes, and Neuroimaging Findings. Radiographics 2023; 43:e230039. [PMID: 37535461 DOI: 10.1148/rg.230039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Meningeal lesions can be caused by various conditions and pose diagnostic challenges. The authors review the anatomy of the meninges in the brain and spinal cord to provide a better understanding of the localization and extension of these diseases and summarize the clinical and imaging features of various conditions that cause dural and/or leptomeningeal enhancing lesions. These conditions include infectious meningitis (bacterial, tuberculous, viral, and fungal), autoimmune diseases (vasculitis, connective tissue diseases, autoimmune meningoencephalitis, Vogt-Koyanagi-Harada disease, neuro-Behçet syndrome, Susac syndrome, and sarcoidosis), primary and secondary tumors (meningioma, diffuse leptomeningeal glioneuronal tumor, melanocytic tumors, and lymphoma), tumorlike diseases (histiocytosis and immunoglobulin G4-related diseases), medication-induced diseases (immune-related adverse effects and posterior reversible encephalopathy syndrome), and other conditions (spontaneous intracranial hypotension, amyloidosis, and moyamoya disease). Although meningeal lesions may manifest with nonspecific imaging findings, correct diagnosis is important because the treatment strategy varies among these diseases. ©RSNA, 2023 Online supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article. Quiz questions for this article are available through the Online Learning Center.
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Affiliation(s)
- Ryo Kurokawa
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
| | - Mariko Kurokawa
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
| | - Saiko Isshiki
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
| | - Taisuke Harada
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
| | - Moto Nakaya
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
| | - Akira Baba
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
| | - Shotaro Naganawa
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
| | - John Kim
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
| | - Jayapalli Bapuraj
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
| | - Ashok Srinivasan
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
| | - Osamu Abe
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
| | - Toshio Moritani
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (R.K., M.K., A.B., S.N., J.K., J.B., A.S., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K., M.K., M.N., S.N., O.A.); Department of Radiology, Niizashiki Central General Hospital, Saitama, Japan (S.I.); and Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan (T.H.)
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23
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Koyama H, Kurokawa R, Kato S, Ishida M, Kuroda R, Ushiku T, Kume H, Abe O. MR imaging features to predict the type of bone metastasis in prostate cancer. Sci Rep 2023; 13:11580. [PMID: 37463944 DOI: 10.1038/s41598-023-38878-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 07/17/2023] [Indexed: 07/20/2023] Open
Abstract
Bone metastases (BMs) of prostate cancer (PCa) have been considered predominantly osteoblastic, but non-osteoblastic (osteolytic or mixed osteoblastic and osteolytic) BMs can occur. We investigated the differences in prostate MRI and clinical findings between patients with osteoblastic and non-osteoblastic BMs. Between 2014 and 2021, patients with pathologically proven PCa without a history of other malignancies were included in this study. Age, Gleason score, prostate-specific antigen (PSA) density, normalized mean apparent diffusion coefficient and normalized T2 signal intensity (nT2SI) of PCa, and Prostate Imaging Reporting and Data System category on MRI were compared between groups. A multivariate logistic regression analysis using factors with P-values < 0.2 was performed to detect the independent parameters for predicting non-osteoblastic BM group. Twenty-five (mean 73 ± 6.6 years) and seven (69 ± 13.1 years) patients were classified into the osteoblastic and non-osteoblastic groups, respectively. PSA density and nT2SI were significantly higher in the non-osteoblastic group than in the osteoblastic group. nT2SI was an independent predictive factor for non-osteoblastic BMs in the multivariate logistic regression analysis. These results indicated that PCa patients with high nT2SI and PSA density should be examined for osteolytic BMs.
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Affiliation(s)
- Hiroaki Koyama
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Shimpei Kato
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masanori Ishida
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ryohei Kuroda
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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24
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Kurokawa R, Kurokawa M, Baba A, Kim J, Srinivasan A, Moritani T. Dynamic susceptibility contrast perfusion-weighted and diffusion-weighted magnetic resonance imaging findings in pilocytic astrocytoma and H3.3 and H3.1 variant diffuse midline glioma, H3K27-altered. PLoS One 2023; 18:e0288412. [PMID: 37450487 PMCID: PMC10348548 DOI: 10.1371/journal.pone.0288412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVE This study compared the dynamic susceptibility contrast (DSC) magnetic resonance imaging parameters and apparent diffusion coefficient (ADC) between pilocytic astrocytoma (PA) and diffuse midline glioma, H3K27-altered (DMG) variants. METHODS The normalized relative cerebral blood volume (nrCBV), normalized relative flow (nrCBF), percentile signal recovery (PSR), and normalized mean ADC (nADCmean) of 23 patients with midline PAs (median age, 13 years [range, 1-71 years]; 13 female patients) and 40 patients with DMG (8.5 years [1-35 years]; 19 female patients), including 35 patients with H3.3- and five patients with H3.1-mutant tumors, treated between January 2016 and May 2022 were statistically compared. RESULTS DMG had a significantly lower nADCmean (median: 1.48 vs. 1.96; p = 0.00075) and lower PSR (0.97 vs. 1.23, p = 0.13) but higher nrCBV and nrCBF (1.66 vs. 1.17, p = 0.058, respectively, and 1.87 vs. 1.19, p = 0.028, respectively) than PA. The H3.3 variant had a lower nADCmean than the H3.1 variant (1.46 vs. 1.80, p = 0.10). CONCLUSION DMG had lower ADC and PSR and higher rCBV and rCBF than PA. The H3.3 variant had a lower ADC than the H3.1 variant. Recognizing the differences and similarities in the DSC parameters and ADC between these tumors may help presurgical diagnosis.
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Affiliation(s)
- Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, United States of America
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, United States of America
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, United States of America
| | - John Kim
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, United States of America
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, United States of America
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, United States of America
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25
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Baba A, Kurokawa R, Kurokawa M, Srinivasan A. Dynamic contrast-enhanced MRI parameters and apparent diffusion coefficient as treatment response markers of skull base osteomyelitis: a preliminary study. Pol J Radiol 2023; 88:e319-e324. [PMID: 37576380 PMCID: PMC10415807 DOI: 10.5114/pjr.2023.130383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/01/2023] [Accepted: 05/09/2023] [Indexed: 08/15/2023] Open
Abstract
Purpose Currently, there is no definitive consensus on the optimal imaging modality for determining the treatment response in patients with skull base osteomyelitis (SBO). This study aimed to investigate the utility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters and apparent diffusion coefficient (ADC) as treatment response markers of SBO. Material and methods This study included 6 patients with SBO, who underwent both pre- and post-treatment DCE-MRI and diffusion-weighted imaging (DWI). Quantitative DCE-MRI parameters and ADC of the region-of-interest were analysed. These normalized parameters were calculated by dividing the region-of-interest by the reference region. The Wilcoxon signed rank test was used to compare these parameters between pre- and post-treatment periods. Results The normalized fraction of the extravascular extracellular space (Ve) and ADC of the post-treatment status of SBO was significantly lower than those of pre-treatment measures (p = 0.03). The normalized fraction of blood plasma (Vp), normalized rate of transfer from the blood plasma into the extravascular extracellular space (Ktrans), and normalized backflow leakage of material from the extravascular extracellular space into the blood plasma (Kep) demonstrated no significant differences between pre- and post-treatment. Conclusions DCE-MRI parameters Ve and ADC demonstrated a significant reduction when comparing measures across the pre- and post-treatment periods. These parameters may potentially serve as a valuable surrogate treatment response marker for SBO activity.
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Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Michigan, United States
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Michigan, United States
- Department of Radiology, The University of Tokyo, Tokyo, Japan
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Michigan, United States
- Department of Radiology, The University of Tokyo, Tokyo, Japan
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Michigan, United States
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26
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Baba A, Kurokawa R, Rivera-de Choudens R, Kurokawa M, Ota Y, Srinivasan A. Diffusion and Perfusion Imaging in Post-Treatment Evaluation of the Head and Neck. Semin Roentgenol 2023; 58:347-354. [PMID: 37507174 DOI: 10.1053/j.ro.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/27/2023] [Accepted: 02/25/2023] [Indexed: 07/30/2023]
Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, 48109
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, 48109
| | | | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, 48109
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, 48109
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, 48109.
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Kurokawa M, Kurokawa R, Tamura K, Baba A, Ota Y, Nakaya M, Yokoyama K, Kim J, Moritani T, Abe O. Imaging Features of Ectopic Tissues and Their Complications: Embryologic and Anatomic Approach. Radiographics 2023; 43:e220111. [PMID: 37141139 DOI: 10.1148/rg.220111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Ectopic tissue is an anatomic abnormality in which tissue develops in an area outside its normal location. It is primarily caused by abnormalities during the process of embryologic development. Although the majority of individuals with ectopic tissues remain asymptomatic, various symptoms and associated complications can occur. Failure in normal embryologic development leads to loss of normal physiologic function or may result in harmful functions such as ectopic hormonal secretion in the ectopic pituitary adenoma. Ectopic tissues may also frequently mimic tumors. For example, developmental abnormalities in the pharyngeal pouches may result in an ectopic parathyroid gland and ectopic thymus, both of which are frequently misdiagnosed as tumors. Adequate knowledge of embryology is essential for understanding the differential diagnoses of ectopic tissues and facilitating appropriate management. The authors summarize the embryologic development and pathogenesis of ectopic tissues by using illustrations to facilitate a deeper understanding of embryologic development and anatomy. Characteristic imaging findings (US, CT, MRI, and scintigraphy) are described for ectopic tissues of the brain, head, neck, thorax, abdomen, and pelvis by focusing on common conditions that radiologists may encounter in daily practice and their differential diagnoses. ©RSNA, 2023 Quiz questions for this article are available through the Online Learning Center.
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Affiliation(s)
- Mariko Kurokawa
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (M.K., R.K., A.B., Y.O., J.K., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (M.K., R.K., M.N., O.A.); Department of Radiology, National Institutes for Quantum Science and Technology, Chiba, Japan (K.T.); and Department of Radiology and Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan (K.Y.)
| | - Ryo Kurokawa
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (M.K., R.K., A.B., Y.O., J.K., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (M.K., R.K., M.N., O.A.); Department of Radiology, National Institutes for Quantum Science and Technology, Chiba, Japan (K.T.); and Department of Radiology and Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan (K.Y.)
| | - Kentaro Tamura
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (M.K., R.K., A.B., Y.O., J.K., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (M.K., R.K., M.N., O.A.); Department of Radiology, National Institutes for Quantum Science and Technology, Chiba, Japan (K.T.); and Department of Radiology and Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan (K.Y.)
| | - Akira Baba
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (M.K., R.K., A.B., Y.O., J.K., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (M.K., R.K., M.N., O.A.); Department of Radiology, National Institutes for Quantum Science and Technology, Chiba, Japan (K.T.); and Department of Radiology and Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan (K.Y.)
| | - Yoshiaki Ota
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (M.K., R.K., A.B., Y.O., J.K., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (M.K., R.K., M.N., O.A.); Department of Radiology, National Institutes for Quantum Science and Technology, Chiba, Japan (K.T.); and Department of Radiology and Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan (K.Y.)
| | - Moto Nakaya
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (M.K., R.K., A.B., Y.O., J.K., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (M.K., R.K., M.N., O.A.); Department of Radiology, National Institutes for Quantum Science and Technology, Chiba, Japan (K.T.); and Department of Radiology and Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan (K.Y.)
| | - Kota Yokoyama
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (M.K., R.K., A.B., Y.O., J.K., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (M.K., R.K., M.N., O.A.); Department of Radiology, National Institutes for Quantum Science and Technology, Chiba, Japan (K.T.); and Department of Radiology and Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan (K.Y.)
| | - John Kim
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (M.K., R.K., A.B., Y.O., J.K., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (M.K., R.K., M.N., O.A.); Department of Radiology, National Institutes for Quantum Science and Technology, Chiba, Japan (K.T.); and Department of Radiology and Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan (K.Y.)
| | - Toshio Moritani
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (M.K., R.K., A.B., Y.O., J.K., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (M.K., R.K., M.N., O.A.); Department of Radiology, National Institutes for Quantum Science and Technology, Chiba, Japan (K.T.); and Department of Radiology and Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan (K.Y.)
| | - Osamu Abe
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (M.K., R.K., A.B., Y.O., J.K., T.M.); Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (M.K., R.K., M.N., O.A.); Department of Radiology, National Institutes for Quantum Science and Technology, Chiba, Japan (K.T.); and Department of Radiology and Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan (K.Y.)
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28
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Shimazaki K, Kurokawa R, Franson A, Kurokawa M, Baba A, Bou-Maroun L, Kim J, Moritani T. Neuroimaging features of FOXR2-activated CNS neuroblastoma: A case series and systematic review. J Neuroimaging 2023; 33:359-367. [PMID: 36806312 DOI: 10.1111/jon.13095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND AND PURPOSE CNS neuroblastoma, FOXR2-activated (CNS NB-FOXR2) is a newly recognized tumor type in the 2021 World Health Organization classification of central nervous system (CNS) tumors. We aimed to investigate the clinical and neuroimaging findings of CNS NB-FOXR2 and systematically review previous publications and three new cases. METHODS We searched PubMed, SCOPUS, and Embase databases for patients with pathologically proven CNS NB-FOXR2 with sufficient information for preoperative CT and MRI findings. Two board-certified radiologists reviewed the studies and imaging data. RESULTS Thirty-one patients from six previous publications and 3 patients from our hospital comprised the study population (median age, 4.2 [range: 1.4-16] years; 19 girls). Clinically, CNS NB-FOXR2 mainly affected children between 2 and 6 years (24/34, 67.6%). Nausea/vomiting and seizures were reported as the main presenting symptoms (100% in total). The tumors frequently showed hyperdensity compared to the cortex on nonenhanced CT (4/5, 80%) with calcification along the inner rim of the tumor (4/5, 80%). More than half of patients showed susceptibility artifacts indicating intratumoral hemorrhage and/or calcification (15/28, 53.6%) on T2*- and/or susceptibility-weighted imaging. Elevated relative cerebral blood volume and flow and percentile signal recovery were observed in one case with dynamic susceptibility contrast MRI. CONCLUSIONS Characteristic imaging features including hyperdense attenuation of the solid components and calcification along the inner rim on CT and susceptibility-weighted imaging may assist with preoperative diagnosis of CNS NB-FOXR2 in pediatric patients.
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Affiliation(s)
- Kenichiro Shimazaki
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Andrea Franson
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Ann Arbor, Michigan, USA
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Laura Bou-Maroun
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Ann Arbor, Michigan, USA
| | - John Kim
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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29
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Baba A, Kurokawa R, Kurokawa M, Reifeiss S, Policeni BA, Ota Y, Srinivasan A. Advanced imaging of head and neck infections. J Neuroimaging 2023. [PMID: 36922159 DOI: 10.1111/jon.13099] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/29/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/17/2023] Open
Abstract
When head and neck infection is suspected, appropriate imaging contributes to treatment decisions and prognosis. While contrast-enhanced CT is the standard imaging modality for evaluating head and neck infections, MRI can better characterize the skull base, intracranial involvement, and osteomyelitis, implying that these are complementary techniques for a comprehensive assessment. Both CT and MRI are useful in the evaluation of abscesses and thrombophlebitis, while MRI is especially useful in the evaluation of intracranial inflammatory spread/abscess formation, differentiation of abscess from other conditions, evaluation of the presence and activity of inflammation and osteomyelitis, evaluation of mastoid extension in middle ear cholesteatoma, and evaluation of facial neuritis and labyrinthitis. Apparent diffusion coefficient derived from diffusion-weighted imaging is useful for differential diagnosis and treatment response of head and neck infections in various anatomical sites. Dynamic contrast-enhanced MRI perfusion may be useful in assessing the activity of skull base osteomyelitis. MR bone imaging may be of additional value in evaluating bony structures of the skull base and jaw. Dual-energy CT is helpful in reducing metal artifacts, evaluating deep neck abscess, and detecting salivary stones. Subtraction CT techniques are used to detect progressive bone-destructive changes and to reduce dental amalgam artifacts. This article provides a region-based approach to the imaging evaluation of head and neck infections, using both conventional and advanced imaging techniques.
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Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Scott Reifeiss
- Department of Radiology, Roy Caver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Bruno A Policeni
- Department of Radiology, Roy Caver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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Kurokawa R, Kurokawa M, Mitsutake A, Nakaya M, Baba A, Nakata Y, Moritani T, Abe O. Clinical and neuroimaging review of triplet repeat diseases. Jpn J Radiol 2023; 41:115-130. [PMID: 36169768 PMCID: PMC9889482 DOI: 10.1007/s11604-022-01343-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/18/2022] [Indexed: 02/04/2023]
Abstract
Triplet repeat diseases (TRDs) refer to a group of diseases caused by three nucleotide repeats elongated beyond a pathologic threshold. TRDs are divided into the following four groups depending on the pathomechanisms, although the pathomechanisms of several diseases remain unelucidated: polyglutamine disorders, caused by a pathologic repeat expansion of CAG (coding the amino acid glutamine) located within the exon; loss-of-function repeat disorders, characterized by the common feature of a loss of function of the gene within which they occur; RNA gain-of-function disorders, involving the production of a toxic RNA species; and polyalanine disorders, caused by a pathologic repeat expansion of GCN (coding the amino acid alanine) located within the exon. Many of these TRDs manifest through neurologic symptoms; moreover, neuroimaging, especially brain magnetic resonance imaging, plays a pivotal role in the detection of abnormalities, differentiation, and management of TRDs. In this article, we reviewed the clinical and neuroimaging features of TRDs. An early diagnosis of TRDs through clinical and imaging approaches is important and may contribute to appropriate medical intervention for patients and their families.
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Affiliation(s)
- Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan ,Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109 USA
| | - Mariko Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan ,Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109 USA
| | - Akihiko Mitsutake
- Department of Neurology, International University of Health and Welfare, Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329 Japan
| | - Moto Nakaya
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109 USA
| | - Yasuhiro Nakata
- Department of Neuroradiology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo 183-0042 Japan
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109 USA
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
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Kurokawa M, Kurokawa R, Baba A, Kim J, Tournade C, Mchugh J, Trobe JD, Srinivasan A, Bapuraj JR, Moritani T. Deadly Fungi: Invasive Fungal Rhinosinusitis in the Head and Neck. Radiographics 2023; 43:e229015. [PMID: 36490211 DOI: 10.1148/rg.229015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Baba A, Kurokawa R, Kurokawa M, Ota Y, Srinivasan A. Dynamic Contrast-Enhanced MRI Parameters and Normalized ADC Values Could Aid Differentiation of Skull Base Osteomyelitis from Nasopharyngeal Cancer. AJNR Am J Neuroradiol 2023; 44:74-78. [PMID: 36521963 PMCID: PMC9835913 DOI: 10.3174/ajnr.a7740] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE The skull base osteomyelitis sometimes can be difficult to distinguish from nasopharyngeal cancer. This study aimed to investigate the differences between skull base osteomyelitis and nasopharyngeal cancer using dynamic contrast-enhanced MR imaging and normalized ADC values. MATERIALS AND METHODS This study included 8 and 12 patients with skull base osteomyelitis and nasopharyngeal cancer, respectively, who underwent dynamic contrast-enhanced MR imaging and DWI before primary treatment. Quantitative dynamic contrast-enhanced MR imaging parameters and ADC values of the ROIs were analyzed. Normalized ADC parameters were calculated by dividing the ROIs of the lesion by that of the spinal cord. RESULTS The rate transfer constant between extravascular extracellular space and blood plasma per minute (Kep) was significantly lower in patients with skull base osteomyelitis than in those with nasopharyngeal cancer (median, 0.43 versus 0.57; P = .04). The optimal cutoff value of Kep was 0.48 (area under the curve, 0.78; 95% CI, 0.55-1). The normalized mean ADC was significantly higher in patients with skull base osteomyelitis than in those with nasopharyngeal cancer (median, 1.90 versus 0.87; P < .001). The cutoff value of normalized mean ADC was 1.55 (area under the curve, 0.96; 95% CI, 0.87-1). The area under the curve of the combination of dynamic contrast-enhanced MR imaging parameters (Kep and extravascular extracellular space volume per unit tissue volume) was 0.89 (95% CI, 0.73-1), and the area under the curve of the combination of dynamic contrast-enhanced MR imaging parameters and normalized mean ADC value was 0.98 (95% CI, 0.93-1). CONCLUSIONS Quantitative dynamic contrast-enhanced MR imaging parameters and normalized ADC values may be useful in differentiating skull base osteomyelitis and nasopharyngeal cancer. The combination of dynamic contrast-enhanced MR imaging parameters and normalized ADC values outperformed each measure in isolation.
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Affiliation(s)
- A Baba
- From the Division of Neuroradiology (A.B., R.K., M.K., Y.O., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
- Department of Radiology (A.B.), The Jikei University School of Medicine, Tokyo, Japan
| | - R Kurokawa
- From the Division of Neuroradiology (A.B., R.K., M.K., Y.O., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - M Kurokawa
- From the Division of Neuroradiology (A.B., R.K., M.K., Y.O., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Y Ota
- From the Division of Neuroradiology (A.B., R.K., M.K., Y.O., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - A Srinivasan
- From the Division of Neuroradiology (A.B., R.K., M.K., Y.O., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
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Kurokawa M, Kurokawa R, Lin AY, Capizzano AA, Baba A, Kim J, Johnson TD, Srinivasan A, Moritani T. Neurological and Neuroradiological Manifestations in Neonates Born to Mothers With Coronavirus Disease 2019. Pediatr Neurol 2022; 141:9-17. [PMID: 36731229 PMCID: PMC9741496 DOI: 10.1016/j.pediatrneurol.2022.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 11/07/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND To investigate the complications that occurred in neonates born to mothers with coronavirus disease 2019 (COVID-19), focusing on neurological and neuroradiological findings, and to compare differences associated with the presence of maternal symptoms. METHODS Ninety neonates from 88 mothers diagnosed with coronavirus disease 2019 (COVID-19) during pregnancy were retrospectively reviewed. Neonates were divided into two groups: symptomatic (Sym-M-N, n = 34) and asymptomatic mothers (Asym-M-N, n = 56). The results of neurological physical examinations were compared between the groups. Data on electroencephalography, brain ultrasound, and magnetic resonance imaging abnormalities were collected for neonates with neurological abnormalities. RESULTS Neurological abnormalities at birth were found in nine neonates (Sym-M-N, seven of 34, 20.6%). Decreased tone was the most common physical abnormality (n = 7). Preterm and very preterm birth (P < 0.01), very low birth weight (P < 0.01), or at least one neurological abnormality on physical examination (P = 0.049) was more frequent in Sym-M-N neonates. All infants with abnormalities on physical examination showed neuroradiological abnormalities. The most common neuroradiological abnormalities were intracranial hemorrhage (n = 5; germinal matrix, n = 2; parenchymal, n = 2; intraventricular, n = 1) and hypoxic brain injury (n = 3). CONCLUSIONS Neonates born to mothers with symptomatic COVID-19 showed an increased incidence of neurological abnormalities. Most of the mothers (96.4%) were unvaccinated before the COVID-19 diagnosis. Our results highlight the importance of neurological and neuroradiological management in infants born to mothers with COVID-19 and the prevention of maternal COVID-19 infection.
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Affiliation(s)
- Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan.
| | - Ava Yun Lin
- Division of Neurology, University of Michigan, Ann Arbor, Michigan
| | - Aristides A Capizzano
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - John Kim
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Timothy D Johnson
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
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Kawakibi AR, Tarapore R, Gardner S, Chi A, Kurz S, Wen PY, Arrillaga-Romany I, Batchelor T, Butowski N, Sumrall A, Shonka N, Harrison R, DeGroot J, Mehta M, Odia Y, Hall M, Daghistani D, Cloughesy T, Ellingson B, Kim M, Umemura Y, Garton H, Franson A, Schwartz J, Li S, Cartaxo R, Ravi K, Cantor E, Cummings J, Paul A, Walling D, Dun M, Cain J, Li J, Filbin M, Zhao L, Kumar-Sinha C, Mody R, Chinnaiyan A, Kurokawa R, Pratt D, Venneti S, Grill J, Kline C, Mueller S, Resnick AC, Nazarian J, Waszak S, Allen JE, Koschmann C. CTNI-61. CLINICAL EFFICACY AND PREDICTIVE BIOMARKERS OF ONC201 IN H3K27M-MUTANT DIFFUSE MIDLINE GLIOMA. Neuro Oncol 2022. [PMCID: PMC9660897 DOI: 10.1093/neuonc/noac209.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Patients with H3K27M-mutated diffuse midline glioma (DMG) have no proven effective therapies beyond radiation. ONC201, a DRD2 antagonist and mitochondrial ClpP agonist, has shown promise in this population. Clinical and genetic variables associated with ONC201 response in H3K27M-mutant DMG continue to be investigated. A combined clinical and genetic study evaluated patients with H3K27M-DMG treated with single-agent ONC201 at the established phase 2 dose. Clinical outcomes of patients treated on two recently completed multi-site clinical studies (NCT03416530 and NCT03134131, n = 75) were compared with historical control data from patients with confirmed H3K27M-DMG (n = 391 total, n = 119 recurrent). Patients treated with ONC201 monotherapy following initial radiation, but prior to recurrence, demonstrated a median overall survival (OS) of 25.6 months from diagnosis and recurrent patients demonstrated a median OS of 16.2 months from recurrence, both of these more than doubling historical outcomes. Using a Cox model to correct for age, gender and tumor location, OS of ONC201-treated patients with H3K27M-mutant tumors remained significantly better than non-ONC201-treated historical controls (p = 0.0001). A survival and radiographic analysis based on tumor location, revealed stronger responses in thalamic patients. In patients with thalamic tumors treated after initial radiation (n = 16), median OS was not reached with median follow up of 22.1 months (historical control median OS of 12.5 months, n = 83, p = 0.0001). Significant correlations were found between baseline cerebral blood flow (CBF) on perfusion imaging and OS (Pearson’s r = 0.75, p = 0.003) and between nrCBF and PFS (r = 0.77, p = 0.002). Baseline tumor sequencing from treated patients (n = 20) demonstrates EGFR mutation (n = 3) and high EGFR expression as a marker of resistance and improved response in tumors with MAPK-pathway alterations (n = 5). In conclusion, ONC201 demonstrates unprecedented clinical and radiographic efficacy in H3K27M-mutant DMG with outcomes enriched in patients with thalamic tumors, treatment prior to recurrence, MAPK-pathway alterations, and patients with relatively high CBF.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Nicholas Butowski
- Department of Neurological Surgery, University of California San Francisco , San Francisco, CA , USA
| | - Ashley Sumrall
- Atrium Health Levine Cancer Institute, , Charlotte, NC , USA
| | | | - Rebecca Harrison
- Dept Neuro-Oncology, University of Texas MD Anderson Cancer Center , Houston, TX , USA
| | - John DeGroot
- University of Texas MD Anderson Cancer Center , Houston , USA
| | | | | | - Matthew Hall
- Miami Cancer Institute, Baptist Health South Florida , Miami , USA
| | | | | | | | | | | | | | - Andrea Franson
- C. S. Mott Children's Hospital, University of Michigan , Ann Arbor, MI , USA
| | | | | | | | | | | | | | | | | | - Matthew Dun
- Cancer Signalling Research Group, School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle , Callaghan, NSW , Australia
| | - Jason Cain
- Hudson Institute of Medical Research , Clayton, VIC , Australia
| | - Jiang Li
- Dana-Farber Boston Children’s Cancer and Blood Disorders Center , Boston , USA
| | - Mariella Filbin
- Dana-Farber Boston Children’s Cancer and Blood Disorders Center , Boston , USA
| | | | | | - Rajen Mody
- University of Michigan , Ann Arbor , USA
| | | | | | - Drew Pratt
- Center for Cancer Research, National Cancer Institute , Bethesda , USA
| | | | - Jacques Grill
- Gustave Roussy and University Paris-Saclay , Villejuif , USA
| | - Cassie Kline
- Children's Hospital of Philadelphia , Philadelphia , USA
| | - Sabine Mueller
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco , San Francisco, CA , USA
| | - Adam C Resnick
- Children's Hospital of Philadelphia , Philadelphia , USA
| | - Javad Nazarian
- Department of Oncology, Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland , Zurich , Switzerland
| | | | | | - Carl Koschmann
- Department of Pediatrics, Michigan Medicine , Ann Arbor, MI , USA
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Kurokawa R, Kurokawa M, Baba A, Kim J, Capizzano A, Bapuraj J, Srinivasan A, Moritani T. NIMG-90. DIFFERENTIATION OF INTRACRANIAL SOLITARY FIBROUS TUMOR AND MENINGIOMA ON CONVENTIONAL, DIFFUSION-WEIGHTED, AND DYNAMIC SUSCEPTIBILITY CONTRAST PERFUSION MRI. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac209.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
BACKGROUND AND PURPOSE
To evaluate the differences in the imaging findings of intracranial solitary fibrous tumor (SFT) and meningioma on dynamic susceptibility contrast (DSC) perfusion MRI, apparent diffusion coefficient (ADC), and conventional sequences.
METHODS
Between January 2016 and April 2022, the study enrolled 14 (median, 46 years [range, 25–74]; six females; seven with DSC-MRI) and 27 patients (median, 53 years [21–83]; 23 females; all with DSC-MRI) with pathologically proven SFT and meningioma, respectively. The normalized relative cerebral blood volume and flow (nrCBV and nrCBF), percentage signal recovery (PSR), normalized mean ADC (nADCmean), and conventional imaging features, including T1-weighted hyperintensity, were evaluated and statistically compared using Bonferonni correction.
RESULTS
PSR was significantly lower in SFT compared with that in meningioma (median, 22.5 [range, 6.4–48.8] vs. 70.1 [range, 18.6–104.2], p< 0.001). The majority of SFT showed mainly T1-weighted hyperintensities compared to the gray matter, while only one meningioma showed the finding (8/14 [57.1%] vs. 1/27 [3.7%], p< 0.001). No significant difference was observed in nrCBV, nrCBF, or nADCmean.
CONCLUSIONS
PFS was significantly lower in intracranial SFT compared with that in meningioma, indicating the difference in capillary permeability between the tumors. Comparing the hyperintensity on T1WI of the solid components with that of the cerebral cortex was a simple and useful characteristic to differentiate SFT from meningioma.
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Affiliation(s)
| | | | - Akira Baba
- University of Michigan , Ann Arbor, MI , USA
| | - John Kim
- University of Michigan , Ann Arbor, MI , USA
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Kurokawa R, Kurokawa M, Baba A, Kim J, Capizzano A, Bapuraj J, Srinivasan A, Moritani T. Differentiation of pilocytic astrocytoma, medulloblastoma, and hemangioblastoma on diffusion-weighted and dynamic susceptibility contrast perfusion MRI. Medicine (Baltimore) 2022; 101:e31708. [PMID: 36343086 PMCID: PMC9646672 DOI: 10.1097/md.0000000000031708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This study aimed to evaluate the diagnostic performance of dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging and apparent diffusion coefficient (ADC) for differentiating common posterior fossa tumors, pilocytic astrocytoma (PA), medulloblastoma (MB), and hemangioblastoma (HB). Between January 2016 and April 2022, we enrolled 23 (median age, 7 years [range, 2-26]; 12 female), 13 (10 years [1-24]; 3 female), and 12 (43 years [23-73]; 7 female) patients with PA, MB, and HB, respectively. Normalized relative cerebral blood volume and flow (nrCBV and nrCBF) and normalized mean ADC (nADCmean) were calculated from volume-of-interest and statistically compared. nADCmean was significantly higher in PA than in MB (PA: median, 2.2 [range, 1.59-2.65] vs MB: 0.93 [0.70-1.37], P < .001). nrCBF was significantly higher in HB than in PA and MB (PA: 1.10 [0.54-2.26] vs MB: 1.62 [0.93-3.16] vs HB: 7.83 [2.75-20.1], all P < .001). nrCBV was significantly different between all 3 tumor types (PA: 0.89 [0.34-2.28] vs MB: 1.69 [0.93-4.23] vs HB: 8.48 [4.59-16.3], P = .008 for PA vs MB; P < .001 for PA vs HB and MB vs HB). All tumors were successfully differentiated using an algorithmic approach with a threshold value of 4.58 for nrCBV and subsequent threshold value of 1.38 for nADCmean. DSC parameters and nADCmean were significantly different between PA, MB, and HB. An algorithmic approach combining nrCBV and nADCmean may be useful for differentiating these tumor types.
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Affiliation(s)
- Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
- * Correspondence: Ryo Kurokawa, Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109, USA (e-mail: )
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - John Kim
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Aristides Capizzano
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jayapalli Bapuraj
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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Kurokawa R, Kurokawa M, Holmes A, Baba A, Bapuraj J, Capizzano A, Kim J, Srinivasan A, Moritani T. Skull metastases and osseous venous malformations: The role of diffusion-weighted and dynamic contrast-enhanced MRI. J Neuroimaging 2022; 32:1170-1176. [PMID: 35922879 DOI: 10.1111/jon.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/01/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND PURPOSE Skull metastasis (SM) is a common secondary malignancy. We evaluated the diagnostic performance of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (MRI) in differentiating SM from osseous venous malformations and SM of various origins. METHODS This study included 31 patients with SM (median age, 64 years; range, 41-87 years; 29 women; 24 and 7 patients with breast and non-small cell lung cancer, respectively) and 16 with osseous venous malformations (median age, 68 years; range, 20-81 years; 10 women) who underwent both DWI and dynamic contrast-enhanced MRI between January 2015 and October 2021. Normalized mean apparent diffusion coefficients (ADCs) and dynamic contrast-enhanced MRI parameters were compared between SM and osseous venous malformations, and between breast cancer and non-small cell lung cancer. Multivariate stepwise logistic regression analyses were performed to identify statistically significant parameters. RESULTS Plasma volume and time-to-maximum enhancement were the most statistically significant parameters for differentiating SM from osseous venous malformations, with an area under the receiver operating characteristic curve of 0.962. The normalized mean ADC and peak enhancement values were the most statistically significant parameters for differentiating breast cancer from non-small cell lung cancer, with an area under the curve of 0.924. CONCLUSIONS Our results highlight the efficacious diagnostic performance of DWI and dynamic contrast-enhanced MRI in distinguishing SM from osseous venous malformations and differentiating SM of various origins.
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Affiliation(s)
- Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Adam Holmes
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jayapalli Bapuraj
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Aristides Capizzano
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - John Kim
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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Kurokawa R, Kato S, Koyama H, Ishida M, Kurokawa M, Kuroda R, Ushiku T, Kume H, Abe O. Osteolytic or mixed bone metastasis is not uncommon in patients with high-grade prostate cancer. Eur J Radiol 2022; 157:110595. [DOI: 10.1016/j.ejrad.2022.110595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/18/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022]
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Kurokawa M, Kurokawa R, Baba A, Kim J, Tournade C, Mchugh J, Trobe JD, Srinivasan A, Bapuraj JR, Moritani T. Deadly Fungi: Invasive Fungal Rhinosinusitis in the Head and Neck. Radiographics 2022; 42:2075-2094. [PMID: 36178803 DOI: 10.1148/rg.220059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Invasive fungal rhinosinusitis (IFRS) is a serious infection that is associated with high morbidity and mortality rates. The incidence of IFRS has been increasing, mainly because of the increased use of antibiotics and immunosuppressive drugs. Rhino-orbital cerebral mucormycosis has recently reemerged among patients affected by COVID-19 and has become a global concern. The detection of extrasinus involvement in its early stage contributes to improved outcomes; therefore, imaging studies are essential in establishing the degree of involvement and managing the treatment properly, especially in immunocompromised patients. The common sites of extrasinus fungal invasion are the intraorbital, cavernous sinus, and intracranial regions. Fungi spread directly to these regions along the blood vessels or nerves, causing devastating complications such as optic nerve ischemia or compression, optic neuritis or perineuritis, orbital cellulitis, cavernous sinus thrombosis, mycotic aneurysm, vasculitis, internal carotid arterial occlusion, cerebral infarction, cerebritis, and brain abscess. IFRS has a broad imaging spectrum, and familiarity with intra- and extrasinonasal imaging features, such as loss of contrast enhancement of the affected region, which indicates tissue ischemia due to angioinvasion of fungi, and the surrounding anatomy is essential for prompt diagnosis and management. The authors summarize the epidemiology, etiology, risk factors, and complications of IFRS and review the anatomy and key diagnostic imaging features of IFRS beyond the sinonasal regions. ©RSNA, 2022.
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Affiliation(s)
- Mariko Kurokawa
- From the Division of Neuroradiology, Department of Radiology (M.K., R.K., A.B., J.K., C.T., A.S., J.R.B., T.M.), Department of Pathology, Michigan Medicine (J.M.), and Kellogg Eye Center, Department of Ophthalmology and Visual Sciences and Department of Neurology (J.D.T.), University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K.)
| | - Ryo Kurokawa
- From the Division of Neuroradiology, Department of Radiology (M.K., R.K., A.B., J.K., C.T., A.S., J.R.B., T.M.), Department of Pathology, Michigan Medicine (J.M.), and Kellogg Eye Center, Department of Ophthalmology and Visual Sciences and Department of Neurology (J.D.T.), University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K.)
| | - Akira Baba
- From the Division of Neuroradiology, Department of Radiology (M.K., R.K., A.B., J.K., C.T., A.S., J.R.B., T.M.), Department of Pathology, Michigan Medicine (J.M.), and Kellogg Eye Center, Department of Ophthalmology and Visual Sciences and Department of Neurology (J.D.T.), University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K.)
| | - John Kim
- From the Division of Neuroradiology, Department of Radiology (M.K., R.K., A.B., J.K., C.T., A.S., J.R.B., T.M.), Department of Pathology, Michigan Medicine (J.M.), and Kellogg Eye Center, Department of Ophthalmology and Visual Sciences and Department of Neurology (J.D.T.), University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K.)
| | - Christopher Tournade
- From the Division of Neuroradiology, Department of Radiology (M.K., R.K., A.B., J.K., C.T., A.S., J.R.B., T.M.), Department of Pathology, Michigan Medicine (J.M.), and Kellogg Eye Center, Department of Ophthalmology and Visual Sciences and Department of Neurology (J.D.T.), University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K.)
| | - Jonathan Mchugh
- From the Division of Neuroradiology, Department of Radiology (M.K., R.K., A.B., J.K., C.T., A.S., J.R.B., T.M.), Department of Pathology, Michigan Medicine (J.M.), and Kellogg Eye Center, Department of Ophthalmology and Visual Sciences and Department of Neurology (J.D.T.), University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K.)
| | - Jonathan D Trobe
- From the Division of Neuroradiology, Department of Radiology (M.K., R.K., A.B., J.K., C.T., A.S., J.R.B., T.M.), Department of Pathology, Michigan Medicine (J.M.), and Kellogg Eye Center, Department of Ophthalmology and Visual Sciences and Department of Neurology (J.D.T.), University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K.)
| | - Ashok Srinivasan
- From the Division of Neuroradiology, Department of Radiology (M.K., R.K., A.B., J.K., C.T., A.S., J.R.B., T.M.), Department of Pathology, Michigan Medicine (J.M.), and Kellogg Eye Center, Department of Ophthalmology and Visual Sciences and Department of Neurology (J.D.T.), University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K.)
| | - Jayapalli Rajiv Bapuraj
- From the Division of Neuroradiology, Department of Radiology (M.K., R.K., A.B., J.K., C.T., A.S., J.R.B., T.M.), Department of Pathology, Michigan Medicine (J.M.), and Kellogg Eye Center, Department of Ophthalmology and Visual Sciences and Department of Neurology (J.D.T.), University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K.)
| | - Toshio Moritani
- From the Division of Neuroradiology, Department of Radiology (M.K., R.K., A.B., J.K., C.T., A.S., J.R.B., T.M.), Department of Pathology, Michigan Medicine (J.M.), and Kellogg Eye Center, Department of Ophthalmology and Visual Sciences and Department of Neurology (J.D.T.), University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (R.K.)
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Gardner SL, Tarapore RS, Allen J, McGovern SL, Zaky W, Odia Y, Daghistani D, Diaz Z, Hall MD, Khatib Z, Koschmann C, Cantor E, Kurokawa R, MacDonald TJ, Aguilera D, Fouladi M, Vitanza NA, Mueller S, Kline C, Lu G, Allen JE, Khatua S. Phase 1 dose escalation and expansion trial of single agent ONC201 in pediatric diffuse midline gliomas following radiotherapy. Neurooncol Adv 2022; 4:vdac143. [PMID: 36382108 PMCID: PMC9639395 DOI: 10.1093/noajnl/vdac143] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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] [Indexed: 11/28/2022] Open
Abstract
Background ONC201, a dopamine receptor D2 (DRD2) antagonist and caseinolytic protease P (ClpP) agonist, has induced durable tumor regressions in adults with recurrent H3 K27M-mutant glioma. We report results from the first phase I pediatric clinical trial of ONC201. Methods This open-label, multi-center clinical trial (NCT03416530) of ONC201 for pediatric H3 K27M-mutant diffuse midline glioma (DMG) or diffuse intrinsic pontine glioma (DIPG) employed a dose-escalation and dose-expansion design. The primary endpoint was the recommended phase II dose (RP2D). A standard 3 + 3 dose escalation design was implemented. The target dose was the previously established adult RP2D (625 mg), scaled by body weight. Twenty-two pediatric patients with DMG/DIPG were treated following radiation; prior lines of systemic therapy in addition to radiation were permitted providing sufficient time had elapsed prior to study treatment. Results The RP2D of orally administered ONC201 in this pediatric population was determined to be the adult RP2D (625 mg), scaled by body weight; no dose-limiting toxicities (DLT) occurred. The most frequent treatment-emergent Grade 1-2 AEs were headache, nausea, vomiting, dizziness and increase in alanine aminotransferase. Pharmacokinetics were determined following the first dose: T1/2, 8.4 h; Tmax, 2.1 h; Cmax, 2.3 µg/mL; AUC0-tlast, 16.4 hµg/mL. Median duration of treatment was 20.6 weeks (range 5.1-129). Five (22.7%) patients, all of whom initiated ONC201 following radiation and prior to recurrence, were alive at 2 years from diagnosis. Conclusions The adult 625 mg weekly RP2D of ONC201 scaled by body weight was well tolerated. Further investigation of ONC201 for DMG/DIPG is warranted.
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Affiliation(s)
- Sharon L Gardner
- NYU Langone Medical Center and School of Medicine , New York, NY
| | | | - Jeffrey Allen
- NYU Langone Medical Center and School of Medicine , New York, NY
| | | | - Wafik Zaky
- The University of Texas MD Anderson Cancer Center , Houston, TX
| | - Yazmin Odia
- Miami Cancer Institute, Baptist Health South Florida , Miami, FL
| | | | - Zuanel Diaz
- Miami Cancer Institute, Baptist Health South Florida , Miami, FL
| | - Matthew D Hall
- Miami Cancer Institute, Baptist Health South Florida , Miami, FL
- Nicklaus Children’s Hospital , Miami, FL
| | | | - Carl Koschmann
- Michigan Medicine, University of Michigan Medical School , Ann Arbor, MI
| | - Evan Cantor
- Michigan Medicine, University of Michigan Medical School , Ann Arbor, MI
| | - Ryo Kurokawa
- Michigan Medicine, University of Michigan Medical School , Ann Arbor, MI
| | - Tobey J MacDonald
- Children’s Healthcare of Atlanta, Emory University School of Medicine , Atlanta, GA
| | - Dolly Aguilera
- Children’s Healthcare of Atlanta, Emory University School of Medicine , Atlanta, GA
| | - Maryam Fouladi
- Cincinnati Children’s Hospital , Cincinnati, OH
- Nationwide Children’s Hospital in Columbus , Ohio
| | - Nicholas A Vitanza
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute , Seattle, WA
- Department of Pediatrics, Seattle Children’s Hospital, University of Washington , Seattle, WA
| | | | - Cassie Kline
- University of California , San Francisco, SF
- Children's Hospital of Philadelphia , Philadelphia, PA
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Kurokawa R, Baba A, Kurokawa M, Capizzano A, Ota Y, Kim J, Srinivasan A, Moritani T. Perfusion and diffusion-weighted imaging parameters: Comparison between pre- and postbiopsy MRI for high-grade glioma. Medicine (Baltimore) 2022; 101:e30183. [PMID: 36107564 PMCID: PMC9439799 DOI: 10.1097/md.0000000000030183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We aimed to evaluate the differences in dynamic susceptibility contrast (DSC)- magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) parameters between the pre- and postbiopsy MRI obtained before treatment in patients with diffuse midline glioma, H3K27-altered. The data of 25 patients with pathologically proven diffuse midline glioma, H3K27-altered, were extracted from our hospital's database between January 2017 and August 2021. Twenty (median age, 13 years; range, 3-52 years; 12 women) and 8 (13.5 years; 5-68 years; 1 woman) patients underwent preoperative DSC-MRI and DWI before and after biopsy, respectively. The normalized corrected relative cerebral blood volume (ncrCBV), normalized relative cerebral blood flow (nrCBF), and normalized maximum, mean, and minimum apparent diffusion coefficient (ADC) were calculated using the volumes-of-interest of the tumor and normal-appearing reference region. The macroscopic postbiopsy changes (i.e., biopsy tract, tissue defect, and hemorrhage) were meticulously excluded from the postbiopsy measurements. The DSC-MRI and DWI parameters of the pre- and postbiopsy groups were compared using the Mann-Whitney U test. The ncrCBV was significantly lower in the postbiopsy group than in the prebiopsy group [prebiopsy group: median 1.293 (range, 0.513 to 2.547) versus postbiopsy group: 0.877 (0.748 to 1.205), P = .016]. No significant difference was observed in the nrCBF and normalized ADC values, although the median nrCBF was lower in the postbiopsy group. The DSC-MRI parameters differed between the pre- and postbiopsy MRI obtained pretreatment, although the macroscopic postbiopsy changes were carefully excluded from the analysis. The results emphasize the potential danger of integrating and analyzing DSC-MRI parameters derived from pre- and postbiopsy MRI.
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Affiliation(s)
- Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI
- *Correspondence: Ryo Kurokawa, Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109 (e-mail: )
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI
| | - Aristides Capizzano
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI
| | - John Kim
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI
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Ota Y, Liao E, Capizzano AA, Baba A, Kurokawa R, Kurokawa M, Srinivasan A. Differentiation of Skull Base Chondrosarcomas, Chordomas, and Metastases: Utility of DWI and Dynamic Contrast-Enhanced Perfusion MR Imaging. AJNR Am J Neuroradiol 2022; 43:1325-1332. [PMID: 35953276 PMCID: PMC9451640 DOI: 10.3174/ajnr.a7607] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 06/28/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE Differentiation of skull base tumors, including chondrosarcomas, chordomas, and metastases, on conventional imaging remains a challenge. We aimed to test the utility of DWI and dynamic contrast-enhanced MR imaging for skull base tumors. MATERIALS AND METHODS Fifty-nine patients with chondrosarcomas, chordomas, or metastases between January 2015 and October 2021 were included in this retrospective study. Pretreatment normalized mean ADC and dynamic contrast-enhanced MR imaging parameters were calculated. The Kruskal-Wallis H test for all tumor types and the Mann-Whitney U test for each pair of tumors were used. RESULTS Fifteen chondrosarcomas (9 men; median age, 62 years), 14 chordomas (6 men; median age, 47 years), and 30 metastases (11 men; median age, 61 years) were included in this study. Fractional plasma volume helped distinguish all 3 tumor types (P = .003, <.001, and <.001, respectively), whereas the normalized mean ADC was useful in distinguishing chondrosarcomas from chordomas and metastases (P < .001 and P < .001, respectively); fractional volume of extracellular space, in distinguishing chondrosarcomas from metastases (P = .02); and forward volume transfer constant, in distinguishing metastases from chondrosarcomas/chondroma (P = .002 and .002, respectively) using the Kruskal-Wallis H test. The diagnostic performances of fractional plasma volume for each pair of tumors showed areas under curve of 0.86-0.99 (95% CI, 0.70-1.0); the forward volume transfer constant differentiated metastases from chondrosarcomas/chordomas with areas under curve of 0.82 and 0.82 (95% CI, 0.67-0.98), respectively; and the normalized mean ADC distinguished chondrosarcomas from chordomas/metastases with areas under curve of 0.96 and 0.95 (95% CI, 0.88-1.0), respectively. CONCLUSIONS DWI and dynamic contrast-enhanced MR imaging sequences can be beneficial for differentiating the 3 common skull base tumors.
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Affiliation(s)
- Y Ota
- From the Division of Neuroradiology (Y.O., E.L., A.A.C., A.B., R.K., M.K., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - E Liao
- From the Division of Neuroradiology (Y.O., E.L., A.A.C., A.B., R.K., M.K., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - A A Capizzano
- From the Division of Neuroradiology (Y.O., E.L., A.A.C., A.B., R.K., M.K., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - A Baba
- From the Division of Neuroradiology (Y.O., E.L., A.A.C., A.B., R.K., M.K., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
- Department of Radiology (A.B.), Jikei University School of Medicine Ringgold standard institution, Tokyo, Japan
| | - R Kurokawa
- From the Division of Neuroradiology (Y.O., E.L., A.A.C., A.B., R.K., M.K., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
- Department of Radiology (R.K.), The University of Tokyo Hospital, Tokyo, Japan
| | - M Kurokawa
- From the Division of Neuroradiology (Y.O., E.L., A.A.C., A.B., R.K., M.K., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
- Department of Radiology (M.K.), Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Ringgold standard institution, Bunkyo-ku, Japan
| | - A Srinivasan
- From the Division of Neuroradiology (Y.O., E.L., A.A.C., A.B., R.K., M.K., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
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Baba A, Kurokawa R, Rawie E, Kurokawa M, Ota Y, Srinivasan A. Normalized Parameters of Dynamic Contrast-Enhanced Perfusion MRI and DWI-ADC for Differentiation between Posttreatment Changes and Recurrence in Head and Neck Cancer. AJNR Am J Neuroradiol 2022; 43:1184-1189. [PMID: 35835592 PMCID: PMC9575415 DOI: 10.3174/ajnr.a7567] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/22/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Differentiating recurrence from benign posttreatment changes has clinical importance in the imaging follow-up of head and neck cancer. This study aimed to investigate the utility of normalized dynamic contrast-enhanced MR imaging and ADC for their differentiation. MATERIALS AND METHODS This study included 51 patients with a history of head and neck cancer who underwent follow-up dynamic contrast-enhanced MR imaging with DWI-ADC, of whom 25 had recurrences and 26 had benign posttreatment changes. Quantitative and semiquantitative dynamic contrast-enhanced MR imaging parameters and ADC of the ROI and reference region were analyzed. Normalized dynamic contrast-enhanced MR imaging parameters and normalized DWI-ADC parameters were calculated by dividing the ROI by the reference region. RESULTS Normalized plasma volume, volume transfer constant between extravascular extracellular space and blood plasma per minute (K trans), area under the curve, and wash-in were significantly higher in patients with recurrence than in those with benign posttreatment change (P = .003 to <.001). The normalized mean ADC was significantly lower in patients with recurrence than in those with benign posttreatment change (P < .001). The area under the receiver operating characteristic curve of the combination of normalized dynamic contrast-enhanced MR imaging parameters with significance (normalized plasma volume, normalized extravascular extracellular space volume per unit tissue volume, normalized K trans, normalized area under the curve, and normalized wash-in) and normalized mean ADC was 0.97 (95% CI, 0.93-1). CONCLUSIONS Normalized dynamic contrast-enhanced MR imaging parameters, normalized mean ADC, and their combination were effective in differentiating recurrence and benign posttreatment changes in head and neck cancer.
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Affiliation(s)
- A Baba
- From the Division of Neuroradiology (A.B., R.K., M.K., Y.O., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - R Kurokawa
- From the Division of Neuroradiology (A.B., R.K., M.K., Y.O., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - E Rawie
- Department of Radiology (E.R.), Brooke Army Medical Center, San Antonio, Texas
| | - M Kurokawa
- From the Division of Neuroradiology (A.B., R.K., M.K., Y.O., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Y Ota
- From the Division of Neuroradiology (A.B., R.K., M.K., Y.O., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - A Srinivasan
- From the Division of Neuroradiology (A.B., R.K., M.K., Y.O., A.S.), Department of Radiology, University of Michigan, Ann Arbor, Michigan
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Baba A, Kurokawa R, Fukuda T, Fujioka H, Kurokawa M, Fukasawa N, Sonobe S, Omura K, Matsushima S, Ota Y, Yamauchi H, Shimizu K, Kurata N, Srinivasan A, Ojiri H. Radiological features of human papillomavirus-related multiphenotypic sinonasal carcinoma: systematic review and case series. Neuroradiology 2022; 64:2049-2058. [PMID: 35833947 DOI: 10.1007/s00234-022-03009-5] [Citation(s) in RCA: 2] [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: 04/14/2022] [Accepted: 07/02/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To comprehensively summarize the radiological characteristics of human papillomavirus (HPV)-related multiphenotypic sinonasal carcinomas (HMSCs). METHODS We reviewed the findings for patients with HMSCs who underwent computed tomography (CT) and/or magnetic resonance imaging (MRI) and included nine cases from nine publications that were identified through a systematic review and three cases from our institution. Two board-certified radiologists reviewed and evaluated the radiological images. RESULTS The locations in almost all cases included the nasal cavity (11/12, 91.7%). The involved paranasal sinuses included the ethmoid sinus (6/12, 50.0%) and maxillary sinus (3/12, 25.0%). The mean long diameter of the tumors was 46.3 mm. The margins in 91.7% (11/12) of the cases were well-defined and smooth. Heterogeneous enhancement on contrast-enhanced CT, heterogeneous high signal intensities on T2-weighted images and heterogeneous enhancement on gadolinium-enhanced T1-weighted images were noted in 2/2, 5/5, and 8/8 cases, respectively. Mean apparent diffusion coefficient values in two cases of our institution were 1.17 and 1.09 × 10-3 mm2/s. Compressive changes in the surrounding structures were common (75%, 9/12). Few cases showed intraorbital or intracranial extension. None of the cases showed a perineural spread, neck lymph node metastasis, or remote lesions. CONCLUSIONS We summarized the CT and MRI findings of HMSCs. Knowledge of such characteristics is expected to facilitate prompt diagnosis and appropriate management.
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Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA. .,Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Takeshi Fukuda
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroaki Fujioka
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Nei Fukasawa
- Department of Pathology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shoko Sonobe
- Department of Pathology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Satoshi Matsushima
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Hideomi Yamauchi
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kanichiro Shimizu
- Department of Radiology, The Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa-shi, Chiba, 277-8567, Japan
| | - Naoki Kurata
- Department of Radiology, The Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa-shi, Chiba, 277-8567, Japan
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
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Kurokawa R, Kurokawa M, Baba A, Ota Y, Pinarbasi E, Camelo-Piragua S, Capizzano AA, Liao E, Srinivasan A, Moritani T. Major Changes in 2021 World Health Organization Classification of Central Nervous System Tumors. Radiographics 2022; 42:1474-1493. [PMID: 35802502 DOI: 10.1148/rg.210236] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The World Health Organization (WHO) published the fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5) in 2021, as an update of the WHO central nervous system (CNS) classification system published in 2016. WHO CNS5 was drafted on the basis of recommendations from the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT-NOW) and expounds the classification scheme of the previous edition, which emphasized the importance of genetic and molecular changes in the characteristics of CNS tumors. Multiple newly recognized tumor types, including those for which there is limited knowledge regarding neuroimaging features, are detailed in WHO CNS5. The authors describe the major changes introduced in WHO CNS5, including revisions to tumor nomenclature. For example, WHO grade IV tumors in the fourth edition are equivalent to CNS WHO grade 4 tumors in the fifth edition, and diffuse midline glioma, H3 K27M-mutant, is equivalent to midline glioma, H3 K27-altered. With regard to tumor typing, isocitrate dehydrogenase (IDH)-mutant glioblastoma has been modified to IDH-mutant astrocytoma. In tumor grading, IDH-mutant astrocytomas are now graded according to the presence or absence of homozygous CDKN2A/B deletion. Moreover, the molecular mechanisms of tumorigenesis, as well as the clinical characteristics and imaging features of the tumor types newly recognized in WHO CNS5, are summarized. Given that WHO CNS5 has become the foundation for daily practice, radiologists need to be familiar with this new edition of the WHO CNS tumor classification system. Online supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article. ©RSNA, 2022.
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Affiliation(s)
- Ryo Kurokawa
- From the Division of Neuroradiology, Department of Radiology (R.K., M.K., A.B., Y.O., A.A.C., E.L., A.S., T.M.) and Department of Pathology (E.P., S.C.P.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (R.K., M.K.)
| | - Mariko Kurokawa
- From the Division of Neuroradiology, Department of Radiology (R.K., M.K., A.B., Y.O., A.A.C., E.L., A.S., T.M.) and Department of Pathology (E.P., S.C.P.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (R.K., M.K.)
| | - Akira Baba
- From the Division of Neuroradiology, Department of Radiology (R.K., M.K., A.B., Y.O., A.A.C., E.L., A.S., T.M.) and Department of Pathology (E.P., S.C.P.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (R.K., M.K.)
| | - Yoshiaki Ota
- From the Division of Neuroradiology, Department of Radiology (R.K., M.K., A.B., Y.O., A.A.C., E.L., A.S., T.M.) and Department of Pathology (E.P., S.C.P.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (R.K., M.K.)
| | - Emile Pinarbasi
- From the Division of Neuroradiology, Department of Radiology (R.K., M.K., A.B., Y.O., A.A.C., E.L., A.S., T.M.) and Department of Pathology (E.P., S.C.P.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (R.K., M.K.)
| | - Sandra Camelo-Piragua
- From the Division of Neuroradiology, Department of Radiology (R.K., M.K., A.B., Y.O., A.A.C., E.L., A.S., T.M.) and Department of Pathology (E.P., S.C.P.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (R.K., M.K.)
| | - Aristides A Capizzano
- From the Division of Neuroradiology, Department of Radiology (R.K., M.K., A.B., Y.O., A.A.C., E.L., A.S., T.M.) and Department of Pathology (E.P., S.C.P.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (R.K., M.K.)
| | - Eric Liao
- From the Division of Neuroradiology, Department of Radiology (R.K., M.K., A.B., Y.O., A.A.C., E.L., A.S., T.M.) and Department of Pathology (E.P., S.C.P.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (R.K., M.K.)
| | - Ashok Srinivasan
- From the Division of Neuroradiology, Department of Radiology (R.K., M.K., A.B., Y.O., A.A.C., E.L., A.S., T.M.) and Department of Pathology (E.P., S.C.P.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (R.K., M.K.)
| | - Toshio Moritani
- From the Division of Neuroradiology, Department of Radiology (R.K., M.K., A.B., Y.O., A.A.C., E.L., A.S., T.M.) and Department of Pathology (E.P., S.C.P.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (R.K., M.K.)
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Baba A, Kurokawa R, Kurokawa M, McHugh JB, Hines C, Ota Y, Srinivasan A. The relationship between contrast-enhanced computed tomography features of hard palate cancer and pathologic depth of invasion. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:649-657. [DOI: 10.1016/j.oooo.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/04/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
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Ota Y, Liao E, Capizzano AA, Baba A, Kurokawa R, Kurokawa M, Srinivasan A. Intracranial paragangliomas versus schwannomas: Role of dynamic susceptibility contrast perfusion and diffusion MRI. J Neuroimaging 2022; 32:875-883. [PMID: 35562184 PMCID: PMC9546409 DOI: 10.1111/jon.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/22/2022] [Revised: 04/09/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Differentiating paragangliomas from schwannomas and distinguishing sporadic from neurofibromatosis type 2 (NF 2)-related schwannomas is challenging but clinically important. This study aimed to assess the utility of dynamic susceptibility contrast perfusion MRI (DSC-MRI) and diffusion-weighted imaging (DWI) in discriminating infratentorial extra-axial schwannomas from paragangliomas and NF2-related schwannomas. METHODS This retrospective study included 41 patients diagnosed with paragangliomas, sporadic schwannomas, and NF2-related schwannomas in the infratentorial extra-axial space between April 2013 and August 2021. All cases had pretreatment DSC-MRI and DWI. Normalized mean apparent diffusion coefficient (nADCmean), normalized relative cerebral blood volume (nrCBV), and normalized relative cerebral blood flow (nrCBF) were compared between paragangliomas and schwannomas and between sporadic and NF2-related schwannomas as appropriate. RESULTS nrCBV and nrCBF were significantly higher in paragangliomas than in sporadic/NF2-related schwannomas (nrCBV: median 11.5 vs. 1.14/3.74; p < .001 and .004, nrCBF: median 7.43 vs. 1.13/2.85; p < .001 and .007, respectively), while nADCmean were not. The corresponding diagnostic performances were area under the curves (AUCs) of .99/.92 and 1.0/.90 with cutoffs of 2.56/4.22 and 1.94/3.36, respectively. nADCmean were lower, and nrCBV and nrCBF were higher in NF2-related than in sporadic schwannomas (nADCmean: median 1.23 vs. 1.58, nrCBV: median 3.74 vs. 1.14, nrCBF: median 2.85 vs. 1.13; all p < .001), and the corresponding diagnostic performances were AUCs of .93, .91, and .95 with cutoffs of 1.37, 2.63, and 2.48, respectively. CONCLUSIONS DSC-MRI and DWI both can aid in differentiating paragangliomas from schwannomas and sporadic from NF2-related schwannomas.
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Affiliation(s)
- Yoshiaki Ota
- Department of Radiology, Division of Neuroradiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Eric Liao
- Department of Radiology, Division of Neuroradiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Aristides A Capizzano
- Department of Radiology, Division of Neuroradiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Akira Baba
- Department of Radiology, Division of Neuroradiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ryo Kurokawa
- Department of Radiology, Division of Neuroradiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mariko Kurokawa
- Department of Radiology, Division of Neuroradiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashok Srinivasan
- Department of Radiology, Division of Neuroradiology, University of Michigan, Ann Arbor, Michigan, USA
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Kurokawa R, Baba A, Emile P, Kurokawa M, Ota Y, Kim J, Capizzano A, Srinivasan A, Moritani T. Neuroimaging features of angiocentric glioma: A case series and systematic review. J Neuroimaging 2022; 32:389-399. [PMID: 35201652 PMCID: PMC9306893 DOI: 10.1111/jon.12983] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 12/29/2021] [Revised: 01/20/2022] [Accepted: 02/14/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND PURPOSE Angiocentric gliomas (AGs) are epileptogenic low-grade gliomas in young patients. We aimed to investigate the MRI findings of AGs and systematically review previous publications and three new cases. METHODS We searched PubMed, Elsevier's abstract and citation database, and Embase databases and included 50 patients with pathologically proven AGs with analyzable preoperative MRI including 3 patients from our institution and 47 patients from 38 publications (median age, 13 years [range, 2-83 years]; 35 men). Two board-certified radiologists reviewed all images. The relationships between seizure/epilepsy history and MRI findings were statistically analyzed. Moreover, clinical and imaging differences were evaluated between supratentorial and brainstem AGs. RESULTS Intratumoral T1-weighted high-intensity areas, stalk-like signs, and regional brain parenchymal atrophy were observed in 23 out of 50 (46.0%), 10 out of 50 (20.0%), and 14 out of 50 (28.0%) patients, respectively. Intratumoral T1-weighted high-intensity areas were observed significantly more frequently in patients with stalk-like signs (positive, 9/10 vs. negative, 14/40, p = .0031) and regional atrophy (13/14 vs. 10/36, p = .0001). There were significant relationships between the length of seizure/epilepsy history and presence of intratumoral T1-weighted high-intensity area (median 3 years vs. 0.5 years, p = .0021), stalk-like sign (13.5 vs. 1 year, p < .0001), and regional atrophy (14 vs. 0.5 years, p < .0001). Patients with brainstem AGs (n = 7) did not have a seizure/epilepsy history and were significantly younger than those with supratentorial AGs (median, 5 vs. 13 years, p < .0001, respectively). CONCLUSIONS Intratumoral T1-weighted high-intensity areas, stalk-like signs, and regional brain atrophy were frequent imaging features in AG. We also found that affected age was different between supratentorial and brainstem AGs.
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Affiliation(s)
- Ryo Kurokawa
- Division of Neuroradiology, Department of RadiologyUniversity of MichiganAnn ArborMichiganUSA
| | - Akira Baba
- Division of Neuroradiology, Department of RadiologyUniversity of MichiganAnn ArborMichiganUSA
| | - Pinarbasi Emile
- Department of PathologyUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of RadiologyUniversity of MichiganAnn ArborMichiganUSA
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of RadiologyUniversity of MichiganAnn ArborMichiganUSA
| | - John Kim
- Division of Neuroradiology, Department of RadiologyUniversity of MichiganAnn ArborMichiganUSA
| | - Aristides Capizzano
- Division of Neuroradiology, Department of RadiologyUniversity of MichiganAnn ArborMichiganUSA
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of RadiologyUniversity of MichiganAnn ArborMichiganUSA
| | - Toshio Moritani
- Division of Neuroradiology, Department of RadiologyUniversity of MichiganAnn ArborMichiganUSA
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Baba A, Kurokawa R, Fukuda T, Kurokawa M, Tsuyumu M, Matsushima S, Ota Y, Yamauchi H, Ojiri H, Srinivasan A. Comprehensive radiological features of laryngeal sarcoidosis: cases series and systematic review. Neuroradiology 2022; 64:1239-1248. [PMID: 35246700 DOI: 10.1007/s00234-022-02922-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 12/15/2021] [Accepted: 02/20/2022] [Indexed: 12/18/2022]
Abstract
PURPOSE To comprehensively summarize the characteristic radiological findings of laryngeal sarcoidosis. METHODS We reviewed patients with laryngeal sarcoidosis who underwent computed tomography (CT) and/or magnetic resonance imaging (MRI) and included 8 cases from 8 publications that were found through a systematic review and 6 cases from our institutions. Two board-certified radiologists reviewed and evaluated the radiological images. RESULTS Almost all cases exhibited supraglottic lesions 13/14 (92.9%) and most of them involved aryepiglottic folds (12/13, 92.3%), epiglottis (11/14, 78.6%), and arytenoid region (10/14, 71.4%). Most lesions were bilateral (12/14, 85.7%). All cases showed well-defined margins and a diffuse swelling appearance (14/14, 100%). Non-contrast CT revealed a low density (4/5, 80%). The contrast-enhanced CT showed a slight patchy enhancement predominantly at the margin of the lesion in most cases (12/13, 92.3%). In one case, T2-weighted images showed high signal intensity peripherally and low signal intensity centrally (1/1, 100%). Gadolinium-enhanced MRI showed moderate heterogeneous enhancement predominantly at the margin of the lesion (2/2, 100%). In one case, diffusion-weighted imaging showed intermediate signal intensity; the apparent diffusion coefficient value was 2.4 × 10-3 mm2/s. The larynx was the only region affected by sarcoidosis in 57.1% (8/14) of the cases. Involvement of the neck lymph nodes and distant organs was observed in 4/14 (28.6%) patients, respectively. CONCLUSION We summarized the CT and MRI findings of patients with laryngeal sarcoidosis. Knowledge of these characteristics is expected to facilitate prompt diagnosis and appropriate management.
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Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA. .,Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Takeshi Fukuda
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Matsusato Tsuyumu
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Satoshi Matsushima
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Hideomi Yamauchi
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
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Ota Y, Leung D, Lin E, Liao E, Kurokawa R, Kurokawa M, Baba A, Yokota H, Bathla G, Moritani T, Srinivasan A, Capizzano A. Prognostic Factors of Stroke-Like Migraine Attacks after Radiation Therapy (SMART) Syndrome. AJNR Am J Neuroradiol 2022; 43:396-401. [PMID: 35177545 PMCID: PMC8910816 DOI: 10.3174/ajnr.a7424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/10/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Prognostic factors of stroke-like migraine attacks after radiation therapy (SMART) syndrome have not been fully explored. This study aimed to assess clinical and imaging features to predict the clinical outcome of SMART syndrome. MATERIALS AND METHODS We retrospectively reviewed the clinical manifestations and imaging findings of 20 patients with SMART syndrome (median age, 48 years; 5 women) from January 2016 to January 2020 at 4 medical centers. Patient demographics and MR imaging features at the time of diagnosis were reviewed. This cohort was divided into 2 groups based on the degree of clinical improvement (completely versus incompletely recovered). The numeric and categoric variables were compared as appropriate. RESULTS There were statistically significant differences between the completely recovered group (n = 11; median age, 44 years; 2 women) and the incompletely recovered group (n = 9; median age, 55 years; 3 women) in age, months of follow-up, and the presence of steroid treatment at diagnosis (P = .028, .002, and .01, respectively). Regarding MR imaging features, there were statistically significant differences in the presence of linear subcortical WM susceptibility abnormality, restricted diffusion, and subcortical WM edematous changes in the acute SMART region (3/11 versus 8/9, P = .01; 0/11 versus 4/9, P = .026; and 2/11 versus 7/9, P = .022, respectively). Follow-up MRIs showed persistent susceptibility abnormality (11/11) and subcortical WM edematous changes (9/9), with resolution of restricted diffusion (4/4). CONCLUSIONS Age, use of steroid treatment at the diagnosis of SMART syndrome, and MR imaging findings of abnormal susceptibility signal, restricted diffusion, and subcortical WM change in the acute SMART region can be prognostic factors in SMART syndrome.
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Affiliation(s)
- Y. Ota
- From the Division of Neuroradiology (Y.O., E. Liao, R.K., M.K., A.B., T.M., A.S., A.A.C.)
| | - D. Leung
- Department of Radiology and Division of Neuro-Oncology (D.L.), Department of Neurology, University of Michigan, Ann Arbor, Michigan
| | - E. Lin
- Division of Neuroradiology (E. Lin), Department of Radiology, University of Rochester Medical Center, Rochester, New York
| | - E. Liao
- From the Division of Neuroradiology (Y.O., E. Liao, R.K., M.K., A.B., T.M., A.S., A.A.C.)
| | - R. Kurokawa
- From the Division of Neuroradiology (Y.O., E. Liao, R.K., M.K., A.B., T.M., A.S., A.A.C.)
| | - M. Kurokawa
- From the Division of Neuroradiology (Y.O., E. Liao, R.K., M.K., A.B., T.M., A.S., A.A.C.)
| | - A. Baba
- From the Division of Neuroradiology (Y.O., E. Liao, R.K., M.K., A.B., T.M., A.S., A.A.C.)
| | - H. Yokota
- Department of Diagnostic Radiology and Radiation Oncology (H.Y.), Graduate School of Medicine, Chiba University, Chiba, Japan
| | - G. Bathla
- Division of Neuroradiology (G.B.), Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - T. Moritani
- From the Division of Neuroradiology (Y.O., E. Liao, R.K., M.K., A.B., T.M., A.S., A.A.C.)
| | - A. Srinivasan
- From the Division of Neuroradiology (Y.O., E. Liao, R.K., M.K., A.B., T.M., A.S., A.A.C.)
| | - A.A. Capizzano
- From the Division of Neuroradiology (Y.O., E. Liao, R.K., M.K., A.B., T.M., A.S., A.A.C.)
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