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Hu LS, Smits M, Kaufmann TJ, Knutsson L, Rapalino O, Galldiks N, Sundgrene PC, Cha S. Advanced Imaging in the Diagnosis and Response Assessment of High-Grade Glioma: AJR Expert Panel Narrative Review. AJR Am J Roentgenol 2024. [PMID: 38477525 DOI: 10.2214/ajr.23.30612] [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: 03/14/2024]
Abstract
This AJR Expert Panel Narrative explores the current status of advanced MRI and PET techniques for the post-therapeutic response assessment of high-grade adult-type gliomas, focusing on ongoing clinical controversies in current practice. Discussed techniques that complement conventional MRI and aid the differentiation of recurrent tumor from post-treatment effects include DWI and diffusion tensor imaging; perfusion MRI techniques including dynamic susceptibility contrast (DSC), dynamic contrast-enhanced MRI, and arterial spin labeling; MR spectroscopy including assessment of 2-hydroxyglutarate (2HG) concentration; glucose- and amino acid (AA)-based PET; and amide proton transfer imaging. Updated criteria for Response Assessment in Neuro-Oncology are presented. Given the abundant supporting clinical evidence, the panel supports a recommendation that routine response assessment after HGG treatment should include perfusion MRI, particularly given the development of a consensus recommended DSC-MRI protocol. Although published studies support 2HG MRS and AA PET, these techniques' widespread adoption will likely require increased availability (for 2HG MRS) or increased insurance funding in the United States (for AA PET). The article concludes with a series of consensus opinions from the author panel, centered on the clinical integration of the advanced imaging techniques into posttreatment surveillance protocols.
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Affiliation(s)
- Leland S Hu
- Department of Radiology, Mayo Clinic, Phoenix, AZ
- Department of Cancer Biology, Mayo Clinic, Phoenix, AZ
- Department of Neurological Surgery, Mayo Clinic, Phoenix, AZ
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- Medical Delta, Delft, The Netherlands
| | | | - Linda Knutsson
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Otto Rapalino
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Norbert Galldiks
- Dept. of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
- Inst. of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich, Germany
- Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne, and Duesseldorf, Cologne, Germany
| | - Pia C Sundgrene
- Institution of Clinical Sciences Lund/Radiology, Lund University, Lund Sweden
- Lund BioImaging Center, Lund University, Lud, Sweden
- Department of Medical Imaging and Function Skane University hospital, Lund, Sweden
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
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Reddy S, Cha S, LaHue SC. Clinical Reasoning: A 22-Year-Old Man With Multifocal Brain and Osseous Lesions. Neurology 2023; 101:1025-1031. [PMID: 37813582 PMCID: PMC10727208 DOI: 10.1212/wnl.0000000000207918] [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: 04/25/2023] [Accepted: 08/24/2023] [Indexed: 10/14/2023] Open
Abstract
The evaluation of patients with disseminated processes with CNS and osseous involvement is often challenging. A 22-year-old healthy man developed left-sided weakness, paresthesias, and neck pain over several weeks. On clinical examination, he was noted to have decreased right eye visual acuity, left-sided pyramidal weakness and numbness, and bilateral hyperreflexia. MRI revealed multifocal widespread abnormalities: nonenhancing lesions throughout the infratentorial brain, pituitary gland, right frontal lobe, and optic nerves, in addition to an enhancing intramedullary cervical spinal cord lesion, extensive nodular leptomeningeal enhancement of the spine, and numerous enhancing bony lesions throughout the vertebrae and iliac bones. CSF analysis was notable for normal opening pressure, protein 465 mg/dL, glucose 21 mg/dL, and normal cell count. Extensive serum and CSF analysis for infectious, inflammatory, and neoplastic etiologies was unrevealing, and the diagnosis was ultimately revealed after additional staining of tissue biopsy specimen from sacral and cerebellar biopsies. This case highlights the differential diagnoses for widely disseminated disease affecting the CNS and bones and informs pediatric and adult clinicians of important recent developments regarding this diagnostic entity.
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Affiliation(s)
- Sumanth Reddy
- From the Department of Neurology (S.R., S.C.), School of Medicine, Department of Neurology (S.R., S.C.), UCSF Weill Institute for Neurosciences, and Neuroradiology Section (S.C.L.), Department of Radiology and Biomedical Imaging, University of California, San Francisco.
| | - Soonmee Cha
- From the Department of Neurology (S.R., S.C.), School of Medicine, Department of Neurology (S.R., S.C.), UCSF Weill Institute for Neurosciences, and Neuroradiology Section (S.C.L.), Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Sara C LaHue
- From the Department of Neurology (S.R., S.C.), School of Medicine, Department of Neurology (S.R., S.C.), UCSF Weill Institute for Neurosciences, and Neuroradiology Section (S.C.L.), Department of Radiology and Biomedical Imaging, University of California, San Francisco
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Jung J, Oh Y, Cha S, Ohe J. An analysis of contributing factors of head and neck space infections of odontogenic origin: A long-term retrospective clinical study (including COVID-19 pandemic period). Med Oral Patol Oral Cir Bucal 2023; 28:e622-e629. [PMID: 37330958 PMCID: PMC10635621 DOI: 10.4317/medoral.26018] [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: 03/12/2023] [Accepted: 05/15/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND The purpose of this study is to investigate predisposing factors for the head and neck infections (HNIs), regarding to the demographic data, anatomical spaces, microbiology and antibiotic sensitivity for affected patients. MATERIAL AND METHODS A 13-year of retrospective study evaluating 470 patients with HNIs, treated as inpatient management in the Department of Oral and Maxillofacial Surgery of KyungHee University school of Dentistry, Seoul, Korea, from January 2009 to February 2022. Statistical analysis of demographic, time-related, anatomic, microbiologic, and treatment variables were investigated for each patient. RESULTS The frequency of HNIs was significantly higher in 50's in males, followed by 70's in females. High Severity score (SS) were significantly associated with increased LOH (Length of hospital stay) and LOM (Length of medication), while LOH showed more intensive relationship compared with LOM. The most frequently involved space in abscess was submandibular space, though incidence and severity of HNIs shows declining tendency throughout 13-year research. Streptococcus viridans was the most predominant species isolated from pus culture growth, and a combination of ampicillin and sulbactam was the 1st choice of antibiotics intravenously. According to the comparison analysis between recommended antibiotics from resistance testing result and clinically administered antibiotics, final coincidence rate was estimated about 55%. CONCLUSIONS Due to HNIs being multifactorial, predicting progression and management of HNIs is still a challenge for oral and maxillofacial surgeons. The present study showed several predisposing factors of SHNIs and their correlations, which could contribute to earlier diagnosis and more effective treatment planning for clinicians, thereby leading to the improvement of prognosis for patients, ultimately.
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Affiliation(s)
- J Jung
- Department of Oral and Maxillofacial Surgery 02447 Seoul, Republic of Korea
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Young JS, Al-Adli N, Scotford K, Cha S, Berger MS. Pseudoprogression versus true progression in glioblastoma: what neurosurgeons need to know. J Neurosurg 2023; 139:748-759. [PMID: 36790010 PMCID: PMC10412732 DOI: 10.3171/2022.12.jns222173] [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: 09/19/2022] [Accepted: 12/12/2022] [Indexed: 02/16/2023]
Abstract
Management of patients with glioblastoma (GBM) is complex and involves implementing standard therapies including resection, radiation therapy, and chemotherapy, as well as novel immunotherapies and targeted small-molecule inhibitors through clinical trials and precision medicine approaches. As treatments have advanced, the radiological and clinical assessment of patients with GBM has become even more challenging and nuanced. Advances in spatial resolution and both anatomical and physiological information that can be derived from MRI have greatly improved the noninvasive assessment of GBM before, during, and after therapy. Identification of pseudoprogression (PsP), defined as changes concerning for tumor progression that are, in fact, transient and related to treatment response, is critical for successful patient management. These temporary changes can produce new clinical symptoms due to mass effect and edema. Differentiating this entity from true tumor progression is a major decision point in the patient's management and prognosis. Providers may choose to start an alternative therapy, transition to a clinical trial, consider repeat resection, or continue with the current therapy in hopes of resolution. In this review, the authors describe the invasive and noninvasive techniques neurosurgeons need to be aware of to identify PsP and facilitate surgical decision-making.
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Affiliation(s)
- Jacob S. Young
- Department of Neurological Surgery, University of California, San Francisco, California
| | - Nadeem Al-Adli
- Department of Neurological Surgery, University of California, San Francisco, California
- School of Medicine, Texas Christian University, Fort Worth, Texas
| | - Katie Scotford
- Department of Neurological Surgery, University of California, San Francisco, California
| | - Soonmee Cha
- Department of Neurological Surgery, University of California, San Francisco, California
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Mitchel S. Berger
- Department of Neurological Surgery, University of California, San Francisco, California
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Isikbay M, Carrodeguas E, Tatem A, Cha S. Challenges of Preparing for Diagnostic Radiology Call. Radiology 2023; 308:e230421. [PMID: 37724966 PMCID: PMC10546280 DOI: 10.1148/radiol.230421] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 09/21/2023]
Affiliation(s)
- Masis Isikbay
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA
94143
| | - Emmanuel Carrodeguas
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA
94143
| | - Alexia Tatem
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA
94143
| | - Soonmee Cha
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA
94143
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Li HB, Conte GM, Anwar SM, Kofler F, Ezhov I, van Leemput K, Piraud M, Diaz M, Cole B, Calabrese E, Rudie J, Meissen F, Adewole M, Janas A, Kazerooni AF, LaBella D, Moawad AW, Farahani K, Eddy J, Bergquist T, Chung V, Shinohara RT, Dako F, Wiggins W, Reitman Z, Wang C, Liu X, Jiang Z, Familiar A, Johanson E, Meier Z, Davatzikos C, Freymann J, Kirby J, Bilello M, Fathallah-Shaykh HM, Wiest R, Kirschke J, Colen RR, Kotrotsou A, Lamontagne P, Marcus D, Milchenko M, Nazeri A, Weber MA, Mahajan A, Mohan S, Mongan J, Hess C, Cha S, Villanueva-Meyer J, Colak E, Crivellaro P, Jakab A, Albrecht J, Anazodo U, Aboian M, Yu T, Chung V, Bergquist T, Eddy J, Albrecht J, Baid U, Bakas S, Linguraru MG, Menze B, Iglesias JE, Wiestler B. The Brain Tumor Segmentation (BraTS) Challenge 2023: Brain MR Image Synthesis for Tumor Segmentation (BraSyn). ArXiv 2023:arXiv:2305.09011v5. [PMID: 37608932 PMCID: PMC10441440] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Automated brain tumor segmentation methods have become well-established and reached performance levels offering clear clinical utility. These methods typically rely on four input magnetic resonance imaging (MRI) modalities: T1-weighted images with and without contrast enhancement, T2-weighted images, and FLAIR images. However, some sequences are often missing in clinical practice due to time constraints or image artifacts, such as patient motion. Consequently, the ability to substitute missing modalities and gain segmentation performance is highly desirable and necessary for the broader adoption of these algorithms in the clinical routine. In this work, we present the establishment of the Brain MR Image Synthesis Benchmark (BraSyn) in conjunction with the Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2023. The primary objective of this challenge is to evaluate image synthesis methods that can realistically generate missing MRI modalities when multiple available images are provided. The ultimate aim is to facilitate automated brain tumor segmentation pipelines. The image dataset used in the benchmark is diverse and multi-modal, created through collaboration with various hospitals and research institutions.
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Affiliation(s)
- Hongwei Bran Li
- University of Zurich, Switzerland
- Department of Informatics, Technical University Munich, Germany
- Klinikum rechts der Isar, Technical University of Munich, Germany
| | | | - Syed Muhammad Anwar
- Children's National Hospital, Washington DC, USA
- George Washington University, Washington DC, USA
| | - Florian Kofler
- Helmholtz AI, Helmholtz Munich, Germany
- Department of Informatics, Technical University Munich, Germany
- TranslaTUM - Central Institute for Translational Cancer Research, Technical University of Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Germany
| | - Ivan Ezhov
- Department of Informatics, Technical University Munich, Germany
| | | | | | | | | | - Evan Calabrese
- Duke University Medical Center, Department of Radiology, USA
- University of California San Francisco, CA, USA
| | - Jeff Rudie
- University of California San Francisco, CA, USA
| | - Felix Meissen
- Department of Informatics, Technical University Munich, Germany
| | - Maruf Adewole
- Medical Artificial Intelligence (MAI) Lab, Crestview Radiology, Lagos, Nigeria
| | | | - Anahita Fathi Kazerooni
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
- Center for AI and Data Science for Integrated Diagnostics (AI2D) I& Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
| | - Dominic LaBella
- Duke University Medical Center, Department of Radiation Oncology, USA
| | | | - Keyvan Farahani
- Cancer Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD 20814, USA
| | | | | | | | - Russell Takeshi Shinohara
- Center for AI and Data Science for Integrated Diagnostics (AI2D) I& Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, USA
| | - Farouk Dako
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Walter Wiggins
- Duke University Medical Center, Department of Radiology, USA
| | - Zachary Reitman
- Duke University Medical Center, Department of Radiation Oncology, USA
| | - Chunhao Wang
- Duke University Medical Center, Department of Radiation Oncology, USA
| | - Xinyang Liu
- Children's National Hospital, Washington DC, USA
- George Washington University, Washington DC, USA
| | - Zhifan Jiang
- Children's National Hospital, Washington DC, USA
- George Washington University, Washington DC, USA
| | - Ariana Familiar
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Elaine Johanson
- PrecisionFDA, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | | | - Christos Davatzikos
- Center for AI and Data Science for Integrated Diagnostics (AI2D) I& Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John Freymann
- Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21701, USA
- Cancer Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD 20814, USA
| | - Justin Kirby
- Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21701, USA
- Cancer Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD 20814, USA
| | - Michel Bilello
- Center for AI and Data Science for Integrated Diagnostics (AI2D) I& Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Roland Wiest
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
- Support Centre for Advanced Neuroimaging Inselspital, Institute for Diagnostic and Interventional Neuroradiology, Bern University Hospital, Bern, Switzerland
| | - Jan Kirschke
- Department of Neuroradiology, Technical University of Munich, Munich, Germany
| | - Rivka R Colen
- University of Pittsburgh Medical Center, PA, USA
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aikaterini Kotrotsou
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Daniel Marcus
- Neuroimaging Informatics and Analysis Center, Washington University, St. Louis, MO, USA
- Department of Radiology, Washington University, St. Louis, MO, USA
| | - Mikhail Milchenko
- Neuroimaging Informatics and Analysis Center, Washington University, St. Louis, MO, USA
- Department of Radiology, Washington University, St. Louis, MO, USA
| | - Arash Nazeri
- Department of Radiology, Washington University, St. Louis, MO, USA
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Ernst-Heydemann-Str. 6, 18057 Rostock, Germany
| | - Abhishek Mahajan
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Suyash Mohan
- Center for AI and Data Science for Integrated Diagnostics (AI2D) I& Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John Mongan
- University of California San Francisco, CA, USA
| | | | - Soonmee Cha
- University of California San Francisco, CA, USA
| | | | | | | | | | | | - Udunna Anazodo
- Montreal Neurological Institute (MNI), McGill University, Montreal, QC, Canada
| | | | - Thomas Yu
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, USA
| | | | | | | | | | - Ujjwal Baid
- Center for AI and Data Science for Integrated Diagnostics (AI2D) I& Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Spyridon Bakas
- Center for AI and Data Science for Integrated Diagnostics (AI2D) I& Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Kersch CN, Muldoon LL, Claunch CJ, Fu R, Schwartz D, Cha S, Starkey J, Neuwelt EA, Barajas RF. Multiparametric magnetic resonance imaging discerns glioblastoma immune microenvironmental heterogeneity. Neuroradiol J 2023:19714009231163560. [PMID: 37306690 DOI: 10.1177/19714009231163560] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
RATIONALE AND OBJECTIVE Poor clinical outcomes for patients with glioblastoma are in part due to dysfunction of the tumor-immune microenvironment. An imaging approach able to characterize immune microenvironmental signatures could provide a framework for biologically based patient stratification and response assessment. We hypothesized spatially distinct gene expression networks can be distinguished by multiparametric Magnetic Resonance Imaging (MRI) phenotypes. MATERIALS AND METHODS Patients with newly diagnosed glioblastoma underwent image-guided tissue sampling allowing for co-registration of MRI metrics with gene expression profiles. MRI phenotypes based on gadolinium contrast enhancing lesion (CEL) and non-enhancing lesion (NCEL) regions were subdivided based on imaging parameters (relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC)). Gene set enrichment analysis and immune cell type abundance was estimated using CIBERSORT methodology. Significance thresholds were set at a p-value cutoff 0.005 and an FDR q-value cutoff of 0.1. RESULTS Thirteen patients (eight men, five women, mean age 58 ± 11 years) provided 30 tissue samples (16 CEL and 14 NCEL). Six non-neoplastic gliosis samples differentiated astrocyte repair from tumor associated gene expression. MRI phenotypes displayed extensive transcriptional variance reflecting biological networks, including multiple immune pathways. CEL regions demonstrated higher immunologic signature expression than NCEL, while NCEL regions demonstrated stronger immune signature expression levels than gliotic non-tumor brain. Incorporation of rCBV and ADC metrics identified sample clusters with differing immune microenvironmental signatures. CONCLUSION Taken together, our study demonstrates that MRI phenotypes provide an approach for non-invasively characterizing tumoral and immune microenvironmental glioblastoma gene expression networks.
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Affiliation(s)
- Cymon N Kersch
- Department of Neurology, Blood-Brain Barrier Program, Oregon Health & Sciences University, USA
- Department of Radiation Medicine, Oregon Health & Sciences University, USA
| | - Leslie L Muldoon
- Department of Neurology, Blood-Brain Barrier Program, Oregon Health & Sciences University, USA
| | - Cheryl J Claunch
- Department of Biomedical Engineering, Knight Cancer Institute, OHSU Center for Spatial Systems Biomedicine, Oregon Health & Sciences University, USA
| | - Rongwei Fu
- OHSU-PSU School of Public Health, Oregon Health & Sciences University, USA
| | - Daniel Schwartz
- Advanced Imaging Research Center, Oregon Health & Sciences University, USA
- Department of Neurology, Layton Aging and Alzheimer's Disease Center, Oregon Health & Sciences University, USA
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California San Francisco, USA
| | - Jay Starkey
- Department of Radiology, Oregon Health & Sciences University, USA
| | - Edward A Neuwelt
- Department of Neurology, Blood-Brain Barrier Program, Oregon Health & Sciences University, USA
- Department of Neurosurgery, Oregon Health & Sciences University, USA
- Office of Research and Development, Department of Veterans Affairs Medical Center, USA
| | - Ramon F Barajas
- Advanced Imaging Research Center, Oregon Health & Sciences University, USA
- Department of Radiology, Oregon Health & Sciences University, USA
- Knight Cancer Institute, Oregon Health & Sciences University, USA
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8
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Browne J, Chipps KA, Schmidt K, Schatz H, Ahn S, Pain SD, Montes F, Ong WJ, Greife U, Allen J, Bardayan DW, Blackmon JC, Blankstein D, Cha S, Chae KY, Febbraro M, Hall MR, Jones KL, Kontos A, Meisel Z, O'Malley PD, Schmitt KT, Smith K, Smith MS, Thompson P, Toomey R, Vostinar M, Walter D. First Direct Measurement Constraining the ^{34}Ar(α,p)^{37}K Reaction Cross Section for Mixed Hydrogen and Helium Burning in Accreting Neutron Stars. Phys Rev Lett 2023; 130:212701. [PMID: 37295108 DOI: 10.1103/physrevlett.130.212701] [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] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/19/2022] [Accepted: 05/02/2023] [Indexed: 06/12/2023]
Abstract
The rate of the final step in the astrophysical αp process, the ^{34}Ar(α,p)^{37}K reaction, suffers from large uncertainties due to a lack of experimental data, despite having a considerable impact on the observable light curves of x-ray bursts and the composition of the ashes of hydrogen and helium burning on accreting neutron stars. We present the first direct measurement constraining the ^{34}Ar(α,p)^{37}K reaction cross section, using the Jet Experiments in Nuclear Structure and Astrophysics gas jet target. The combined cross section for the ^{34}Ar,Cl(α,p)^{37}K,Ar reaction is found to agree well with Hauser-Feshbach predictions. The ^{34}Ar(α,2p)^{36}Ar cross section, which can be exclusively attributed to the ^{34}Ar beam component, also agrees to within the typical uncertainties quoted for statistical models. This indicates the applicability of the statistical model for predicting astrophysical (α,p) reaction rates in this part of the αp process, in contrast to earlier findings from indirect reaction studies indicating orders-of-magnitude discrepancies. This removes a significant uncertainty in models of hydrogen and helium burning on accreting neutron stars.
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Affiliation(s)
- J Browne
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - K A Chipps
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996
| | - Konrad Schmidt
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
- Institute of Radiation Physics, Helmholtz-Zentrum Dresden-Rossendorf, Bautzner Landstrasse 400, 01328 Dresden, Germany
| | - H Schatz
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - S Ahn
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - S D Pain
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996
| | - F Montes
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - W J Ong
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - U Greife
- Physics Department, Colorado School of Mines, Golden, Colorado 80401
| | - J Allen
- Department of Physics and Astronomy, University of Notre Dame, Notre Dame, Indiana 46556
| | - D W Bardayan
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
- Department of Physics and Astronomy, University of Notre Dame, Notre Dame, Indiana 46556
| | - J C Blackmon
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, Louisiana 70803
| | - D Blankstein
- Department of Physics and Astronomy, University of Notre Dame, Notre Dame, Indiana 46556
| | - S Cha
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - K Y Chae
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - M Febbraro
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
| | - M R Hall
- Department of Physics and Astronomy, University of Notre Dame, Notre Dame, Indiana 46556
| | - K L Jones
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996
| | - A Kontos
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - Z Meisel
- Department of Physics and Astronomy and National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824
- Joint Institute for Nuclear Astrophysics (JINA-CEE), Michigan State University, East Lansing, Michigan 48824
| | - P D O'Malley
- Department of Physics and Astronomy, University of Notre Dame, Notre Dame, Indiana 46556
| | - K T Schmitt
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
| | - K Smith
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996
| | - M S Smith
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
| | - P Thompson
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996
| | - R Toomey
- Department of Physics and Astronomy, Rutgers University, Piscataway, New Jersey 08854
| | - M Vostinar
- Department of Physics and Astronomy, Rutgers University, Piscataway, New Jersey 08854
| | - D Walter
- Department of Physics and Astronomy, Rutgers University, Piscataway, New Jersey 08854
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LaHue SC, Guterman EL, Mikhail M, Li Y, Cha S, Richie MB. Clinical and Radiographic Characteristics of Nocardia vs Non- Nocardia Brain Abscesses. Neurol Clin Pract 2023; 13:e200134. [PMID: 37064583 PMCID: PMC10101715 DOI: 10.1212/cpj.0000000000200134] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/18/2022] [Indexed: 04/18/2023]
Abstract
Background and Objectives Diagnosis and treatment of CNS nocardiosis is challenging and often delayed, which increases morbidity and mortality. The primary objective was to compare the clinical and radiographic characteristics of patients with CNS nocardiosis with non-Nocardia bacterial brain abscesses. Methods We performed a case-control study of patients with brain abscesses diagnosed between 1998 and 2018 at a tertiary academic center. We identified 56 patients with brain MRI demonstrating brain abscess from the institutional imaging database: 14 with culture-confirmed nocardiosis and 42 randomly selected prevalent controls with culture-confirmed non-Nocardia bacterial infection. The primary outcomes were the diagnosis of concomitant lung infection and history of immunosuppression. Secondary outcomes included abscess radiographic characteristics: multifocality, occipital lobe and/or infratentorial location, and bilobed morphology. Results Compared with patients with non-Nocardia brain abscesses, patients with CNS nocardiosis were older (median 61 years [IQR 59-69] vs 48 years [IQR 34-61]; p = 0.03), more likely to be immunosuppressed [71% (10) vs 19% (8); p < 0.001), have diabetes (36% (5) vs 10% [4]; p = 0.03), or a concomitant lung infection (86% [12] vs 2% [1]; p < 0.001). Radiographically, more cases of CNS nocardiosis exhibited multifocal abscesses (29% [4] vs 2% [1]; p = 0.01), which were located in the infratentorial (43% [6] vs 10% (4); p = 0.01) or occipital (36% [5] vs 5% [2]; p = 0.008) regions and had a bilobed (as opposed to unilobed) morphology (79% [11] vs 19% [8]; p < 0.001). Blood and CSF cultures were negative in most of the cases and controls, whereas neurosurgical specimen culture yielded a diagnosis in 100% of specimens. Discussion Patients with CNS nocardiosis were more likely to be older, have a history of diabetes or immunosuppression, or have a concomitant lung infection compared with those with non-Nocardia brain abscesses. Abscesses because of CNS nocardiosis were more likely to be multifocal, affect the infratentorial region or occipital lobe, or have a bilobed appearance. Neurosurgical specimen culture was most likely to yield a diagnosis for both Nocardia and non-Nocardia abscesses. The combination of clinical and imaging findings may suggest CNS nocardiosis and inform early initiation of targeted empiric treatment.
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Affiliation(s)
- Sara C LaHue
- Department of Neurology (SCL, ELG, MBR), School of Medicine; Weill Institute for Neurosciences (SCL, ELG, MBR), Department of Neurology; and Department of Radiology and Biomedical Imaging (MM, YL, SC), University of California, San Francisco, CA
| | - Elan L Guterman
- Department of Neurology (SCL, ELG, MBR), School of Medicine; Weill Institute for Neurosciences (SCL, ELG, MBR), Department of Neurology; and Department of Radiology and Biomedical Imaging (MM, YL, SC), University of California, San Francisco, CA
| | - Mathew Mikhail
- Department of Neurology (SCL, ELG, MBR), School of Medicine; Weill Institute for Neurosciences (SCL, ELG, MBR), Department of Neurology; and Department of Radiology and Biomedical Imaging (MM, YL, SC), University of California, San Francisco, CA
| | - Yi Li
- Department of Neurology (SCL, ELG, MBR), School of Medicine; Weill Institute for Neurosciences (SCL, ELG, MBR), Department of Neurology; and Department of Radiology and Biomedical Imaging (MM, YL, SC), University of California, San Francisco, CA
| | - Soonmee Cha
- Department of Neurology (SCL, ELG, MBR), School of Medicine; Weill Institute for Neurosciences (SCL, ELG, MBR), Department of Neurology; and Department of Radiology and Biomedical Imaging (MM, YL, SC), University of California, San Francisco, CA
| | - Megan B Richie
- Department of Neurology (SCL, ELG, MBR), School of Medicine; Weill Institute for Neurosciences (SCL, ELG, MBR), Department of Neurology; and Department of Radiology and Biomedical Imaging (MM, YL, SC), University of California, San Francisco, CA
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10
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Pati S, Baid U, Edwards B, Sheller M, Wang SH, Reina GA, Foley P, Gruzdev A, Karkada D, Davatzikos C, Sako C, Ghodasara S, Bilello M, Mohan S, Vollmuth P, Brugnara G, Preetha CJ, Sahm F, Maier-Hein K, Zenk M, Bendszus M, Wick W, Calabrese E, Rudie J, Villanueva-Meyer J, Cha S, Ingalhalikar M, Jadhav M, Pandey U, Saini J, Garrett J, Larson M, Jeraj R, Currie S, Frood R, Fatania K, Huang RY, Chang K, Balaña C, Capellades J, Puig J, Trenkler J, Pichler J, Necker G, Haunschmidt A, Meckel S, Shukla G, Liem S, Alexander GS, Lombardo J, Palmer JD, Flanders AE, Dicker AP, Sair HI, Jones CK, Venkataraman A, Jiang M, So TY, Chen C, Heng PA, Dou Q, Kozubek M, Lux F, Michálek J, Matula P, Keřkovský M, Kopřivová T, Dostál M, Vybíhal V, Vogelbaum MA, Mitchell JR, Farinhas J, Maldjian JA, Yogananda CGB, Pinho MC, Reddy D, Holcomb J, Wagner BC, Ellingson BM, Cloughesy TF, Raymond C, Oughourlian T, Hagiwara A, Wang C, To MS, Bhardwaj S, Chong C, Agzarian M, Falcão AX, Martins SB, Teixeira BCA, Sprenger F, Menotti D, Lucio DR, LaMontagne P, Marcus D, Wiestler B, Kofler F, Ezhov I, Metz M, Jain R, Lee M, Lui YW, McKinley R, Slotboom J, Radojewski P, Meier R, Wiest R, Murcia D, Fu E, Haas R, Thompson J, Ormond DR, Badve C, Sloan AE, Vadmal V, Waite K, Colen RR, Pei L, Ak M, Srinivasan A, Bapuraj JR, Rao A, Wang N, Yoshiaki O, Moritani T, Turk S, Lee J, Prabhudesai S, Morón F, Mandel J, Kamnitsas K, Glocker B, Dixon LVM, Williams M, Zampakis P, Panagiotopoulos V, Tsiganos P, Alexiou S, Haliassos I, Zacharaki EI, Moustakas K, Kalogeropoulou C, Kardamakis DM, Choi YS, Lee SK, Chang JH, Ahn SS, Luo B, Poisson L, Wen N, Tiwari P, Verma R, Bareja R, Yadav I, Chen J, Kumar N, Smits M, van der Voort SR, Alafandi A, Incekara F, Wijnenga MMJ, Kapsas G, Gahrmann R, Schouten JW, Dubbink HJ, Vincent AJPE, van den Bent MJ, French PJ, Klein S, Yuan Y, Sharma S, Tseng TC, Adabi S, Niclou SP, Keunen O, Hau AC, Vallières M, Fortin D, Lepage M, Landman B, Ramadass K, Xu K, Chotai S, Chambless LB, Mistry A, Thompson RC, Gusev Y, Bhuvaneshwar K, Sayah A, Bencheqroun C, Belouali A, Madhavan S, Booth TC, Chelliah A, Modat M, Shuaib H, Dragos C, Abayazeed A, Kolodziej K, Hill M, Abbassy A, Gamal S, Mekhaimar M, Qayati M, Reyes M, Park JE, Yun J, Kim HS, Mahajan A, Muzi M, Benson S, Beets-Tan RGH, Teuwen J, Herrera-Trujillo A, Trujillo M, Escobar W, Abello A, Bernal J, Gómez J, Choi J, Baek S, Kim Y, Ismael H, Allen B, Buatti JM, Kotrotsou A, Li H, Weiss T, Weller M, Bink A, Pouymayou B, Shaykh HF, Saltz J, Prasanna P, Shrestha S, Mani KM, Payne D, Kurc T, Pelaez E, Franco-Maldonado H, Loayza F, Quevedo S, Guevara P, Torche E, Mendoza C, Vera F, Ríos E, López E, Velastin SA, Ogbole G, Soneye M, Oyekunle D, Odafe-Oyibotha O, Osobu B, Shu'aibu M, Dorcas A, Dako F, Simpson AL, Hamghalam M, Peoples JJ, Hu R, Tran A, Cutler D, Moraes FY, Boss MA, Gimpel J, Veettil DK, Schmidt K, Bialecki B, Marella S, Price C, Cimino L, Apgar C, Shah P, Menze B, Barnholtz-Sloan JS, Martin J, Bakas S. Author Correction: Federated learning enables big data for rare cancer boundary detection. Nat Commun 2023; 14:436. [PMID: 36702828 PMCID: PMC9879935 DOI: 10.1038/s41467-023-36188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Sarthak Pati
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
| | - Ujjwal Baid
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | | | | | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chiharu Sako
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Satyam Ghodasara
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michel Bilello
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Suyash Mohan
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Philipp Vollmuth
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Gianluca Brugnara
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Felix Sahm
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Klaus Maier-Hein
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
- Pattern Analysis and Learning Group, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Maximilian Zenk
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Wick
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurology Clinic, Heidelberg University Hospital, Heidelberg, Germany
| | - Evan Calabrese
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey Rudie
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Javier Villanueva-Meyer
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Soonmee Cha
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Madhura Ingalhalikar
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Manali Jadhav
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Umang Pandey
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - John Garrett
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Matthew Larson
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Robert Jeraj
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Stuart Currie
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Russell Frood
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Kavi Fatania
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ken Chang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | | | | | - Josep Puig
- Department of Radiology (IDI), Girona Biomedical Research Institute (IdIBGi), Josep Trueta University Hospital, Girona, Spain
| | - Johannes Trenkler
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Josef Pichler
- Department of Neurooncology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Georg Necker
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Andreas Haunschmidt
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Stephan Meckel
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
- Institute of Diagnostic and Interventional Neuroradiology, RKH Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Gaurav Shukla
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiation Oncology, Christiana Care Health System, Philadelphia, PA, USA
| | - Spencer Liem
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Gregory S Alexander
- Department of Radiation Oncology, University of Maryland, Baltimore, MD, USA
| | - Joseph Lombardo
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joshua D Palmer
- Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Adam E Flanders
- Department of Radiology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Adam P Dicker
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Haris I Sair
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Craig K Jones
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Archana Venkataraman
- Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Meirui Jiang
- The Chinese University of Hong Kong, Hong Kong, China
| | - Tiffany Y So
- The Chinese University of Hong Kong, Hong Kong, China
| | - Cheng Chen
- The Chinese University of Hong Kong, Hong Kong, China
| | | | - Qi Dou
- The Chinese University of Hong Kong, Hong Kong, China
| | - Michal Kozubek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Filip Lux
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Jan Michálek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Petr Matula
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Miloš Keřkovský
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Tereza Kopřivová
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Marek Dostál
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
- Department of Biophysics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Václav Vybíhal
- Department of Neurosurgery, Faculty of Medicine, Masaryk University, Brno, and University Hospital and Czech Republic, Brno, Czech Republic
| | - Michael A Vogelbaum
- Department of Neuro Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - J Ross Mitchell
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Joaquim Farinhas
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | | | - Marco C Pinho
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Divya Reddy
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - James Holcomb
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Timothy F Cloughesy
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Talia Oughourlian
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Akifumi Hagiwara
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Chencai Wang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Minh-Son To
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Sargam Bhardwaj
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Chee Chong
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Marc Agzarian
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | | | | | - Bernardo C A Teixeira
- Instituto de Neurologia de Curitiba, Curitiba, Paraná, Brazil
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Flávia Sprenger
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - David Menotti
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Diego R Lucio
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Pamela LaMontagne
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Daniel Marcus
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Benedikt Wiestler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
| | - Florian Kofler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Ivan Ezhov
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Marie Metz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Rajan Jain
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Matthew Lee
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Yvonne W Lui
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Richard McKinley
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Johannes Slotboom
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Piotr Radojewski
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Raphael Meier
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Derrick Murcia
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Eric Fu
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Rourke Haas
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - John Thompson
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - David Ryan Ormond
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Chaitra Badve
- Department of Radiology, University Hospitals Cleveland, Cleveland, OH, USA
| | - Andrew E Sloan
- Department of Neurological Surgery, University Hospitals-Seidman Cancer Center, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Cleveland, OH, USA
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Vachan Vadmal
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kristin Waite
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Rivka R Colen
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Linmin Pei
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Murat Ak
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ashok Srinivasan
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - J Rajiv Bapuraj
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Arvind Rao
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas Wang
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Ota Yoshiaki
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Toshio Moritani
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Sevcan Turk
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Joonsang Lee
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Snehal Prabhudesai
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Fanny Morón
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Jacob Mandel
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Konstantinos Kamnitsas
- Department of Computing, Imperial College London, London, UK
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Ben Glocker
- Department of Computing, Imperial College London, London, UK
| | - Luke V M Dixon
- Department of Radiology, Imperial College NHS Healthcare Trust, London, UK
| | - Matthew Williams
- Computational Oncology Group, Institute for Global Health Innovation, Imperial College London, London, UK
| | - Peter Zampakis
- Department of NeuroRadiology, University of Patras, Patras, Greece
| | | | - Panagiotis Tsiganos
- Clinical Radiology Laboratory, Department of Medicine, University of Patras, Patras, Greece
| | - Sotiris Alexiou
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | - Ilias Haliassos
- Department of Neuro-Oncology, University of Patras, Patras, Greece
| | - Evangelia I Zacharaki
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | | | | | | | | | | | | | - Sung Soo Ahn
- Yonsei University College of Medicine, Seoul, Korea
| | - Bing Luo
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Laila Poisson
- Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Ning Wen
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
- SJTU-Ruijin-UIH Institute for Medical Imaging Technology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
| | | | - Ruchika Verma
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
- Case Western Reserve University, Cleveland, OH, USA
| | - Rohan Bareja
- Case Western Reserve University, Cleveland, OH, USA
| | - Ipsa Yadav
- Case Western Reserve University, Cleveland, OH, USA
| | | | - Neeraj Kumar
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Sebastian R van der Voort
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Ahmed Alafandi
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Fatih Incekara
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Maarten M J Wijnenga
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Georgios Kapsas
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Renske Gahrmann
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Joost W Schouten
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Hendrikus J Dubbink
- Department of Pathology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Arnaud J P E Vincent
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Martin J van den Bent
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Pim J French
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Stefan Klein
- Biomedical Imaging Group Rotterdam, Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Yading Yuan
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sonam Sharma
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tzu-Chi Tseng
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Saba Adabi
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simone P Niclou
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Olivier Keunen
- Translation Radiomics, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Ann-Christin Hau
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
- Luxembourg Center of Neuropathology, Laboratoire National De Santé, Luxembourg, Luxembourg
| | - Martin Vallières
- Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - David Fortin
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Division of Neurosurgery and Neuro-Oncology, Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Lepage
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Department of Nuclear Medicine and Radiobiology, Sherbrooke Molecular Imaging Centre, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Bennett Landman
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Karthik Ramadass
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Kaiwen Xu
- Department of Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Silky Chotai
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lola B Chambless
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Akshitkumar Mistry
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Reid C Thompson
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yuriy Gusev
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Krithika Bhuvaneshwar
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anousheh Sayah
- Division of Neuroradiology & Neurointerventional Radiology, Department of Radiology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Camelia Bencheqroun
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anas Belouali
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Subha Madhavan
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Thomas C Booth
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- Department of Neuroradiology, Ruskin Wing, King's College Hospital NHS Foundation Trust, London, UK
| | - Alysha Chelliah
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Haris Shuaib
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Carmen Dragos
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
| | | | | | | | | | - Shady Gamal
- University of Cairo School of Medicine, Giza, Egypt
| | | | | | | | - Ji Eun Park
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Jihye Yun
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Ho Sung Kim
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Abhishek Mahajan
- The Clatterbridge Cancer Centre NHS Foundation Trust Pembroke Place, Liverpool, UK
| | - Mark Muzi
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Sean Benson
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, Netherlands
- GROW School of Oncology and Developmental Biology, Maastricht, Netherlands
| | - Jonas Teuwen
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - William Escobar
- Clínica Imbanaco Grupo Quirón Salud, Cali, Colombia
- Universidad del Valle, Cali, Colombia
| | | | - Jose Bernal
- Universidad del Valle, Cali, Colombia
- The University of Edinburgh, Edinburgh, UK
| | | | - Joseph Choi
- Department of Industrial and Systems Engineering, University of Iowa, Iowa, USA
| | - Stephen Baek
- Department of Industrial and Systems Engineering, Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Yusung Kim
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Heba Ismael
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Bryan Allen
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - John M Buatti
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | | | - Hongwei Li
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Tobias Weiss
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andrea Bink
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Bertrand Pouymayou
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | | | - Joel Saltz
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Prateek Prasanna
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Sampurna Shrestha
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Kartik M Mani
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Department of Radiation Oncology, Stony Brook University, Stony Brook, NY, USA
| | - David Payne
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Tahsin Kurc
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Scientific Data Group, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Enrique Pelaez
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | - Francis Loayza
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | | | | | | | - Franco Vera
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Elvis Ríos
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Eduardo López
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Sergio A Velastin
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Godwin Ogbole
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mayowa Soneye
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Dotun Oyekunle
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | | | - Babatunde Osobu
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mustapha Shu'aibu
- Department of Radiology, Muhammad Abdullahi Wase Teaching Hospital, Kano, Nigeria
| | - Adeleye Dorcas
- Department of Radiology, Obafemi Awolowo University Ile-Ife, Ile-Ife, Osun, Nigeria
| | - Farouk Dako
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amber L Simpson
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Mohammad Hamghalam
- School of Computing, Queen's University, Kingston, ON, Canada
- Department of Electrical Engineering, Qazvin Branch, Islamic Azad University, Qazvin, Iran
| | - Jacob J Peoples
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Ricky Hu
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Anh Tran
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Danielle Cutler
- The Faculty of Arts & Sciences, Queen's University, Kingston, ON, Canada
| | - Fabio Y Moraes
- Department of Oncology, Queen's University, Kingston, ON, Canada
| | - Michael A Boss
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - James Gimpel
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Deepak Kattil Veettil
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Kendall Schmidt
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Brian Bialecki
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Sailaja Marella
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Cynthia Price
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Lisa Cimino
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Charles Apgar
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | | | - Bjoern Menze
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Jill S Barnholtz-Sloan
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute (NCI), National Institute of Health, Bethesda, MD, USA
| | | | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA.
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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11
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Kulac I, Yenidogan I, Oflaz Sozmen B, Baygul A, Cha S, Pekmezci M, Tihan T. Pathological perspectives in pilocytic astrocytomas: Extent of resection as the sole critical factor for recurrence-free survival, and the challenge of evaluating conclusions derived from limited data. Free Neuropathol 2023; 4:4-17. [PMID: 37901684 PMCID: PMC10601208 DOI: 10.17879/freeneuropathology-2023-5116] [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] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 10/09/2023] [Indexed: 10/31/2023]
Abstract
Introduction: Pilocytic astrocytoma (PA) is one of the most common primary intracranial neoplasms in childhood with an overall favorable prognosis. Despite decades of experience, there are still diagnostic and treatment challenges and unresolved issues regarding risk factors associated with recurrence, most often due to conclusions of publications with limited data. We analyzed 499 patients with PA diagnosed in a single institution over 30 years in order to provide answers to some of the unresolved issues. Materials and Methods: We identified pilocytic astrocytomas diagnosed at the University of California, San Francisco, between 1989 and 2019, confirmed the diagnoses using the WHO 2021 essential and desirable criteria, and performed a retrospective review of the demographic and clinical features of the patients and the radiological, pathologic and molecular features of the tumors. Results: Among the patients identified from pathology archives, 499 cases fulfilled the inclusion criteria. Median age at presentation was 12 years (range 3.5 months - 73 years) and the median follow-up was 78.5 months. Tumors were predominantly located in the posterior fossa (52.6%). There were six deaths, but there were confounding factors that prevented a clear association of death to tumor progression. Extent of resection was the only significant factor for recurrence-free survival. Recurrence-free survival time was 321.0 months for gross total resection, compared to 160.9 months for subtotal resection (log rank, p <0.001). Conclusion: Multivariate analysis was able to identify extent of resection as the only significant variable to influence recurrence-free survival. We did not find a statistically significant association between age, NF1 status, tumor location, molecular alterations, and outcome. Smaller series with apparently significant results may have suffered from limited sample size, limited variables, acceptance of univariate analysis findings as well as a larger p value for biological significance. PA still remains a predominantly surgical disease and every attempt should be made to achieve gross total resection since this appears to be the most reliable predictor of recurrence-free survival.
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Affiliation(s)
- Ibrahim Kulac
- Department of Pathology, Koc University School of Medicine, Istanbul, Turkey
| | - Irem Yenidogan
- Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey
| | - Banu Oflaz Sozmen
- Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey
- Division of Pediatric Hematology and Oncology, Koc University School of Medicine, Istanbul, Turkey
| | - Arzu Baygul
- Department of Biostatistics, Koc University School of Medicine, Istanbul, Turkey
| | - Soonmee Cha
- Department of Radiology, University of California, San Francisco, CA, USA
| | - Melike Pekmezci
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Tarik Tihan
- Department of Pathology, University of California, San Francisco, CA, USA
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12
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Pati S, Baid U, Edwards B, Sheller M, Wang SH, Reina GA, Foley P, Gruzdev A, Karkada D, Davatzikos C, Sako C, Ghodasara S, Bilello M, Mohan S, Vollmuth P, Brugnara G, Preetha CJ, Sahm F, Maier-Hein K, Zenk M, Bendszus M, Wick W, Calabrese E, Rudie J, Villanueva-Meyer J, Cha S, Ingalhalikar M, Jadhav M, Pandey U, Saini J, Garrett J, Larson M, Jeraj R, Currie S, Frood R, Fatania K, Huang RY, Chang K, Balaña C, Capellades J, Puig J, Trenkler J, Pichler J, Necker G, Haunschmidt A, Meckel S, Shukla G, Liem S, Alexander GS, Lombardo J, Palmer JD, Flanders AE, Dicker AP, Sair HI, Jones CK, Venkataraman A, Jiang M, So TY, Chen C, Heng PA, Dou Q, Kozubek M, Lux F, Michálek J, Matula P, Keřkovský M, Kopřivová T, Dostál M, Vybíhal V, Vogelbaum MA, Mitchell JR, Farinhas J, Maldjian JA, Yogananda CGB, Pinho MC, Reddy D, Holcomb J, Wagner BC, Ellingson BM, Cloughesy TF, Raymond C, Oughourlian T, Hagiwara A, Wang C, To MS, Bhardwaj S, Chong C, Agzarian M, Falcão AX, Martins SB, Teixeira BCA, Sprenger F, Menotti D, Lucio DR, LaMontagne P, Marcus D, Wiestler B, Kofler F, Ezhov I, Metz M, Jain R, Lee M, Lui YW, McKinley R, Slotboom J, Radojewski P, Meier R, Wiest R, Murcia D, Fu E, Haas R, Thompson J, Ormond DR, Badve C, Sloan AE, Vadmal V, Waite K, Colen RR, Pei L, Ak M, Srinivasan A, Bapuraj JR, Rao A, Wang N, Yoshiaki O, Moritani T, Turk S, Lee J, Prabhudesai S, Morón F, Mandel J, Kamnitsas K, Glocker B, Dixon LVM, Williams M, Zampakis P, Panagiotopoulos V, Tsiganos P, Alexiou S, Haliassos I, Zacharaki EI, Moustakas K, Kalogeropoulou C, Kardamakis DM, Choi YS, Lee SK, Chang JH, Ahn SS, Luo B, Poisson L, Wen N, Tiwari P, Verma R, Bareja R, Yadav I, Chen J, Kumar N, Smits M, van der Voort SR, Alafandi A, Incekara F, Wijnenga MMJ, Kapsas G, Gahrmann R, Schouten JW, Dubbink HJ, Vincent AJPE, van den Bent MJ, French PJ, Klein S, Yuan Y, Sharma S, Tseng TC, Adabi S, Niclou SP, Keunen O, Hau AC, Vallières M, Fortin D, Lepage M, Landman B, Ramadass K, Xu K, Chotai S, Chambless LB, Mistry A, Thompson RC, Gusev Y, Bhuvaneshwar K, Sayah A, Bencheqroun C, Belouali A, Madhavan S, Booth TC, Chelliah A, Modat M, Shuaib H, Dragos C, Abayazeed A, Kolodziej K, Hill M, Abbassy A, Gamal S, Mekhaimar M, Qayati M, Reyes M, Park JE, Yun J, Kim HS, Mahajan A, Muzi M, Benson S, Beets-Tan RGH, Teuwen J, Herrera-Trujillo A, Trujillo M, Escobar W, Abello A, Bernal J, Gómez J, Choi J, Baek S, Kim Y, Ismael H, Allen B, Buatti JM, Kotrotsou A, Li H, Weiss T, Weller M, Bink A, Pouymayou B, Shaykh HF, Saltz J, Prasanna P, Shrestha S, Mani KM, Payne D, Kurc T, Pelaez E, Franco-Maldonado H, Loayza F, Quevedo S, Guevara P, Torche E, Mendoza C, Vera F, Ríos E, López E, Velastin SA, Ogbole G, Soneye M, Oyekunle D, Odafe-Oyibotha O, Osobu B, Shu'aibu M, Dorcas A, Dako F, Simpson AL, Hamghalam M, Peoples JJ, Hu R, Tran A, Cutler D, Moraes FY, Boss MA, Gimpel J, Veettil DK, Schmidt K, Bialecki B, Marella S, Price C, Cimino L, Apgar C, Shah P, Menze B, Barnholtz-Sloan JS, Martin J, Bakas S. Federated learning enables big data for rare cancer boundary detection. Nat Commun 2022; 13:7346. [PMID: 36470898 PMCID: PMC9722782 DOI: 10.1038/s41467-022-33407-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 09/16/2022] [Indexed: 12/12/2022] Open
Abstract
Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing.
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Affiliation(s)
- Sarthak Pati
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
| | - Ujjwal Baid
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | | | | | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chiharu Sako
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Satyam Ghodasara
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michel Bilello
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Suyash Mohan
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Philipp Vollmuth
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Gianluca Brugnara
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Felix Sahm
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Klaus Maier-Hein
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
- Pattern Analysis and Learning Group, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Maximilian Zenk
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Wick
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurology Clinic, Heidelberg University Hospital, Heidelberg, Germany
| | - Evan Calabrese
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey Rudie
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Javier Villanueva-Meyer
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Soonmee Cha
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Madhura Ingalhalikar
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Manali Jadhav
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Umang Pandey
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - John Garrett
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Matthew Larson
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Robert Jeraj
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Stuart Currie
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Russell Frood
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Kavi Fatania
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ken Chang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | | | | | - Josep Puig
- Department of Radiology (IDI), Girona Biomedical Research Institute (IdIBGi), Josep Trueta University Hospital, Girona, Spain
| | - Johannes Trenkler
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Josef Pichler
- Department of Neurooncology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Georg Necker
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Andreas Haunschmidt
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Stephan Meckel
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
- Institute of Diagnostic and Interventional Neuroradiology, RKH Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Gaurav Shukla
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiation Oncology, Christiana Care Health System, Philadelphia, PA, USA
| | - Spencer Liem
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Gregory S Alexander
- Department of Radiation Oncology, University of Maryland, Baltimore, MD, USA
| | - Joseph Lombardo
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joshua D Palmer
- Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Adam E Flanders
- Department of Radiology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Adam P Dicker
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Haris I Sair
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Craig K Jones
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Archana Venkataraman
- Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Meirui Jiang
- The Chinese University of Hong Kong, Hong Kong, China
| | - Tiffany Y So
- The Chinese University of Hong Kong, Hong Kong, China
| | - Cheng Chen
- The Chinese University of Hong Kong, Hong Kong, China
| | | | - Qi Dou
- The Chinese University of Hong Kong, Hong Kong, China
| | - Michal Kozubek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Filip Lux
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Jan Michálek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Petr Matula
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Miloš Keřkovský
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Tereza Kopřivová
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Marek Dostál
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
- Department of Biophysics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Václav Vybíhal
- Department of Neurosurgery, Faculty of Medicine, Masaryk University, Brno, and University Hospital and Czech Republic, Brno, Czech Republic
| | - Michael A Vogelbaum
- Department of Neuro Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - J Ross Mitchell
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Joaquim Farinhas
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | | | - Marco C Pinho
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Divya Reddy
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - James Holcomb
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Timothy F Cloughesy
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Talia Oughourlian
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Akifumi Hagiwara
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Chencai Wang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Minh-Son To
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Sargam Bhardwaj
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Chee Chong
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Marc Agzarian
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | | | | | - Bernardo C A Teixeira
- Instituto de Neurologia de Curitiba, Curitiba, Paraná, Brazil
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Flávia Sprenger
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - David Menotti
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Diego R Lucio
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Pamela LaMontagne
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Daniel Marcus
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Benedikt Wiestler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
| | - Florian Kofler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Ivan Ezhov
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Marie Metz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Rajan Jain
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Matthew Lee
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Yvonne W Lui
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Richard McKinley
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Johannes Slotboom
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Piotr Radojewski
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Raphael Meier
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Derrick Murcia
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Eric Fu
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Rourke Haas
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - John Thompson
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - David Ryan Ormond
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Chaitra Badve
- Department of Radiology, University Hospitals Cleveland, Cleveland, OH, USA
| | - Andrew E Sloan
- Department of Neurological Surgery, University Hospitals-Seidman Cancer Center, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Cleveland, OH, USA
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Vachan Vadmal
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kristin Waite
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Rivka R Colen
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Linmin Pei
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Murat Ak
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ashok Srinivasan
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - J Rajiv Bapuraj
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Arvind Rao
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas Wang
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Ota Yoshiaki
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Toshio Moritani
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Sevcan Turk
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Joonsang Lee
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Snehal Prabhudesai
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Fanny Morón
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Jacob Mandel
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Konstantinos Kamnitsas
- Department of Computing, Imperial College London, London, UK
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Ben Glocker
- Department of Computing, Imperial College London, London, UK
| | - Luke V M Dixon
- Department of Radiology, Imperial College NHS Healthcare Trust, London, UK
| | - Matthew Williams
- Computational Oncology Group, Institute for Global Health Innovation, Imperial College London, London, UK
| | - Peter Zampakis
- Department of NeuroRadiology, University of Patras, Patras, Greece
| | | | - Panagiotis Tsiganos
- Clinical Radiology Laboratory, Department of Medicine, University of Patras, Patras, Greece
| | - Sotiris Alexiou
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | - Ilias Haliassos
- Department of Neuro-Oncology, University of Patras, Patras, Greece
| | - Evangelia I Zacharaki
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | | | | | | | | | | | | | - Sung Soo Ahn
- Yonsei University College of Medicine, Seoul, Korea
| | - Bing Luo
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Laila Poisson
- Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Ning Wen
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
- SJTU-Ruijin-UIH Institute for Medical Imaging Technology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
| | | | - Ruchika Verma
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
- Case Western Reserve University, Cleveland, OH, USA
| | - Rohan Bareja
- Case Western Reserve University, Cleveland, OH, USA
| | - Ipsa Yadav
- Case Western Reserve University, Cleveland, OH, USA
| | | | - Neeraj Kumar
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Sebastian R van der Voort
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Ahmed Alafandi
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Fatih Incekara
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Maarten M J Wijnenga
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Georgios Kapsas
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Renske Gahrmann
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Joost W Schouten
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Hendrikus J Dubbink
- Department of Pathology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Arnaud J P E Vincent
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Martin J van den Bent
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Pim J French
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Stefan Klein
- Biomedical Imaging Group Rotterdam, Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Yading Yuan
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sonam Sharma
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tzu-Chi Tseng
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Saba Adabi
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simone P Niclou
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Olivier Keunen
- Translation Radiomics, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Ann-Christin Hau
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
- Luxembourg Center of Neuropathology, Laboratoire National De Santé, Luxembourg, Luxembourg
| | - Martin Vallières
- Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - David Fortin
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Division of Neurosurgery and Neuro-Oncology, Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Lepage
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Department of Nuclear Medicine and Radiobiology, Sherbrooke Molecular Imaging Centre, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Bennett Landman
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Karthik Ramadass
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Kaiwen Xu
- Department of Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Silky Chotai
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lola B Chambless
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Akshitkumar Mistry
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Reid C Thompson
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yuriy Gusev
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Krithika Bhuvaneshwar
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anousheh Sayah
- Division of Neuroradiology & Neurointerventional Radiology, Department of Radiology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Camelia Bencheqroun
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anas Belouali
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Subha Madhavan
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Thomas C Booth
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- Department of Neuroradiology, Ruskin Wing, King's College Hospital NHS Foundation Trust, London, UK
| | - Alysha Chelliah
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Haris Shuaib
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Carmen Dragos
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
| | | | | | | | | | - Shady Gamal
- University of Cairo School of Medicine, Giza, Egypt
| | | | | | | | - Ji Eun Park
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Jihye Yun
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Ho Sung Kim
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Abhishek Mahajan
- The Clatterbridge Cancer Centre NHS Foundation Trust Pembroke Place, Liverpool, UK
| | - Mark Muzi
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Sean Benson
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, Netherlands
- GROW School of Oncology and Developmental Biology, Maastricht, Netherlands
| | - Jonas Teuwen
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - William Escobar
- Clínica Imbanaco Grupo Quirón Salud, Cali, Colombia
- Universidad del Valle, Cali, Colombia
| | | | - Jose Bernal
- Universidad del Valle, Cali, Colombia
- The University of Edinburgh, Edinburgh, UK
| | | | - Joseph Choi
- Department of Industrial and Systems Engineering, University of Iowa, Iowa, USA
| | - Stephen Baek
- Department of Industrial and Systems Engineering, Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Yusung Kim
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Heba Ismael
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Bryan Allen
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - John M Buatti
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | | | - Hongwei Li
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Tobias Weiss
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andrea Bink
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Bertrand Pouymayou
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | | | - Joel Saltz
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Prateek Prasanna
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Sampurna Shrestha
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Kartik M Mani
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Department of Radiation Oncology, Stony Brook University, Stony Brook, NY, USA
| | - David Payne
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Tahsin Kurc
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Scientific Data Group, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Enrique Pelaez
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | - Francis Loayza
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | | | | | | | - Franco Vera
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Elvis Ríos
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Eduardo López
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Sergio A Velastin
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Godwin Ogbole
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mayowa Soneye
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Dotun Oyekunle
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | | | - Babatunde Osobu
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mustapha Shu'aibu
- Department of Radiology, Muhammad Abdullahi Wase Teaching Hospital, Kano, Nigeria
| | - Adeleye Dorcas
- Department of Radiology, Obafemi Awolowo University Ile-Ife, Ile-Ife, Osun, Nigeria
| | - Farouk Dako
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amber L Simpson
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Mohammad Hamghalam
- School of Computing, Queen's University, Kingston, ON, Canada
- Department of Electrical Engineering, Qazvin Branch, Islamic Azad University, Qazvin, Iran
| | - Jacob J Peoples
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Ricky Hu
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Anh Tran
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Danielle Cutler
- The Faculty of Arts & Sciences, Queen's University, Kingston, ON, Canada
| | - Fabio Y Moraes
- Department of Oncology, Queen's University, Kingston, ON, Canada
| | - Michael A Boss
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - James Gimpel
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Deepak Kattil Veettil
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Kendall Schmidt
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Brian Bialecki
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Sailaja Marella
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Cynthia Price
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Lisa Cimino
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Charles Apgar
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | | | - Bjoern Menze
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Jill S Barnholtz-Sloan
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute (NCI), National Institute of Health, Bethesda, MD, USA
| | | | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA.
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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13
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Calabrese E, Villanueva-Meyer JE, Rudie JD, Rauschecker AM, Baid U, Bakas S, Cha S, Mongan JT, Hess CP. The University of California San Francisco Preoperative Diffuse Glioma MRI Dataset. Radiol Artif Intell 2022; 4:e220058. [PMID: 36523646 PMCID: PMC9748624 DOI: 10.1148/ryai.220058] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/05/2022] [Accepted: 08/02/2022] [Indexed: 06/10/2023]
Abstract
Supplemental material is available for this article. Keywords: Informatics, MR Diffusion Tensor Imaging, MR Perfusion, MR Imaging, Neuro-Oncology, CNS, Brain/Brain Stem, Oncology, Radiogenomics, Radiology-Pathology Integration © RSNA, 2022.
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Affiliation(s)
- Evan Calabrese
- From the Center for Intelligent Imaging (Ci), Department
of Radiology & Biomedical Imaging, University of California San
Francisco, 505 Parnassus Ave, San Francisco, CA 94143 (E.C., J.E.V.M., J.D.R.,
A.M.R., S.C., J.T.M., C.P.H.); and Center for Biomedical Image Computing and
Analytics (CBICA), University of Pennsylvania, Philadelphia, Pa (U.B.,
S.B.)
| | - Javier E. Villanueva-Meyer
- From the Center for Intelligent Imaging (Ci), Department
of Radiology & Biomedical Imaging, University of California San
Francisco, 505 Parnassus Ave, San Francisco, CA 94143 (E.C., J.E.V.M., J.D.R.,
A.M.R., S.C., J.T.M., C.P.H.); and Center for Biomedical Image Computing and
Analytics (CBICA), University of Pennsylvania, Philadelphia, Pa (U.B.,
S.B.)
| | - Jeffrey D. Rudie
- From the Center for Intelligent Imaging (Ci), Department
of Radiology & Biomedical Imaging, University of California San
Francisco, 505 Parnassus Ave, San Francisco, CA 94143 (E.C., J.E.V.M., J.D.R.,
A.M.R., S.C., J.T.M., C.P.H.); and Center for Biomedical Image Computing and
Analytics (CBICA), University of Pennsylvania, Philadelphia, Pa (U.B.,
S.B.)
| | - Andreas M. Rauschecker
- From the Center for Intelligent Imaging (Ci), Department
of Radiology & Biomedical Imaging, University of California San
Francisco, 505 Parnassus Ave, San Francisco, CA 94143 (E.C., J.E.V.M., J.D.R.,
A.M.R., S.C., J.T.M., C.P.H.); and Center for Biomedical Image Computing and
Analytics (CBICA), University of Pennsylvania, Philadelphia, Pa (U.B.,
S.B.)
| | - Ujjwal Baid
- From the Center for Intelligent Imaging (Ci), Department
of Radiology & Biomedical Imaging, University of California San
Francisco, 505 Parnassus Ave, San Francisco, CA 94143 (E.C., J.E.V.M., J.D.R.,
A.M.R., S.C., J.T.M., C.P.H.); and Center for Biomedical Image Computing and
Analytics (CBICA), University of Pennsylvania, Philadelphia, Pa (U.B.,
S.B.)
| | - Spyridon Bakas
- From the Center for Intelligent Imaging (Ci), Department
of Radiology & Biomedical Imaging, University of California San
Francisco, 505 Parnassus Ave, San Francisco, CA 94143 (E.C., J.E.V.M., J.D.R.,
A.M.R., S.C., J.T.M., C.P.H.); and Center for Biomedical Image Computing and
Analytics (CBICA), University of Pennsylvania, Philadelphia, Pa (U.B.,
S.B.)
| | - Soonmee Cha
- From the Center for Intelligent Imaging (Ci), Department
of Radiology & Biomedical Imaging, University of California San
Francisco, 505 Parnassus Ave, San Francisco, CA 94143 (E.C., J.E.V.M., J.D.R.,
A.M.R., S.C., J.T.M., C.P.H.); and Center for Biomedical Image Computing and
Analytics (CBICA), University of Pennsylvania, Philadelphia, Pa (U.B.,
S.B.)
| | - John T. Mongan
- From the Center for Intelligent Imaging (Ci), Department
of Radiology & Biomedical Imaging, University of California San
Francisco, 505 Parnassus Ave, San Francisco, CA 94143 (E.C., J.E.V.M., J.D.R.,
A.M.R., S.C., J.T.M., C.P.H.); and Center for Biomedical Image Computing and
Analytics (CBICA), University of Pennsylvania, Philadelphia, Pa (U.B.,
S.B.)
| | - Christopher P. Hess
- From the Center for Intelligent Imaging (Ci), Department
of Radiology & Biomedical Imaging, University of California San
Francisco, 505 Parnassus Ave, San Francisco, CA 94143 (E.C., J.E.V.M., J.D.R.,
A.M.R., S.C., J.T.M., C.P.H.); and Center for Biomedical Image Computing and
Analytics (CBICA), University of Pennsylvania, Philadelphia, Pa (U.B.,
S.B.)
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14
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Zhang Y, Lucas CHG, Young JS, Morshed RA, McCoy L, Oberheim Bush NA, Taylor JW, Daras M, Butowski NA, Villanueva-Meyer JE, Cha S, Wrensch M, Wiencke JK, Lee JC, Pekmezci M, Phillips JJ, Perry A, Bollen AW, Aghi MK, Theodosopoulos P, Chang EF, Hervey-Jumper SL, Berger MS, Clarke JL, Chang SM, Molinaro AM, Solomon DA. Prospective genomically guided identification of "early/evolving" and "undersampled" IDH-wildtype glioblastoma leads to improved clinical outcomes. Neuro Oncol 2022; 24:1749-1762. [PMID: 35395677 PMCID: PMC9527525 DOI: 10.1093/neuonc/noac089] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Genomic profiling studies of diffuse gliomas have led to new improved classification schemes that better predict patient outcomes compared to conventional histomorphology alone. One example is the recognition that patients with IDH-wildtype diffuse astrocytic gliomas demonstrating lower-grade histologic features but genomic and/or epigenomic profile characteristic of glioblastoma typically have poor outcomes similar to patients with histologically diagnosed glioblastoma. Here we sought to determine the clinical impact of prospective genomic profiling for these IDH-wildtype diffuse astrocytic gliomas lacking high-grade histologic features but with molecular profile of glioblastoma. METHODS Clinical management and outcomes were analyzed for 38 consecutive adult patients with IDH-wildtype diffuse astrocytic gliomas lacking necrosis or microvascular proliferation on histologic examination that were genomically profiled on a prospective clinical basis revealing criteria for an integrated diagnosis of "diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade IV" per cIMPACT-NOW criteria. RESULTS We identified that this diagnosis consists of two divergent clinical scenarios based on integration of radiologic, histologic, and genomic features that we term "early/evolving" and "undersampled" glioblastoma, IDH-wildtype. We found that prospective genomically guided identification of early/evolving and undersampled IDH-wildtype glioblastoma resulted in more aggressive patient management and improved clinical outcomes compared to a biologically matched historical control patient cohort receiving standard-of-care therapy based on histomorphologic diagnosis alone. CONCLUSIONS These results support routine use of genomic and/or epigenomic profiling to accurately classify glial neoplasms, as these assays not only improve diagnostic classification but critically lead to more appropriate patient management that can improve clinical outcomes.
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Affiliation(s)
- Yalan Zhang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Calixto-Hope G Lucas
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Jacob S Young
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Ramin A Morshed
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Lucie McCoy
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Nancy Ann Oberheim Bush
- Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Jennie W Taylor
- Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Mariza Daras
- Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Nicholas A Butowski
- Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Javier E Villanueva-Meyer
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Margaret Wrensch
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - John K Wiencke
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Julieann C Lee
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Melike Pekmezci
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Joanna J Phillips
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Arie Perry
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Andrew W Bollen
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Manish K Aghi
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Philip Theodosopoulos
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Edward F Chang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Shawn L Hervey-Jumper
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Mitchel S Berger
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Jennifer L Clarke
- Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Susan M Chang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
- Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Annette M Molinaro
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - David A Solomon
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
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15
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Richardson G, Park J, Boyer M, Gutierrez M, Carbone D, Savvides P, Kaumaya P, Bekaii-Saab T, Phan T, Chong L, Cha S, Ede N, Nixon B, Withana N, Good A. P1.15-08 Phase 1: IMU-201 (PD1-Vaxx), a B-Cell Immunotherapy as Monotherapy or in Combination with Atezolizumab, in Adults with Non-Small Cell Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.204] [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: 11/25/2022]
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16
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Rudie JD, Calabrese E, Saluja R, Weiss D, Colby JB, Cha S, Hess CP, Rauschecker AM, Sugrue LP, Villanueva-Meyer JE. Longitudinal Assessment of Posttreatment Diffuse Glioma Tissue Volumes with Three-dimensional Convolutional Neural Networks. Radiol Artif Intell 2022; 4:e210243. [PMID: 36204543 PMCID: PMC9530762 DOI: 10.1148/ryai.210243] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 05/17/2022] [Accepted: 07/15/2022] [Indexed: 12/30/2022]
Abstract
Neural networks were trained for segmentation and longitudinal assessment of posttreatment diffuse glioma. A retrospective cohort (from January 2018 to December 2019) of 298 patients with diffuse glioma (mean age, 52 years ± 14 [SD]; 177 men; 152 patients with glioblastoma, 72 patients with astrocytoma, and 74 patients with oligodendroglioma) who underwent two consecutive multimodal MRI examinations were randomly selected into training (n = 198) and testing (n = 100) samples. A posttreatment tumor segmentation three-dimensional nnU-Net convolutional neural network with multichannel inputs (T1, T2, and T1 postcontrast and fluid-attenuated inversion recovery [FLAIR]) was trained to segment three multiclass tissue types (peritumoral edematous, infiltrated, or treatment-changed tissue [ED]; active tumor or enhancing tissue [AT]; and necrotic core). Separate longitudinal change nnU-Nets were trained on registered and subtracted FLAIR and T1 postlongitudinal images to localize and better quantify and classify changes in ED and AT. Segmentation Dice scores, volume similarities, and 95th percentile Hausdorff distances ranged from 0.72 to 0.89, 0.90 to 0.96, and 2.5 to 3.6 mm, respectively. Accuracy rates of the posttreatment tumor segmentation and longitudinal change networks being able to classify longitudinal changes in ED and AT as increased, decreased, or unchanged were 76%-79% and 90%-91%, respectively. The accuracy levels of the longitudinal change networks were not significantly different from those of three neuroradiologists (accuracy, 90%-92%; κ, 0.58-0.63; P > .05). The results of this study support the potential clinical value of artificial intelligence-based automated longitudinal assessment of posttreatment diffuse glioma. Keywords: MR Imaging, Neuro-Oncology, Neural Networks, CNS, Brain/Brain Stem, Segmentation, Quantification, Convolutional Neural Network (CNN) Supplemental material is available for this article. © RSNA, 2022.
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17
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Merkaj S, Bahar RC, Zeevi T, Lin M, Ikuta I, Bousabarah K, Cassinelli Petersen GI, Staib L, Payabvash S, Mongan JT, Cha S, Aboian MS. Machine Learning Tools for Image-Based Glioma Grading and the Quality of Their Reporting: Challenges and Opportunities. Cancers (Basel) 2022; 14:cancers14112623. [PMID: 35681603 PMCID: PMC9179416 DOI: 10.3390/cancers14112623] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 01/27/2023] Open
Abstract
Technological innovation has enabled the development of machine learning (ML) tools that aim to improve the practice of radiologists. In the last decade, ML applications to neuro-oncology have expanded significantly, with the pre-operative prediction of glioma grade using medical imaging as a specific area of interest. We introduce the subject of ML models for glioma grade prediction by remarking upon the models reported in the literature as well as by describing their characteristic developmental workflow and widely used classifier algorithms. The challenges facing these models-including data sources, external validation, and glioma grade classification methods -are highlighted. We also discuss the quality of how these models are reported, explore the present and future of reporting guidelines and risk of bias tools, and provide suggestions for the reporting of prospective works. Finally, this review offers insights into next steps that the field of ML glioma grade prediction can take to facilitate clinical implementation.
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Affiliation(s)
- Sara Merkaj
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, P.O. Box 208042, New Haven, CT 06520, USA; (S.M.); (R.C.B.); (T.Z.); (M.L.); (I.I.); (G.I.C.P.); (L.S.); (S.P.)
- Department of Neurosurgery, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Ryan C. Bahar
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, P.O. Box 208042, New Haven, CT 06520, USA; (S.M.); (R.C.B.); (T.Z.); (M.L.); (I.I.); (G.I.C.P.); (L.S.); (S.P.)
| | - Tal Zeevi
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, P.O. Box 208042, New Haven, CT 06520, USA; (S.M.); (R.C.B.); (T.Z.); (M.L.); (I.I.); (G.I.C.P.); (L.S.); (S.P.)
| | - MingDe Lin
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, P.O. Box 208042, New Haven, CT 06520, USA; (S.M.); (R.C.B.); (T.Z.); (M.L.); (I.I.); (G.I.C.P.); (L.S.); (S.P.)
- Visage Imaging, Inc., 12625 High Bluff Dr, Suite 205, San Diego, CA 92130, USA
| | - Ichiro Ikuta
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, P.O. Box 208042, New Haven, CT 06520, USA; (S.M.); (R.C.B.); (T.Z.); (M.L.); (I.I.); (G.I.C.P.); (L.S.); (S.P.)
| | | | - Gabriel I. Cassinelli Petersen
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, P.O. Box 208042, New Haven, CT 06520, USA; (S.M.); (R.C.B.); (T.Z.); (M.L.); (I.I.); (G.I.C.P.); (L.S.); (S.P.)
| | - Lawrence Staib
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, P.O. Box 208042, New Haven, CT 06520, USA; (S.M.); (R.C.B.); (T.Z.); (M.L.); (I.I.); (G.I.C.P.); (L.S.); (S.P.)
| | - Seyedmehdi Payabvash
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, P.O. Box 208042, New Haven, CT 06520, USA; (S.M.); (R.C.B.); (T.Z.); (M.L.); (I.I.); (G.I.C.P.); (L.S.); (S.P.)
| | - John T. Mongan
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., San Francisco, CA 94143, USA; (J.T.M.); (S.C.)
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., San Francisco, CA 94143, USA; (J.T.M.); (S.C.)
| | - Mariam S. Aboian
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, P.O. Box 208042, New Haven, CT 06520, USA; (S.M.); (R.C.B.); (T.Z.); (M.L.); (I.I.); (G.I.C.P.); (L.S.); (S.P.)
- Correspondence: ; Tel.: +650-285-7577
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18
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Calabrese E, Rudie JD, Rauschecker AM, Villanueva-Meyer JE, Clarke JL, Solomon DA, Cha S. Combining radiomics and deep convolutional neural network features from preoperative MRI for predicting clinically relevant genetic biomarkers in glioblastoma. Neurooncol Adv 2022; 4:vdac060. [PMID: 35611269 PMCID: PMC9122791 DOI: 10.1093/noajnl/vdac060] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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: 11/13/2022] Open
Abstract
Abstract
Background
Glioblastoma is the most common primary brain malignancy, yet treatment options are limited, and prognosis remains guarded. Individualized tumor genetic assessment has become important for accurate prognosis and for guiding emerging targeted therapies. However, challenges remain for widespread tumor genetic testing due to costs and the need for tissue sampling. The aim of this study is to evaluate a novel artificial intelligence method for predicting clinically relevant genetic biomarkers from preoperative brain MRI in patients with glioblastoma.
Methods
We retrospectively analyzed preoperative MRI data from 400 patients with glioblastoma and grade 4 astrocytoma, IDH mutant who underwent resection and genetic testing. Nine genetic biomarkers were assessed: hotspot mutations of IDH1 or TERT promoter, pathogenic mutations of TP53, PTEN, ATRX, or CDKN2A/B, MGMT promoter methylation, EGFR amplification, and combined aneuploidy of chromosomes 7 & 10. Models were developed to predict biomarker status from MRI data using radiomics features, convolutional neural network (CNN) features, and a combination of both.
Results
Combined model performance was good for IDH1 and TERT promoter hotspot mutations, pathogenic mutations of ATRX and CDKN2A/B, and combined aneuploidy of chromosomes 7 & 10, with receiver operating characteristic area under the curve (ROC AUC) > 0.85 and was fair for all other tested biomarkers with ROC AUC > 0.7. Combined model performance was statistically superior to individual radiomics and CNN feature models for prediction chromosome 7 & 10 aneuploidy, MGMT promoter methylation, and PTEN loss.
Conclusions
Combining radiomics and CNN features from preoperative MRI yields improved non-invasive genetic biomarker prediction performance in patients with grade 4 diffuse gliomas.
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Affiliation(s)
- Evan Calabrese
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
- Center for Intelligent Imaging, University of California San Francisco, San Francisco, California, USA
| | - Jeffrey D Rudie
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
| | - Andreas M Rauschecker
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
- Center for Intelligent Imaging, University of California San Francisco, San Francisco, California, USA
| | - Jennifer L Clarke
- Division of Neuro-Oncology, Department of Neurology and Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - David A Solomon
- Department of Pathology, University of California San Francisco, San Francisco, California, USA
- Clinical Cancer Genomics Laboratory, University of California San Francisco, San Francisco, California, USA
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
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19
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Vajapeyam S, Brown D, Ziaei A, Wu S, Vezina G, Stern J, Panigrahy A, Patay Z, Tamrazi B, Jones J, Haque S, Enterline D, Cha S, Jones B, Yeom K, Onar-Thomas A, Dunkel I, Fouladi M, Fangusaro J, Poussaint T. ADC Histogram Analysis of Pediatric Low-Grade Glioma Treated with Selumetinib: A Report from the Pediatric Brain Tumor Consortium. AJNR Am J Neuroradiol 2022; 43:455-461. [PMID: 35210278 PMCID: PMC8910799 DOI: 10.3174/ajnr.a7433] [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: 08/10/2021] [Accepted: 01/01/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND PURPOSE Selumetinib is a promising MAP (mitogen-activated protein) kinase (MEK) 1/2 inhibitor treatment for pediatric low-grade gliomas. We hypothesized that MR imaging-derived ADC histogram metrics would be associated with survival and response to treatment with selumetinib. MATERIALS AND METHODS Children with recurrent, refractory, or progressive pediatric low-grade gliomas who had World Health Organization grade I pilocytic astrocytoma with KIAA1549-BRAF fusion or the BRAF V600E mutation (stratum 1), neurofibromatosis type 1-associated pediatric low-grade gliomas (stratum 3), or sporadic non-neurofibromatosis type 1 optic pathway and hypothalamic glioma (OPHG) (stratum 4) were treated with selumetinib for up to 2 years. Quantitative ADC histogram metrics were analyzed for total and enhancing tumor volumes at baseline and during treatment. RESULTS Each stratum comprised 25 patients. Stratum 1 responders showed lower values of SD of baseline ADC_total as well as a larger decrease with time on treatment in ADC_total mean, mode, and median compared with nonresponders. Stratum 3 responders showed a greater longitudinal decrease in ADC_total. In stratum 4, higher baseline ADC_total skewness and kurtosis were associated with shorter progression-free survival. When all 3 strata were combined, responders showed a greater decrease with time in ADC_total mode and median. Compared with sporadic OPHG, neurofibromatosis type 1-associated OPHG had lower values of ADC_total mean, mode, and median as well as ADC_enhancement mean and median and higher values of ADC_total skewness and kurtosis at baseline. The longitudinal decrease in ADC_total median during treatment was significantly greater in sporadic OPHG compared with neurofibromatosis type 1-associated OPHG. CONCLUSIONS ADC histogram metrics are associated with progression-free survival and response to treatment with selumetinib in pediatric low-grade gliomas.
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Affiliation(s)
- S. Vajapeyam
- From the Department of Radiology (S.V., T.Y.P.), Boston Children’s Hospital,Harvard Medical School, Boston, Massachusetts
| | - D. Brown
- Department of Radiology (D.B.), Massachusetts General Hospital, Boston, Massachusetts
| | - A. Ziaei
- Department of Radiology (A.Z.), Boston Children’s Hospital, Boston, Massachusetts
| | - S. Wu
- Department of Biostatistics (S.W., A.O.-T.), St Jude Children’s Research Hospital, Memphis, Tennessee
| | - G. Vezina
- Department of Radiology (G.V.), Children’s National Medical Center, Washington, DC
| | - J.S. Stern
- Department of Radiology (J.S.S.), Ann and Robert H Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - A. Panigrahy
- Department of Radiology (A.P.), Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Z. Patay
- Department of Diagnostic Imaging (Z.P.), St Jude Children’s Research Hospital, Memphis, Tennessee
| | - B. Tamrazi
- Department of Radiology (B.T.), Children’s Hospital Los Angeles, Los Angeles, California
| | - J.Y. Jones
- Department of Radiology (J.Y.J., M.F.), Nationwide Children’s Hospital, Columbus, Ohio
| | - S.S. Haque
- Department of Radiology (S.S.H., I.J.D.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - D.S. Enterline
- Department of Radiology (D.S.E.), Duke University School of Medicine, Durham, North Carolina
| | - S. Cha
- Department of Radiology (S.C.), University of California San Francisco, San Francisco, California
| | - B.V. Jones
- Department of Radiology (B.V.J.), Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - K.W. Yeom
- Department of Radiology (K.W.Y.), Stanford University School of Medicine, Stanford, California
| | - A. Onar-Thomas
- Department of Biostatistics (S.W., A.O.-T.), St Jude Children’s Research Hospital, Memphis, Tennessee
| | - I.J. Dunkel
- Department of Radiology (S.S.H., I.J.D.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - M. Fouladi
- Department of Radiology (J.Y.J., M.F.), Nationwide Children’s Hospital, Columbus, Ohio
| | - J.R. Fangusaro
- Department of Hematology, Oncology, and Stem Cell Transplantation (J.R.F.), Children’s Healthcare of Atlanta and Emory University, Atlanta, Georgia
| | - T.Y. Poussaint
- From the Department of Radiology (S.V., T.Y.P.), Boston Children’s Hospital,Harvard Medical School, Boston, Massachusetts
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20
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Abstract
Management of gliomas following initial diagnosis requires thoughtful presurgical planning followed by regular imaging to monitor treatment response and survey for new tumor growth. Traditional MR imaging modalities such as T1 post-contrast and T2-weighted sequences have long been a staple of tumor diagnosis, surgical planning, and post-treatment surveillance. While these sequences remain integral in the management of gliomas, advances in imaging techniques have allowed for a more detailed characterization of tumor characteristics. Advanced MR sequences such as perfusion, diffusion, and susceptibility weighted imaging, as well as PET scans have emerged as valuable tools to inform clinical decision making and provide a non-invasive way to help distinguish between tumor recurrence and pseudoprogression. Furthermore, these advances in imaging have extended to the operating room and assist in making surgical resections safer. Nevertheless, surgery, chemotherapy, and radiation treatment continue to make the interpretation of MR changes difficult for glioma patients. As analytics and machine learning techniques improve, radiomics offers the potential to be more quantitative and personalized in the interpretation of imaging data for gliomas. In this review, we describe the role of these newer imaging modalities during the different stages of management for patients with gliomas, focusing on the pre-operative, post-operative, and surveillance periods. Finally, we discuss radiomics as a means of promoting personalized patient care in the future.
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Affiliation(s)
- Luis R. Carrete
- University of California San Francisco School of Medicine, San Francisco, CA, United States
| | - Jacob S. Young
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
- *Correspondence: Jacob S. Young,
| | - Soonmee Cha
- Department of Radiology, University of California, San Francisco, San Francisco, CA, United States
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21
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Lucas CHG, Gupta R, Wu J, Shah K, Ravindranathan A, Barreto J, Gener M, Ginn KF, Prall OWJ, Xu H, Kee D, Ko HS, Yaqoob N, Zia N, Florez A, Cha S, Perry A, Clarke JL, Chang SM, Berger MS, Solomon DA. EWSR1-BEND2 fusion defines an epigenetically distinct subtype of astroblastoma. Acta Neuropathol 2022; 143:109-113. [PMID: 34825267 PMCID: PMC8732961 DOI: 10.1007/s00401-021-02388-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/05/2021] [Accepted: 11/17/2021] [Indexed: 11/02/2022]
Affiliation(s)
- Calixto-Hope G Lucas
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
| | - Rohit Gupta
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
| | - Jasper Wu
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
| | - Kathan Shah
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
| | - Ajay Ravindranathan
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
| | - Jairo Barreto
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
| | - Melissa Gener
- Department of Pathology, Children's Mercy Hospital, Kansas City, MO, USA
| | - Kevin F Ginn
- Department of Pediatric Hematology and Oncology, Children's Mercy Hospital, Kansas City, MO, USA
| | - Owen W J Prall
- Department of Pathology, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Huiling Xu
- Department of Pathology, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Damien Kee
- Department of Medical Oncology, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Hyun S Ko
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Nausheen Yaqoob
- Department of Histopathology, Indus Hospital and Health Network, Karachi, Pakistan
| | - Nida Zia
- Department of Pediatric Hematology and Oncology, Indus Hospital and Health Network, Karachi, Pakistan
| | - Adriana Florez
- Department of Pathology, Fundación Santafé de Bogotá, Bogota, Colombia
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Arie Perry
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Jennifer L Clarke
- Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Susan M Chang
- Division of Neuro-Oncology, Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Mitchel S Berger
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - David A Solomon
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA.
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22
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Haddad AF, Young JS, Morshed RA, Josephson SA, Cha S, Berger MS. Pseudo-insular glioma syndrome: illustrative cases. Journal of Neurosurgery: Case Lessons 2021; 2:CASE21481. [PMID: 35854917 PMCID: PMC9281470 DOI: 10.3171/case21481] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/20/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lower-grade insular gliomas often appear as expansile and infiltrative masses on magnetic resonance imaging (MRI). However, there are nonneoplastic lesions of the insula, such as demyelinating disease and vasculopathies, that can mimic insular gliomas. OBSERVATIONS The authors report two patients who presented with headaches and were found to have mass lesions concerning for lower-grade insular glioma based on MRI obtained at initial presentation. However, on the immediate preoperative MRI obtained a few weeks later, both patients had spontaneous and complete resolution of the insular lesions. LESSONS Tumor mimics should always be in the differential diagnosis of brain masses, including those involving the insula. The immediate preoperative MRI (within 24–48 hours of surgery) must be compared carefully with the initial presentation MRI to assess interval change that suggests tumor mimics to avoid unnecessary surgical intervention.
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Affiliation(s)
| | | | | | | | - Soonmee Cha
- Radiology, University of California, San Francisco, San Francisco, California
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23
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Affiliation(s)
- Megan B Richie
- Department of Neurology, University of California, San Francisco, San Francisco
| | - Elan L Guterman
- Department of Neurology, University of California, San Francisco, San Francisco
| | - Maulik P Shah
- Department of Neurology, University of California, San Francisco, San Francisco
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco
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24
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Morshed RA, Lee AT, Wang EJ, Young JS, Cha S, Hervey-Jumper SL, Berger MS. Functional outcomes after resection of middle frontal gyrus diffuse gliomas. J Neurosurg 2021; 137:1-8. [PMID: 34798608 DOI: 10.3171/2021.8.jns211624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/01/2021] [Accepted: 08/06/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The clinical outcomes for patients undergoing resection of diffuse glioma within the middle frontal gyrus (MFG) are understudied. Anatomically, the MFG is richly interconnected to known language areas, and nearby subcortical fibers are at risk during resection. The goal of this study was to determine the functional outcomes and intraoperative mapping results related to resection of MFG gliomas. Additionally, the study aimed to evaluate if subcortical tract disruption on imaging correlated with functional outcomes. METHODS The authors performed a retrospective review of 39 patients with WHO grade II-IV diffuse gliomas restricted to only the MFG and underlying subcortical region that were treated with resection and had no prior treatment. Intraoperative mapping results and postoperative neurological deficits by discharge and 90 days were assessed. Diffusion tensor imaging (DTI) tractography was used to assess subcortical tract integrity on pre- and postoperative imaging. RESULTS The mean age of the cohort was 37.9 years at surgery, and the median follow-up was 5.1 years. The mean extent of resection was 98.9% for the cohort. Of the 39 tumors, 24 were left sided (61.5%). Thirty-six patients (92.3%) underwent intraoperative mapping, with 59% of patients undergoing an awake craniotomy. No patients had positive cortical mapping sites overlying the tumor, and 12 patients (33.3%) had positive subcortical stimulation sites. By discharge, 8 patients had language dysfunction, and 5 patients had mild weakness. By 90 days, 2 patients (5.1%) had persistent mild hand weakness only. There were no persistent language deficits by 90 days. On univariate analysis, preoperative tumor size (p = 0.0001), positive subcortical mapping (p = 0.03), preoperative tumor invasion of neighboring subcortical tracts on DTI tractography (p = 0.0003), and resection cavity interruption of subcortical tracts on DTI tractography (p < 0.0001) were associated with an increased risk of having a postoperative deficit by discharge. There were no instances of complete subcortical tract transections in the cohort. CONCLUSIONS MFG diffuse gliomas may undergo extensive resection with minimal risk for long-term morbidity. Partial subcortical tract interruption may lead to transient but not permanent deficits. Subcortical mapping is essential to reduce permanent morbidity during resection of MFG tumors by avoiding complete transection of critical subcortical tracts.
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Affiliation(s)
- Ramin A Morshed
- 1Department of Neurological Surgery, University of California, San Francisco, California
| | - Anthony T Lee
- 1Department of Neurological Surgery, University of California, San Francisco, California
| | - Elaina J Wang
- 2Warren Alpert Medical School, Brown University, Providence, Rhode Island; and
| | - Jacob S Young
- 1Department of Neurological Surgery, University of California, San Francisco, California
| | - Soonmee Cha
- 3Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Shawn L Hervey-Jumper
- 1Department of Neurological Surgery, University of California, San Francisco, California
| | - Mitchel S Berger
- 1Department of Neurological Surgery, University of California, San Francisco, California
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25
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Li Y, Sloan E, Bollen A, Solomon D, Theodosopoulos P, Cha S. Systemic and Craniospinal Rosai Dorfman Disease with Intraparenchymal, Intramedullary and Leptomeningeal Disease. Int J Hematol Oncol Stem Cell Res 2021; 15:260-264. [PMID: 35291666 PMCID: PMC8888355 DOI: 10.18502/ijhoscr.v15i4.7482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/01/2020] [Accepted: 12/13/2020] [Indexed: 11/24/2022] Open
Abstract
Rosai Dorfman disease is a rare histiocytic disorder of over-production of non-Langerhans histiocytes, which typically manifests with massive lymphadenopathy and sinonasal involvement. We report a rare case of systemic and disseminated craniospinal Rosai Dorfman disease with intraparenchymal and leptomeningeal involvement, but no sinus or dural-based disease. The diagnosis was established by biopsy of a hypothalamic mass. Additionally, UCSF500 Next Generation Sequencing demonstrated a solitary pathogenic alteration affecting the BRAF oncogene, which supports the morphologic and immunohistochemical diagnosis of Rosai-Dorfman disease.
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Affiliation(s)
- Yi Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States
| | - Emily Sloan
- Department of Pathology, University of California San Francisco, San Francisco, California, United States
| | - Andrew Bollen
- Department of Pathology, University of California San Francisco, San Francisco, California, United States
| | - David Solomon
- Department of Pathology, University of California San Francisco, San Francisco, California, United States
| | - Philip Theodosopoulos
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, United States
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States
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26
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Young JS, Morshed RA, Andrews JP, Cha S, Berger MS. Prosopagnosia following nonlanguage dominant inferior temporal lobe low-grade glioma resection in which the inferior longitudinal fasciculus was disrupted preoperatively: illustrative case. Journal of Neurosurgery: Case Lessons 2021; 2:CASE21277. [PMID: 35855186 PMCID: PMC9265231 DOI: 10.3171/case21277] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 05/24/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND
Prosopagnosia is a rare neurological condition characterized by the impairment of face perception with preserved visual processing and cognitive functioning and is associated with injury to the fusiform gyrus and inferior longitudinal fasciculus (ILF). Reports of this clinical impairment following resection of right temporal lobe diffuse gliomas in the absence of contralateral injury are exceedingly scarce and not expected as a complication of surgery.
OBSERVATIONS
The authors describe the case of a young female patient found to have an incidental diffuse glioma in the right inferior temporal lobe despite evidence of preoperative ILF disruption by the tumor. Following resection of the lesion, despite the preoperative disruption to the ILF by the tumor, the patient developed prosopagnosia. There was no evidence of contralateral, left-sided ILF injury.
LESSONS
Given the significant functional impairment associated with prosopagnosia, neurosurgeons should be aware of the exceedingly rare possibility of a visual-processing deficit following unilateral and, in this case, right-sided inferior temporal lobe glioma resections. More investigation is needed to determine whether preoperative testing can determine dominance of facial-processing networks for patients with lesions in the right inferior posterior temporooccipital lobe and whether intraoperative mapping could help prevent this complication.
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Affiliation(s)
| | | | | | - Soonmee Cha
- Radiology, University of California, San Francisco, California
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27
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Ahn SS, Cha S. Pre- and Post-Treatment Imaging of Primary Central Nervous System Tumors in the Molecular and Genetic Era. Korean J Radiol 2021; 22:1858-1874. [PMID: 34402244 PMCID: PMC8546137 DOI: 10.3348/kjr.2020.1450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/15/2022] Open
Abstract
Recent advances in the molecular and genetic characterization of central nervous system (CNS) tumors have ushered in a new era of tumor classification, diagnosis, and prognostic assessment. In this emerging and rapidly evolving molecular genetic era, imaging plays a critical role in the preoperative diagnosis and surgical planning, molecular marker prediction, targeted treatment planning, and post-therapy assessment of CNS tumors. This review provides an overview of the current imaging methods relevant to the molecular genetic classification of CNS tumors. Specifically, we focused on 1) the correlates between imaging features and specific molecular genetic markers and 2) the post-therapy imaging used for therapeutic assessment.
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Affiliation(s)
- Sung Soo Ahn
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Center for Clinical Image Data Science, Yonsei University College of Medicine, Seoul, Korea.,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
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28
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Kazarian E, Marks A, Cui J, Darbinyan A, Tong E, Mueller S, Cha S, Aboian MS. Topographic correlates of driver mutations and endogenous gene expression in pediatric diffuse midline gliomas and hemispheric high-grade gliomas. Sci Rep 2021; 11:14377. [PMID: 34257334 PMCID: PMC8277861 DOI: 10.1038/s41598-021-92943-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 06/15/2021] [Indexed: 11/09/2022] Open
Abstract
We evaluate the topographic distribution of diffuse midline gliomas and hemispheric high-grade gliomas in children with respect to their normal gene expression patterns and pathologic driver mutation patterns. We identified 19 pediatric patients with diffuse midline or high-grade glioma with preoperative MRI from tumor board review. 7 of these had 500 gene panel mutation testing, 11 patients had 50 gene panel mutation testing and one 343 gene panel testing from a separate institution were included as validation set. Tumor imaging features and gene expression patterns were analyzed using Allen Brain Atlas. Twelve patients had diffuse midline gliomas and seven had hemispheric high-grade gliomas. Three diffuse midline gliomas had the K27M mutation in the tail of histone H3 protein. All patients undergoing 500 gene panel testing had additional mutations, the most common being in ACVR1, PPM1D, and p53. Hemispheric high-grade gliomas had either TP53 or IDH1 mutation and diffuse midline gliomas had H3 K27M-mutation. Gene expression analysis in normal brains demonstrated that genes mutated in diffuse midline gliomas had higher expression along midline structures as compared to the cerebral hemispheres. Our study suggests that topographic location of pediatric diffuse midline gliomas and hemispheric high-grade gliomas correlates with driver mutations of tumor to the endogenous gene expression in that location. This correlation suggests that cellular state that is required for increased gene expression predisposes that location to mutations and defines the driver mutations within tumors that arise from that region.
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Affiliation(s)
- Eve Kazarian
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Asher Marks
- Department of Pediatric Hematology & Oncology, Yale School of Medicine, New Haven, CT, USA
| | - Jin Cui
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Armine Darbinyan
- Department of Neuropathology, Yale School of Medicine, New Haven, CT, USA
| | - Elizabeth Tong
- Department of Radiology, , University of California, San Francisco, San Francisco, USA
| | - Sabine Mueller
- Division of Pediatric Hematology & Oncology, Department of Pediatrics, University of California, San Francisco, San Francisco, USA.,Department of Neurological Surgery, University of California, San Francisco, San Francisco, USA.,Department of Neurology, University of California, San Francisco, San Francisco, USA
| | - Soonmee Cha
- Department of Radiology, , University of California, San Francisco, San Francisco, USA
| | - Mariam S Aboian
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
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29
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Calabrese E, Rudie JD, Rauschecker AM, Villanueva-Meyer JE, Cha S. Feasibility of Simulated Postcontrast MRI of Glioblastomas and Lower-Grade Gliomas by Using Three-dimensional Fully Convolutional Neural Networks. Radiol Artif Intell 2021; 3:e200276. [PMID: 34617027 PMCID: PMC8489450 DOI: 10.1148/ryai.2021200276] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 04/20/2021] [Accepted: 04/29/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate the feasibility and accuracy of simulated postcontrast T1-weighted brain MR images generated by using precontrast MR images in patients with brain glioma. MATERIALS AND METHODS In this retrospective study, a three-dimensional deep convolutional neural network was developed to simulate T1-weighted postcontrast images from eight precontrast sequences in 400 patients (mean age, 57 years; 239 men; from 2015 to 2020), including 332 with glioblastoma and 68 with lower-grade gliomas. Performance was evaluated by using quantitative image similarity and error metrics and enhancing tumor overlap analysis. Performance was also assessed on a multicenter external dataset (n = 286 from the 2019 Multimodal Brain Tumor Segmentation Challenge; mean age, 60 years; ratio of men to women unknown) by using transfer learning. A subset of cases was reviewed by neuroradiologist readers to assess whether simulated images affected the ability to determine the tumor grade. RESULTS Simulated whole-brain postcontrast images were both qualitatively and quantitatively similar to the real postcontrast images in terms of quantitative image similarity (structural similarity index of 0.84 ± 0.05), pixelwise error (symmetric mean absolute percent error of 3.65%), and enhancing tumor compartment overlap (Dice coefficient, 0.65 ± 0.25). Similar results were achieved with the external dataset (Dice coefficient, 0.62 ± 0.27). There was no difference in the ability of the neuroradiologist readers to determine the tumor grade in real versus simulated images (accuracy, 87.7% vs 90.6%; P = .87). CONCLUSION The developed model was capable of producing simulated postcontrast T1-weighted MR images that were similar to real acquired images as determined by both quantitative analysis and radiologist assessment.Keywords: MR-Contrast Agent, MR-Imaging, CNS, Brain/Brain Stem, Contrast Agents-Intravenous, Neoplasms-Primary, Experimental Investigations, Technology Assessment, Supervised Learning, Transfer Learning, Convolutional Neural Network, Deep Learning Algorithms, Machine Learning Algorithms Supplemental material is available for this article. © RSNA, 2021.
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30
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Cluceru J, Nelson SJ, Wen Q, Phillips JJ, Shai A, Molinaro AM, Alcaide-Leon P, Olson MP, Nair D, LaFontaine M, Chunduru P, Villanueva-Meyer JE, Cha S, Chang SM, Berger MS, Lupo JM. Recurrent tumor and treatment-induced effects have different MR signatures in contrast enhancing and non-enhancing lesions of high-grade gliomas. Neuro Oncol 2021; 22:1516-1526. [PMID: 32319527 DOI: 10.1093/neuonc/noaa094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 12/19/2022] Open
Abstract
BACKGROUND Differentiating treatment-induced injury from recurrent high-grade glioma is an ongoing challenge in neuro-oncology, in part due to lesion heterogeneity. This study aimed to determine whether different MR features were relevant for distinguishing recurrent tumor from the effects of treatment in contrast-enhancing lesions (CEL) and non-enhancing lesions (NEL). METHODS This prospective study analyzed 291 tissue samples (222 recurrent tumor, 69 treatment-effect) with known coordinates on imaging from 139 patients who underwent preoperative 3T MRI and surgery for a suspected recurrence. 8 MR parameter values were tested from perfusion-weighted, diffusion-weighted, and MR spectroscopic imaging at each tissue sample location for association with histopathological outcome using generalized estimating equation models for CEL and NEL tissue samples. Individual cutoff values were evaluated using receiver operating characteristic curve analysis with 5-fold cross-validation. RESULTS In tissue samples obtained from CEL, elevated relative cerebral blood volume (rCBV) was associated with the presence of recurrent tumor pathology (P < 0.03), while increases in normalized choline (nCho) and choline-to-NAA index (CNI) were associated with the presence of recurrent tumor pathology in NEL tissue samples (P < 0.008). A mean CNI cutoff value of 2.7 had the highest performance, resulting in mean sensitivity and specificity of 0.61 and 0.81 for distinguishing treatment-effect from recurrent tumor within the NEL. CONCLUSION Although our results support prior work that underscores the utility of rCBV in distinguishing the effects of treatment from recurrent tumor within the contrast enhancing lesion, we found that metabolic parameters may be better at differentiating recurrent tumor from treatment-related changes in the NEL of high-grade gliomas.
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Affiliation(s)
- Julia Cluceru
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Sarah J Nelson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Qiuting Wen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Joanna J Phillips
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.,Department of Neurological Surgery, University of California San Francisco, San Francisco, California.,Department of Pathology, University of California San Francisco, San Francisco, California
| | - Anny Shai
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Annette M Molinaro
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Paula Alcaide-Leon
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Marram P Olson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Devika Nair
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Marisa LaFontaine
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Pranathi Chunduru
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Susan M Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Mitchel S Berger
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Janine M Lupo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
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31
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Park CJ, Han K, Kim H, Ahn SS, Choi D, Park YW, Chang JH, Kim SH, Cha S, Lee SK. MRI Features May Predict Molecular Features of Glioblastoma in Isocitrate Dehydrogenase Wild-Type Lower-Grade Gliomas. AJNR Am J Neuroradiol 2021; 42:448-456. [PMID: 33509914 DOI: 10.3174/ajnr.a6983] [Citation(s) in RCA: 27] [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] [Received: 06/15/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Isocitrate dehydrogenase (IDH) wild-type lower-grade gliomas (histologic grades II and III) with epidermal growth factor receptor (EGFR) amplification or telomerase reverse transcriptase (TERT) promoter mutation are reported to behave similar to glioblastoma. We aimed to evaluate whether MR imaging features could identify a subset of IDH wild-type lower-grade gliomas that carry molecular features of glioblastoma. MATERIALS AND METHODS In this multi-institutional retrospective study, pathologically confirmed IDH wild-type lower-grade gliomas from 2 tertiary institutions and The Cancer Genome Atlas constituted the training set (institution 1 and The Cancer Genome Atlas, 64 patients) and the independent test set (institution 2, 57 patients). Preoperative MRIs were analyzed using the Visually AcceSAble Rembrandt Images and radiomics. The molecular glioblastoma status was determined on the basis of the presence of EGFR amplification and TERT promoter mutation. Molecular glioblastoma was present in 73.4% and 56.1% in the training and test sets, respectively. Models using clinical, Visually AcceSAble Rembrandt Images, and radiomic features were built to predict the molecular glioblastoma status in the training set; then they were validated in the test set. RESULTS In the test set, a model using both Visually AcceSAble Rembrandt Images and radiomic features showed superior predictive performance (area under the curve = 0.854) than that with only clinical features or Visually AcceSAble Rembrandt Images (areas under the curve = 0.514 and 0.648, respectively; P < . 001, both). When both Visually AcceSAble Rembrandt Images and radiomics were added to clinical features, the predictive performance significantly increased (areas under the curve = 0.514 versus 0.863, P < .001). CONCLUSIONS MR imaging features integrated with machine learning classifiers may predict a subset of IDH wild-type lower-grade gliomas that carry molecular features of glioblastoma.
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Affiliation(s)
- C J Park
- From the Department of Radiology (C.J.P.), Yonsei University College of Medicine, Seoul, Korea
| | - K Han
- Department of Radiology (K.H., H.K., S.S.A., Y.W.P., S.-K.L.), Research Institute of Radiological Sciences, Center for Clinical Imaging Data Science
| | - H Kim
- Department of Radiology (K.H., H.K., S.S.A., Y.W.P., S.-K.L.), Research Institute of Radiological Sciences, Center for Clinical Imaging Data Science
| | - S S Ahn
- Department of Radiology (K.H., H.K., S.S.A., Y.W.P., S.-K.L.), Research Institute of Radiological Sciences, Center for Clinical Imaging Data Science
| | - D Choi
- Department of Computer Science (D.C.), Yonsei University, Seoul, Korea
| | - Y W Park
- Department of Radiology (K.H., H.K., S.S.A., Y.W.P., S.-K.L.), Research Institute of Radiological Sciences, Center for Clinical Imaging Data Science
| | | | - S H Kim
- Department of Pathology (S.H.K.), Yonsei University College of Medicine, Seoul, Korea
| | - S Cha
- Department of Radiology and Biomedical Imaging (S.C.), University of California San Francisco, San Francisco, California
| | - S-K Lee
- Department of Radiology (K.H., H.K., S.S.A., Y.W.P., S.-K.L.), Research Institute of Radiological Sciences, Center for Clinical Imaging Data Science
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32
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Aboian M, Barajas R, Shatalov J, Ravanfar V, Bahroos E, Tong E, Taylor JW, Bush NO, Sneed P, Seo Y, Cha S, Hernandez-Pampaloni M. Maximizing the use of batch production of 18F-FDOPA for imaging of brain tumors to increase availability of hybrid PET/MR imaging in clinical setting. Neurooncol Pract 2020; 8:91-97. [PMID: 33664973 DOI: 10.1093/nop/npaa065] [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: 11/14/2022] Open
Abstract
Background Amino acid PET imaging of brain tumors has been shown to play an important role in predicting tumor grade, delineation of tumor margins, and differentiating tumor recurrence from the background of postradiation changes, but is not commonly used in clinical practice because of high cost. We propose that PET/MRI imaging of patients grouped to the day of tracer radiosynthesis will significantly decrease the cost of PET imaging, which will improve patient access to PET. Methods Seventeen patients with either primary brain tumors or metastatic brain tumors were recruited for imaging on 3T PET/MRI and were scanned on 4 separate days in groups of 3 to 5 patients. The first group of consecutively imaged patients contained 3 patients, followed by 2 groups of 5 patients, and a last group of 4 patients. Results For each of the patients, standard of care gadolinium-enhanced MRI and dynamic PET imaging with 18F-FDOPA amino acid tracer was obtained. The total cost savings of scanning 17 patients in batches of 4 as opposed to individual radiosynthesis was 48.5% ($28 321). Semiquantitative analysis of tracer uptake in normal brain were performed with appropriate accumulation and expected subsequent washout. Conclusion Amino acid PET tracers have been shown to play a critical role in the characterization of brain tumors but their adaptation to clinical practice has been limited because of the high cost of PET. Scheduling patient imaging to maximally use the radiosynthesis of imaging tracer significantly reduces the cost of PET and results in increased availability of PET tracer use in neuro-oncology.
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Affiliation(s)
- Mariam Aboian
- Department of Radiology, Yale University School of Medicine, New Haven, CT
| | - Ramon Barajas
- Department of Radiology, Oregon Health Sciences University
| | - Julia Shatalov
- Department of Radiology, Yale University School of Medicine, New Haven, CT
| | - Vahid Ravanfar
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Emma Bahroos
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Elizabeth Tong
- Department of Radiology, Stanford University, Palo Alto, California
| | - Jennie W Taylor
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California.,Department of Neurology, University of California San Francisco, San Francisco, California
| | - N Oberheim Bush
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Patricia Sneed
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Youngho Seo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Miguel Hernandez-Pampaloni
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
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Calabrese E, Villanueva-Meyer JE, Cha S. A fully automated artificial intelligence method for non-invasive, imaging-based identification of genetic alterations in glioblastomas. Sci Rep 2020; 10:11852. [PMID: 32678261 PMCID: PMC7366666 DOI: 10.1038/s41598-020-68857-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/29/2020] [Indexed: 02/02/2023] Open
Abstract
Glioblastoma is the most common malignant brain parenchymal tumor yet remains challenging to treat. The current standard of care-resection and chemoradiation-is limited in part due to the genetic heterogeneity of glioblastoma. Previous studies have identified several tumor genetic biomarkers that are frequently present in glioblastoma and can alter clinical management. Currently, genetic biomarker status is confirmed with tissue sampling, which is costly and only available after tumor resection or biopsy. The purpose of this study was to evaluate a fully automated artificial intelligence approach for predicting the status of several common glioblastoma genetic biomarkers on preoperative MRI. We retrospectively analyzed multisequence preoperative brain MRI from 199 adult patients with glioblastoma who subsequently underwent tumor resection and genetic testing. Radiomics features extracted from fully automated deep learning-based tumor segmentations were used to predict nine common glioblastoma genetic biomarkers with random forest regression. The proposed fully automated method was useful for predicting IDH mutations (sensitivity = 0.93, specificity = 0.88), ATRX mutations (sensitivity = 0.94, specificity = 0.92), chromosome 7/10 aneuploidies (sensitivity = 0.90, specificity = 0.88), and CDKN2 family mutations (sensitivity = 0.76, specificity = 0.86).
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Affiliation(s)
- Evan Calabrese
- Department of Radiology and Biomedical Imaging, University of California At San Francisco, 350 Parnassus Ave, Suite 307H, San Francisco, CA, 94143-0628, USA.
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California At San Francisco, 350 Parnassus Ave, Suite 307H, San Francisco, CA, 94143-0628, USA
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California At San Francisco, 350 Parnassus Ave, Suite 307H, San Francisco, CA, 94143-0628, USA
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Wu X, Li Y, Glastonbury CM, Cha S. Involvement of the Olfactory Apparatus by Gliomas. AJNR Am J Neuroradiol 2020; 41:712-717. [PMID: 32165363 DOI: 10.3174/ajnr.a6471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 01/25/2020] [Indexed: 12/16/2022]
Abstract
The olfactory bulbs and tracts are central nervous system white matter tracts maintained by central neuroglia. Although rare, gliomas can originate from and progress to involve the olfactory apparatus. Through a Health Insurance Portability and Accountability Act-compliant retrospective review of the institutional teaching files and brain MR imaging reports spanning 10 years, we identified 12 cases of gliomas involving the olfactory bulbs and tracts, including 6 cases of glioblastoma, 2 cases of anaplastic oligodendroglioma, and 1 case each of pilocytic astrocytoma, diffuse (grade II) astrocytoma, anaplastic astrocytoma (grade III), and diffuse midline glioma. All except the pilocytic astrocytoma occurred in patients with known primary glial tumors elsewhere. Imaging findings of olfactory tumor involvement ranged from well-demarcated enhancing masses to ill-defined enhancing infiltrative lesions to nonenhancing masslike FLAIR signal abnormality within the olfactory tracts. Familiarity with the imaging findings of glioma involvement of the olfactory nerves is important for timely diagnosis and treatment of recurrent gliomas and to distinguish them from other disease processes.
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Affiliation(s)
- X Wu
- From the Department of Radiology and Imaging Sciences (X.W.), Emory University, Atlanta, Georgia
| | - Y Li
- Departments of Clinical Radiology (Y.L., C.M.G.)
| | - C M Glastonbury
- Departments of Clinical Radiology (Y.L., C.M.G.).,Otolaryngology Head and Neck Surgery (C.M.G.).,Radiation Oncology (C.M.G.)
| | - S Cha
- Radiology (S.C.).,Neurological Surgery (S.C.), University of California, San Francisco, San Francisco, California
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Payabvash S, Aboian M, Tihan T, Cha S. Machine Learning Decision Tree Models for Differentiation of Posterior Fossa Tumors Using Diffusion Histogram Analysis and Structural MRI Findings. Front Oncol 2020; 10:71. [PMID: 32117728 PMCID: PMC7018938 DOI: 10.3389/fonc.2020.00071] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 01/15/2020] [Indexed: 12/16/2022] Open
Abstract
We applied machine learning algorithms for differentiation of posterior fossa tumors using apparent diffusion coefficient (ADC) histogram analysis and structural MRI findings. A total of 256 patients with intra-axial posterior fossa tumors were identified, of whom 248 were included in machine learning analysis, with at least 6 representative subjects per each tumor pathology. The ADC histograms of solid components of tumors, structural MRI findings, and patients' age were applied to construct decision models using Classification and Regression Tree analysis. We also compared different machine learning classification algorithms (i.e., naïve Bayes, random forest, neural networks, support vector machine with linear and polynomial kernel) for dichotomized differentiation of the 5 most common tumors in our cohort: metastasis (n = 65), hemangioblastoma (n = 44), pilocytic astrocytoma (n = 43), ependymoma (n = 27), and medulloblastoma (n = 26). The decision tree model could differentiate seven tumor histopathologies with terminal nodes yielding up to 90% accurate classification rates. In receiver operating characteristics (ROC) analysis, the decision tree model achieved greater area under the curve (AUC) for differentiation of pilocytic astrocytoma (p = 0.020); and atypical teratoid/rhabdoid tumor ATRT (p = 0.001) from other types of neoplasms compared to the official clinical report. However, neuroradiologists' interpretations had greater accuracy in differentiating metastases (p = 0.001). Among different machine learning algorithms, random forest models yielded the highest accuracy in dichotomized classification of the 5 most common tumor types; and in multiclass differentiation of all tumor types random forest yielded an averaged AUC of 0.961 in training datasets, and 0.873 in validation samples. Our study demonstrates the potential application of machine learning algorithms and decision trees for accurate differentiation of brain tumors based on pretreatment MRI. Using easy to apply and understandable imaging metrics, the proposed decision tree model can help radiologists with differentiation of posterior fossa tumors, especially in tumors with similar qualitative imaging characteristics. In particular, our decision tree model provided more accurate differentiation of pilocytic astrocytomas from ATRT than by neuroradiologists in clinical reads.
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Affiliation(s)
- Seyedmehdi Payabvash
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Mariam Aboian
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Tarik Tihan
- Department of Pathology, University of California, San Francisco, San Francisco, CA, United States
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
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Young JS, Morshed RA, Mansoori Z, Cha S, Berger MS. Disruption of Frontal Aslant Tract Is Not Associated with Long-Term Postoperative Language Deficits. World Neurosurg 2020; 133:192-195. [DOI: 10.1016/j.wneu.2019.09.128] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 11/30/2022]
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Cluceru J, Nelson S, Molinaro A, Alcaide-Leon P, Olson M, Berger M, Chang S, Phillips J, Nair D, Wen Q, Villanueva-Meyer J, Chunduru P, Cha S, Lupo J. NIMG-42. RECURRENT TUMOR AND TREATMENT-INDUCED EFFECTS HAVE DIFFERENT MR SIGNATURES IN CONTRAST ENHANCING AND NON-ENHANCING LESIONS OF HIGH-GRADE GLIOMAS. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz175.712] [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: 11/14/2022] Open
Abstract
Abstract
INTRODUCTION
It is estimated that 25 to 35% of patients experience treatment-induced effects that can mimic recurrent high-grade gliomas. This diagnostic challenge is complicated by the coexistence of treatment-related changes and recurrent tumor within the same lesion which limits the accuracy of classification based on summary metrics of multi-parametric MRI. This study aimed to determine whether different MR features were relevant for distinguishing pathological features of recurrent tumor from the effects of treatment in the contrast enhancing and non-enhancing lesions of recurrent high-grade gliomas.
METHODS
Leveraging our unique dataset of image-guided tissue samples that directly maps pathology to MR characteristics, we analyzed 291 tissue samples (222 recurrent tumor; 69 treatment effect) with known coordinates on imaging from 139 patients that underwent preoperative 3T MRI and surgery for a suspected high-grade recurrent tumor. 8 MR parameter values from perfusion-weighted, diffusion-weighted, and MR spectroscopic imaging at each tissue sample location were tested for association with histopathological outcome using univariate and multivariate generalized estimating equation models for enhancing and non-enhancing tissue samples. Individual cutoff values were determined and evaluated using ROC-Curve analysis with 5-fold cross-validation.
RESULTS
In tissue samples obtained from contrast-enhancing lesions, elevated relative cerebral blood volume (rCBV) was significantly associated with the presence of recurrent tumor (p< 0.03), while increases in normalized choline (nCho) and choline-to-NAA index (CNI) were significantly associated with the presence of recurrent tumor in non-enhancing tissue samples (p< 0.008). Cutoff values of 1.6(rCBV), 2.7(CNI), and 2.1(nCho) had the highest performance.
CONCLUSION
Our results confirm the utility of rCBV in distinguishing the effects of treatment from recurrent tumor within the contrast enhancing lesion. We report a novel finding that metabolic parameters can differentiate recurrent tumor from treatment-related changes in the non-enhancing lesion of high-grade gliomas. These results will help improve future management of patients with suspected recurrence.
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Affiliation(s)
- Julia Cluceru
- University of California, San Francisco, San Francisco, CA, USA
| | - Sarah Nelson
- Department of Radiology, University of California, San Francisco, San Francisco, CA, USA
| | | | | | - Marram Olson
- Department of Radiology, University of California, San Francisco, San Francisco, CA, USA
| | - Mitchel Berger
- University of California, San Francisco, San Francisco, CA, USA
| | - Susan Chang
- University of California, San Francisco, San Francisco, CA, USA
| | - Joanna Phillips
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, USA
| | - Devika Nair
- University of California, San Francisco, San Francisco, CA, USA
| | - Qiuting Wen
- University of California, San Francisco, San Francisco, CA, USA
| | | | | | - Soonmee Cha
- University of California, San Francisco, San Francisco, CA, USA
| | - Janine Lupo
- Department of Radiology, University of California, San Francisco, San Francisco, CA, USA
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Aboian MS, Tong E, Solomon DA, Kline C, Gautam A, Vardapetyan A, Tamrazi B, Li Y, Jordan CD, Felton E, Weinberg B, Braunstein S, Mueller S, Cha S. Diffusion Characteristics of Pediatric Diffuse Midline Gliomas with Histone H3-K27M Mutation Using Apparent Diffusion Coefficient Histogram Analysis. AJNR Am J Neuroradiol 2019; 40:1804-1810. [PMID: 31694820 DOI: 10.3174/ajnr.a6302] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 08/31/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Diffuse midline gliomas with histone H3 K27M mutation are biologically aggressive tumors with poor prognosis defined as a new diagnostic entity in the 2016 World Health Organization Classification of Tumors of the Central Nervous System. There are no qualitative imaging differences (enhancement, border, or central necrosis) between histone H3 wildtype and H3 K27M-mutant diffuse midline gliomas. Herein, we evaluated the utility of diffusion-weighted imaging to distinguish H3 K27M-mutant from histone H3 wildtype diffuse midline gliomas. MATERIALS AND METHODS We identified 31 pediatric patients (younger than 21 years of age) with diffuse gliomas centered in midline structures that had undergone assessment for histone H3 K27M mutation. We measured ADC within these tumors using a voxel-based 3D whole-tumor measurement method. RESULTS Our cohort included 18 infratentorial and 13 supratentorial diffuse gliomas centered in midline structures. Twenty-three (74%) tumors carried H3-K27M mutations. There was no difference in ADC histogram parameters (mean, median, minimum, maximum, percentiles) between mutant and wild-type tumors. Subgroup analysis based on tumor location also did not identify a difference in histogram descriptive statistics. Patients who survived <1 year after diagnosis had lower median ADC (1.10 × 10-3mm2/s; 95% CI, 0.90-1.30) compared with patients who survived >1 year (1.46 × 10-3mm2/s; 95% CI, 1.19-1.67; P < .06). Average ADC values for diffuse midline gliomas were 1.28 × 10-3mm2/s (95% CI, 1.21-1.34) and 0.86 × 10-3mm2/s (95% CI, 0.69-1.01) for hemispheric glioblastomas with P < .05. CONCLUSIONS Although no statistically significant difference in diffusion characteristics was found between H3-K27M mutant and H3 wildtype diffuse midline gliomas, lower diffusivity corresponds to a lower survival rate at 1 year after diagnosis. These findings can have an impact on the anticipated clinical course for this patient population and offer providers and families guidance on clinical outcomes.
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Affiliation(s)
- M S Aboian
- From the Department of Radiology and Biomedical Imaging (M.S.A.), Yale School of Medicine, New Haven, Connecticut
| | - E Tong
- Department of Radiology (E.T.), Stanford University, Stanford, California
| | | | - C Kline
- Division of Pediatric Hematology/Oncology (C.K., E.F., S.M.), Department of Pediatrics, University of California, San Francisco, California
| | - A Gautam
- Johns Hopkins University (A.G.), Baltimore, Maryland
| | - A Vardapetyan
- University of California Berkeley (A.V.), Berkeley, California
| | - B Tamrazi
- Department of Radiology (B.T.), Children's Hospital Los Angeles, Los Angeles, California
| | - Y Li
- Department of Pathology, Departments of Radiology (Y.L., C.D.J., S.C.)
| | - C D Jordan
- Department of Pathology, Departments of Radiology (Y.L., C.D.J., S.C.)
| | - E Felton
- Division of Pediatric Hematology/Oncology (C.K., E.F., S.M.), Department of Pediatrics, University of California, San Francisco, California
| | - B Weinberg
- Department of Neuroradiology (B.W.), Emory University, Atlanta, Georgia
| | | | - S Mueller
- Neurological Surgery (S.M.).,Neurology (S.M.).,Division of Pediatric Hematology/Oncology (C.K., E.F., S.M.), Department of Pediatrics, University of California, San Francisco, California
| | - S Cha
- Department of Pathology, Departments of Radiology (Y.L., C.D.J., S.C.)
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Sloan EA, Cooney T, Oberheim Bush NA, Buerki R, Taylor J, Clarke JL, Torkildson J, Kline C, Reddy A, Mueller S, Banerjee A, Butowski N, Chang S, Mummaneni PV, Chou D, Tan L, Theodosopoulos P, McDermott M, Berger M, Raffel C, Gupta N, Sun PP, Li Y, Shah V, Cha S, Braunstein S, Raleigh DR, Samuel D, Scharnhorst D, Fata C, Guo H, Moes G, Kim JYH, Koschmann C, Van Ziffle J, Onodera C, Devine P, Grenert JP, Lee JC, Pekmezci M, Phillips JJ, Tihan T, Bollen AW, Perry A, Solomon DA. Recurrent non-canonical histone H3 mutations in spinal cord diffuse gliomas. Acta Neuropathol 2019; 138:877-881. [PMID: 31515627 DOI: 10.1007/s00401-019-02072-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/01/2019] [Accepted: 09/02/2019] [Indexed: 01/17/2023]
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Aboian M, Ravanfar V, Bahroos E, Tong E, Taylor J, Oberheim Bush NA, Seo Y, Cha S, Pampaloni MH. MLTI-18. PRECISION IMAGING OF METASTATIC AND PRIMARY BRAIN TUMORS AFTER RADIATION WITH 18F-FDOPA PET-MRI IS FEASIBLE AND COST EFFECT. Neurooncol Adv 2019. [PMCID: PMC7213305 DOI: 10.1093/noajnl/vdz014.077] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE: Post-radiation changes in the brain can mimic tumor recurrence on MRI, requiring multiple short term follow-ups to differentiate tumor progression from radiation necrosis. We propose combining functional and anatomic imaging with FDOPA PET tracer in hybrid PET-MRI to improve detection of tumor recurrence. MATERIALS AND METHODS: Seventeen adult patients treated with radiation therapy were identified - four with metastatic disease from breast and lung cancer and thirteen with primary brain glioma (11 IDH wildtype glioblastoma and 2 astrocytoma). Patients were scanned on hybrid PET-MRI (GE Healthcare) with clinical MRI brain sequences and dynamic FDOPA uptake. Dynamic FDOPA uptake within these tumors over 45 minutes after tracer injection was analyzed and compared to ADC histogram analysis. RESULTS: For each of the patients, clinical multi sequence gadolinium enhanced MRI and dynamic PET imaging for up to 45 minutes with 18F-FDOPA amino acid tracer was obtained. The total cost savings of scanning 17 patients in groups was 51.4% ($28,321), as opposed to the cost of individual radiosynthesis performed for each study. Quantitative analysis of tracer uptake in striatum, internal carotid artery, and superior sagittal sinus were performed with appropriate accumulation and subsequent washout of tracer respectively. Successful dynamic FDOPA uptake within the tumor was seen in all patients and ratio of tumor to contralateral ROI were found to range from 1.8–4.5. While raw SUV values did not differentiate between recurrent tumor and radiation changes, T/C SUVmax ratios were elevated to 4.5 in recurrent glioblastoma, 2.5 in hypoxic treated glioblastoma, and 1.8 in non-recurrent metastatic breast cancer after gamma knife treatment. CONCLUSION: Batch imaging of patients with [18F]FDOPA PET-MRI is feasible and cost effective. Understanding radionuclide synthesis process is critical for increasing accessibility of novel PET tracers to patients and results in significant cost savings.
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Affiliation(s)
- Mariam Aboian
- University of California, San Francisco, San Francisco, CA, USA
| | - Vahid Ravanfar
- University of California, San Francisco, San Francisco, CA, USA
| | - Emma Bahroos
- University of California, San Francisco, San Francisco, CA, USA
| | - Elizabeth Tong
- University of California, San Francisco, San Francisco, CA, USA
| | - Jennie Taylor
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Youngho Seo
- University of California, San Francisco, San Francisco, CA, USA
| | - Soonmee Cha
- University of California, San Francisco, San Francisco, CA, USA
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Bowles J, Caminati M, Cha S, Mendoza J. A framework for automated conflict detection and resolution in medical guidelines. Sci Comput Program 2019; 182:42-63. [PMID: 32029957 PMCID: PMC6993806 DOI: 10.1016/j.scico.2019.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 06/09/2019] [Accepted: 07/01/2019] [Indexed: 05/30/2023]
Abstract
Common chronic conditions are routinely treated following standardised procedures known as clinical guidelines. For patients suffering from two or more chronic conditions, known as multimorbidity, several guidelines have to be applied simultaneously, which may lead to severe adverse effects when the combined recommendations and prescribed medications are inconsistent or incomplete. This paper presents an automated formal framework to detect, highlight and resolve conflicts in the treatments used for patients with multimorbidities focusing on medications. The presented extended framework has a front-end which takes guidelines captured in a standard modelling language and returns the visualisation of the detected conflicts as well as suggested alternative treatments. Internally, the guidelines are transformed into formal models capturing the possible unfoldings of the guidelines. The back-end takes the formal models associated with multiple guidelines and checks their correctness with a theorem prover, and inherent inconsistencies with a constraint solver. Key to our approach is the use of an optimising constraint solver which enables us to search for the best solution that resolves/minimises conflicts according to medication efficacy and the degree of severity in case of harmful combinations, also taking into account their temporal overlapping. The approach is illustrated throughout with a real medical example.
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Affiliation(s)
- J. Bowles
- School of Computer Science, University of St Andrews, Jack Cole Building, St Andrews KY16 9SX, United Kingdom
| | - M.B. Caminati
- School of Computer Science, University of St Andrews, Jack Cole Building, St Andrews KY16 9SX, United Kingdom
| | - S. Cha
- Automation and Information Systems, Technical University of Munich, Germany
| | - J. Mendoza
- School of Computer Science, University of St Andrews, Jack Cole Building, St Andrews KY16 9SX, United Kingdom
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Ferris SP, Velazquez Vega J, Aboian M, Lee JC, Van Ziffle J, Onodera C, Grenert JP, Saunders T, Chen YY, Banerjee A, Kline CN, Gupta N, Raffel C, Samuel D, Ruiz-Diaz I, Magaki S, Wilson D, Neltner J, Al-Hajri Z, Phillips JJ, Pekmezci M, Bollen AW, Tihan T, Schniederjan M, Cha S, Perry A, Solomon DA. High-grade neuroepithelial tumor with BCOR exon 15 internal tandem duplication-a comprehensive clinical, radiographic, pathologic, and genomic analysis. Brain Pathol 2019; 30:46-62. [PMID: 31104347 DOI: 10.1111/bpa.12747] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [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: 04/16/2019] [Accepted: 05/14/2019] [Indexed: 12/30/2022] Open
Abstract
High-grade neuroepithelial tumor with BCOR exon 15 internal tandem duplication (HGNET BCOR ex15 ITD) is a recently proposed tumor entity of the central nervous system (CNS) with a distinct methylation profile and characteristic genetic alteration. The complete spectrum of histologic features, accompanying genetic alterations, clinical outcomes, and optimal treatment for this new tumor entity are largely unknown. Here, we performed a comprehensive assessment of 10 new cases of HGNET BCOR ex15 ITD. The tumors mostly occurred in young children and were located in the cerebral or cerebellar hemispheres. On imaging all tumors were large, well-circumscribed, heterogeneous masses with variable enhancement and reduced diffusion. They were histologically characterized by predominantly solid growth, glioma-like fibrillarity, perivascular pseudorosettes, and palisading necrosis, but absence of microvascular proliferation. They demonstrated sparse to absent GFAP expression, no synaptophysin expression, variable OLIG2 and NeuN positivity, and diffuse strong BCOR nuclear positivity. While BCOR exon 15 internal tandem duplication was the solitary pathogenic alteration identified in six cases, four cases contained additional alterations including CDKN2A/B homozygous deletion, TERT amplification or promoter hotspot mutation, and damaging mutations in TP53, BCORL1, EP300, SMARCA2 and STAG2. While the limited clinical follow-up in prior reports had indicated a uniformly dismal prognosis for this tumor entity, this cohort includes multiple long-term survivors. Our study further supports inclusion of HGNET BCOR ex15 ITD as a distinct CNS tumor entity and expands the known clinicopathologic, radiographic, and genetic features.
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Affiliation(s)
- Sean P Ferris
- Department of Pathology, University of California, San Francisco, CA
| | | | - Mariam Aboian
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA
| | - Julieann C Lee
- Department of Pathology, University of California, San Francisco, CA
| | - Jessica Van Ziffle
- Department of Pathology, University of California, San Francisco, CA.,Clinical Cancer Genomics Laboratory, University of California, San Francisco, CA
| | - Courtney Onodera
- Department of Pathology, University of California, San Francisco, CA.,Clinical Cancer Genomics Laboratory, University of California, San Francisco, CA
| | - James P Grenert
- Department of Pathology, University of California, San Francisco, CA.,Clinical Cancer Genomics Laboratory, University of California, San Francisco, CA
| | - Tara Saunders
- Department of Pathology, University of California, San Francisco, CA
| | - Yunn-Yi Chen
- Department of Pathology, University of California, San Francisco, CA
| | - Anu Banerjee
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California, San Francisco, CA
| | - Cassie N Kline
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California, San Francisco, CA.,Department of Neurology, University of California, San Francisco, CA
| | - Nalin Gupta
- Department of Neurological Surgery, University of California, San Francisco, CA
| | - Corey Raffel
- Department of Neurological Surgery, University of California, San Francisco, CA
| | - David Samuel
- Department of Hematology-Oncology, Valley Children's Hospital, Madera, CA
| | - Irune Ruiz-Diaz
- Department of Pathology, Hospital Universitario Donostia, Gipuzkoa, Spain
| | - Shino Magaki
- Department of Pathology and Human Anatomy, Loma Linda University Medical Center, Loma Linda, CA
| | - Dianne Wilson
- Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY
| | - Janna Neltner
- Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY
| | - Zahra Al-Hajri
- Department of Histopathology, Khoula Hospital, Muscat, Sultanate of Oman
| | - Joanna J Phillips
- Department of Pathology, University of California, San Francisco, CA.,Department of Neurological Surgery, University of California, San Francisco, CA
| | - Melike Pekmezci
- Department of Pathology, University of California, San Francisco, CA
| | - Andrew W Bollen
- Department of Pathology, University of California, San Francisco, CA
| | - Tarik Tihan
- Department of Pathology, University of California, San Francisco, CA
| | | | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA
| | - Arie Perry
- Department of Pathology, University of California, San Francisco, CA.,Department of Neurological Surgery, University of California, San Francisco, CA
| | - David A Solomon
- Department of Pathology, University of California, San Francisco, CA.,Clinical Cancer Genomics Laboratory, University of California, San Francisco, CA
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Fangusaro J, Onar-Thomas A, Young Poussaint T, Wu S, Ligon AH, Lindeman N, Banerjee A, Packer RJ, Kilburn LB, Goldman S, Pollack IF, Qaddoumi I, Jakacki RI, Fisher PG, Dhall G, Baxter P, Kreissman SG, Stewart CF, Jones DTW, Pfister SM, Vezina G, Stern JS, Panigrahy A, Patay Z, Tamrazi B, Jones JY, Haque SS, Enterline DS, Cha S, Fisher MJ, Doyle LA, Smith M, Dunkel IJ, Fouladi M. Selumetinib in paediatric patients with BRAF-aberrant or neurofibromatosis type 1-associated recurrent, refractory, or progressive low-grade glioma: a multicentre, phase 2 trial. Lancet Oncol 2019; 20:1011-1022. [PMID: 31151904 DOI: 10.1016/s1470-2045(19)30277-3] [Citation(s) in RCA: 277] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/16/2019] [Accepted: 03/19/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Paediatric low-grade glioma is the most common CNS tumour of childhood. Although overall survival is good, disease often recurs. No single universally accepted treatment exists for these patients; however, standard cytotoxic chemotherapies are generally used. We aimed to assess the activity of selumetinib, a MEK1/2 inhibitor, in these patients. METHODS The Pediatric Brain Tumor Consortium performed a multicentre, phase 2 study in patients with paediatric low-grade glioma in 11 hospitals in the USA. Patients aged 3-21 years with a Lansky or Karnofsky performance score greater than 60 and the presence of recurrent, refractory, or progressive paediatric low-grade glioma after at least one standard therapy were eligible for inclusion. Patients were assigned to six unique strata according to histology, tumour location, NF1 status, and BRAF aberration status; herein, we report the results of strata 1 and 3. Stratum 1 comprised patients with WHO grade I pilocytic astrocytoma harbouring either one of the two most common BRAF aberrations (KIAA1549-BRAF fusion or the BRAFV600E [Val600Glu] mutation). Stratum 3 comprised patients with any neurofibromatosis type 1 (NF1)-associated paediatric low-grade glioma (WHO grades I and II). Selumetinib was provided as capsules given orally at the recommended phase 2 dose of 25 mg/m2 twice daily in 28-day courses for up to 26 courses. The primary endpoint was the proportion of patients with a stratum-specific objective response (partial response or complete response), as assessed by the local site and sustained for at least 8 weeks. All responses were reviewed centrally. All eligible patients who initiated treatment were evaluable for the activity and toxicity analyses. Although the trial is ongoing in other strata, enrolment and planned follow-up is complete for strata 1 and 3. This trial is registered with ClinicalTrials.gov, number NCT01089101. FINDINGS Between July 25, 2013, and June 12, 2015, 25 eligible and evaluable patients were accrued to stratum 1, and between Aug 28, 2013, and June 25, 2015, 25 eligible and evaluable patients were accrued to stratum 3. In stratum 1, nine (36% [95% CI 18-57]) of 25 patients achieved a sustained partial response. The median follow-up for the 11 patients who had not had a progression event by Aug 9, 2018, was 36·40 months (IQR 21·72-45·59). In stratum 3, ten (40% [21-61]) of 25 patients achieved a sustained partial response; median follow-up was 48·60 months (IQR 39·14-51·31) for the 17 patients without a progression event by Aug 9, 2018. The most frequent grade 3 or worse adverse events were elevated creatine phosphokinase (five [10%]) and maculopapular rash (five [10%]). No treatment-realted deaths were reported. INTERPRETATION Selumetinib is active in recurrent, refractory, or progressive pilocytic astrocytoma harbouring common BRAF aberrations and NF1-associated paediatric low-grade glioma. These results show that selumetinib could be an alternative to standard chemotherapy for these subgroups of patients, and have directly led to the development of two Children's Oncology Group phase 3 studies comparing standard chemotherapy to selumetinib in patients with newly diagnosed paediatric low-grade glioma both with and without NF1. FUNDING National Cancer Institute Cancer Therapy Evaluation Program, the American Lebanese Syrian Associated Charities, and AstraZeneca.
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Affiliation(s)
- Jason Fangusaro
- Department of Hematology, Oncology, and Stem Cell Transplantation, Children's Healthcare of Atlanta and Emory University, Atlanta, GA, USA.
| | - Arzu Onar-Thomas
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Shengjie Wu
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Azra H Ligon
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Neal Lindeman
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anuradha Banerjee
- Center for Cancer and Blood Disorders, University of California, San Francisco, San Francisco, CA, USA
| | - Roger J Packer
- Department of Neurology, Children's National Medical Center, Washington, DC, USA
| | - Lindsay B Kilburn
- Department of Haematology and Oncology, Children's National Medical Center, Washington, DC, USA
| | - Stewart Goldman
- Department of Haematology, Oncology, Neuro-Oncology, and Stem Cell Transplantation, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Ian F Pollack
- Department of Neurosurgery, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Ibrahim Qaddoumi
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Regina I Jakacki
- Department of Hematology and Oncology, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Paul G Fisher
- Department of Neurology, Stanford University Medical Center, Palo Alto, CA, USA
| | - Girish Dhall
- Department of Hematology and Oncology, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Patricia Baxter
- Department of Hematology and Oncology, Texas Children's Hospital, Houston, TX, USA
| | - Susan G Kreissman
- Department of Hematology and Oncology, Duke University School of Medicine, Durham, NC, USA
| | - Clinton F Stewart
- Department of Pharmaceutical Science, St Jude Children's Research Hospital, Memphis, TN, USA
| | - David T W Jones
- Department of Pediatric Glioma Research Group, Hopp Children's Cancer Center Heidelberg (KiTZ) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefan M Pfister
- Department of Pediatric Neuro-Oncology, Hopp Children's Cancer Center Heidelberg (KiTZ) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Gilbert Vezina
- Department of Radiology, Children's National Medical Center, Washington, DC, USA
| | - Jessica S Stern
- Department of Radiology, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Ashok Panigrahy
- Department of Radiology, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Zoltan Patay
- Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Benita Tamrazi
- Department of Radiology, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Jeremy Y Jones
- Department of Radiology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Sofia S Haque
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David S Enterline
- Department of Radiology, Duke University School of Medicine, Durham, NC, USA
| | - Soonmee Cha
- Department of Radiology, University of California, San Francisco, San Francisco, CA, USA
| | - Michael J Fisher
- Department of Pediatric Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Laurence Austin Doyle
- Investigational Drug Branch, National Cancer Institute and Cancer Therapy Evaluation Program, Bethesda, MD, USA
| | - Malcolm Smith
- Clinical Investigation Branch, National Cancer Institute and Cancer Therapy Evaluation Program, Bethesda, MD, USA
| | - Ira J Dunkel
- Department of Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maryam Fouladi
- Department of Haematology and Oncology, Cincinnati Children's Hospital, Cincinnati, OH, USA
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Behr SC, Villanueva-Meyer JE, Li Y, Wang YH, Wei J, Moroz A, Lee JK, Hsiao JC, Gao KT, Ma W, Cha S, Wilson DM, Seo Y, Nelson SJ, Chang SM, Evans MJ. Targeting iron metabolism in high-grade glioma with 68Ga-citrate PET/MR. JCI Insight 2018; 3:93999. [PMID: 30385712 DOI: 10.1172/jci.insight.93999] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 03/15/2017] [Accepted: 09/27/2018] [Indexed: 11/17/2022] Open
Abstract
Noninvasive tools that target tumor cells could improve the management of glioma. Cancer generally has a high demand for Fe(III), an essential nutrient for a variety of biochemical processes. We tested whether 68Ga-citrate, an Fe(III) biomimetic that binds to apo-transferrin in blood, detects glioma in preclinical models and patients using hybrid PET/MRI. Mouse PET/CT studies showed that 68Ga-citrate accumulates in subcutaneous U87MG xenografts in a transferrin receptor-dependent fashion within 4 hours after injection. Seventeen patients with WHO grade III or IV glioma received 3.7-10.2 mCi 68Ga-citrate and were imaged with PET/MR 123-307 minutes after injection to establish that the radiotracer can localize to human tumors. Multiple contrast-enhancing lesions were PET avid, and tumor to adjacent normal white matter ratios were consistently greater than 10:1. Several contrast-enhancing lesions were not PET avid. One minimally enhancing lesion and another tumor with significantly reduced enhancement following bevacizumab therapy were PET avid. Advanced MR imaging analysis of one patient with contrast-enhancing glioblastoma showed that metabolic hallmarks of viable tumor spatially overlaid with 68Ga-citrate accumulation. These early data underscore that high-grade glioma may be detectable with a radiotracer that targets Fe(III) transport.
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Affiliation(s)
- Spencer C Behr
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA
| | | | - Yan Li
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA
| | - Yung-Hua Wang
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA
| | - Junnian Wei
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA
| | - Anna Moroz
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA.,Skolkovo Institute of Science and Technology, Skolkovo Innovation Center, Moscow, Russia
| | - Julia Kl Lee
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA
| | - Jeffrey C Hsiao
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA
| | - Kenneth T Gao
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA
| | - Wendy Ma
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA
| | - David M Wilson
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA
| | - Youngho Seo
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA
| | - Sarah J Nelson
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA.,Helen Diller Family Comprehensive Cancer Center.,Department of Bioengineering and Therapeutic Sciences
| | - Susan M Chang
- Helen Diller Family Comprehensive Cancer Center.,Department of Neurological Surgery, and
| | - Michael J Evans
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA.,Helen Diller Family Comprehensive Cancer Center.,Department of Pharmaceutical Chemistry, UCSF, San Francisco, California, USA
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Morin O, Chen W, Villanueva-Meyer J, Gennatas E, Wu A, Cha S, Magill S, Perry A, Sneed P, McDermott M, Solberg T, Valdes G, Braunstein S, Raleigh D. Point-of-Care Local Failure and Overall Survival Prediction Models for Meningioma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Panditharatna E, Kilburn LB, Aboian MS, Kambhampati M, Gordish-Dressman H, Magge SN, Gupta N, Myseros JS, Hwang EI, Kline C, Crawford JR, Warren KE, Cha S, Liang WS, Berens ME, Packer RJ, Resnick AC, Prados M, Mueller S, Nazarian J. Clinically Relevant and Minimally Invasive Tumor Surveillance of Pediatric Diffuse Midline Gliomas Using Patient-Derived Liquid Biopsy. Clin Cancer Res 2018; 24:5850-5859. [PMID: 30322880 DOI: 10.1158/1078-0432.ccr-18-1345] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/27/2018] [Accepted: 08/30/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE Pediatric diffuse midline glioma (DMG) are highly malignant tumors with poor clinical outcomes. Over 70% of patients with DMG harbor the histone 3 p.K27M (H3K27M) mutation, which correlates with a poorer clinical outcome, and is also used as a criterion for enrollment in clinical trials. Because complete surgical resection of DMG is not an option, biopsy at presentation is feasible, but rebiopsy at time of progression is rare. While imaging and clinical-based disease monitoring is the standard of care, molecular-based longitudinal characterization of these tumors is almost nonexistent. To overcome these hurdles, we examined whether liquid biopsy allows measurement of disease response to precision therapy. EXPERIMENTAL DESIGN We established a sensitive and specific methodology that detects major driver mutations associated with pediatric DMGs using droplet digital PCR (n = 48 subjects, n = 110 specimens). Quantification of circulating tumor DNA (ctDNA) for H3K27M was used for longitudinal assessment of disease response compared with centrally reviewed MRI data. RESULTS H3K27M was identified in cerebrospinal fluid (CSF) and plasma in 88% of patients with DMG, with CSF being the most enriched for ctDNA. We demonstrated the feasibility of multiplexing for detection of H3K27M, and additional driver mutations in patient's tumor and matched CSF, maximizing the utility of a single source of liquid biome. A significant decrease in H3K27M plasma ctDNA agreed with MRI assessment of tumor response to radiotherapy in 83% (10/12) of patients. CONCLUSIONS Our liquid biopsy approach provides a molecularly based tool for tumor characterization, and is the first to indicate clinical utility of ctDNA for longitudinal surveillance of DMGs.
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Affiliation(s)
- Eshini Panditharatna
- Rese arch Center for Genetic Medicine, Children's National Health System, Washington, D.C.,Institute for Biomedical Sciences, George Washington University School of Medicine and Health Sciences, Washington, D.C
| | - Lindsay B Kilburn
- Center for Cancer and Blood Disorders, Children's National Health System, Washington D.C.,Brain Tumor Institute, Children's National Health System, Washington, D.C
| | - Mariam S Aboian
- Departments of Neurology, Pediatrics and Neurosurgery, University of California, San Francisco School of Medicine, San Francisco, California
| | - Madhuri Kambhampati
- Rese arch Center for Genetic Medicine, Children's National Health System, Washington, D.C
| | | | - Suresh N Magge
- Division of Neurosurgery, Children's National Health System, Washington, D.C
| | - Nalin Gupta
- Department of Neurological Surgery and Pediatrics, University of California San Francisco, San Francisco, California
| | - John S Myseros
- Division of Neurosurgery, Children's National Health System, Washington, D.C
| | - Eugene I Hwang
- Center for Cancer and Blood Disorders, Children's National Health System, Washington D.C.,Brain Tumor Institute, Children's National Health System, Washington, D.C
| | - Cassie Kline
- Pediatric Hematology-Oncology and Neurology, UCSF Benioff Children's Hospital, San Francisco, California
| | - John R Crawford
- Department of Neurosciences, UC San Diego School of Medicine, La Jolla, California
| | | | - Soonmee Cha
- Department of Radiology, University of California, San Francisco School of Medicine, San Francisco, California
| | - Winnie S Liang
- Translational Genomics Research Institute, Phoenix, Arizona
| | | | - Roger J Packer
- Brain Tumor Institute, Children's National Health System, Washington, D.C
| | - Adam C Resnick
- Center for Data-Driven Discovery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Michael Prados
- Departments of Neurology, Pediatrics and Neurosurgery, University of California, San Francisco School of Medicine, San Francisco, California
| | - Sabine Mueller
- Departments of Neurology, Pediatrics and Neurosurgery, University of California, San Francisco School of Medicine, San Francisco, California
| | - Javad Nazarian
- Rese arch Center for Genetic Medicine, Children's National Health System, Washington, D.C. .,Center for Cancer and Blood Disorders, Children's National Health System, Washington D.C.,Brain Tumor Institute, Children's National Health System, Washington, D.C.,Department of Genomics and Precision Medicine, George Washington University School of Medicine and Health Sciences, Washington, D.C
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Payabvash S, Tihan T, Cha S. Volumetric voxelwise apparent diffusion coefficient histogram analysis for differentiation of the fourth ventricular tumors. Neuroradiol J 2018; 31:554-564. [PMID: 30230411 DOI: 10.1177/1971400918800803] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 12/16/2022] Open
Abstract
PURPOSE We applied voxelwise apparent diffusion coefficient (ADC) histogram analysis in addition to structural magnetic resonance imaging (MRI) findings and patients' age for differentiation of intraaxial posterior fossa tumors involving the fourth ventricle. PARTICIPANTS AND METHODS Pretreatment MRIs of 74 patients with intraaxial brain neoplasm involving the fourth ventricle, from January 1, 2004 to December 31, 2015, were reviewed. The tumor solid components were segmented and voxelwise ADC histogram variables were determined. Histogram-driven variables, structural MRI findings, and patient age were combined to devise a differential diagnosis algorithm. RESULTS The most common neoplasms were ependymomas ( n = 21), medulloblastoma ( n = 17), and pilocytic astrocytomas ( n = 13). Medulloblastomas followed by atypical teratoid/rhabdoid tumors had the lowest ADC histogram percentile values; whereas pilocytic astrocytomas and choroid plexus papillomas had the highest ADC histogram percentile values. In a multivariable multinominal regression analysis, the ADC 10th percentile value from voxelwise histogram was the only independent predictor of tumor type ( p < 0.001). In separate binary logistic regression analyses, the 10th percentile ADC value, tumor morphology, enhancement pattern, extension into Luschka/Magendie foramina, and patient age were predictors of different tumor types. Combining these variables, we devised a stepwise diagnostic model yielding 71% to 82% sensitivity, 91% to 95% specificity, 75% to 78% positive predictive value, and 89% to 95% negative predictive value for differentiation of ependymoma, medulloblastoma, and pilocytic astrocytoma. CONCLUSION We have shown how the addition of quantitative voxelwise ADC histogram analysis of the tumor solid component to structural findings and patient age can help with accurate differentiation of intraaxial posterior fossa neoplasms involving the fourth ventricle based on pretreatment MRI.
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Affiliation(s)
- Seyedmehdi Payabvash
- 1 Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, USA.,2 Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Tarik Tihan
- 3 Department of Pathology, University of California, San Francisco, USA
| | - Soonmee Cha
- 1 Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, USA
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Payabvash S, Tihan T, Cha S. Differentiation of Cerebellar Hemisphere Tumors: Combining Apparent Diffusion Coefficient Histogram Analysis and Structural MRI Features. J Neuroimaging 2018; 28:656-665. [DOI: 10.1111/jon.12550] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 07/07/2018] [Accepted: 07/10/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Seyedmehdi Payabvash
- Department of Radiology and Biomedical Imaging; Yale School of Medicine; New Haven CT
- Department of Radiology and Biomedical Imaging; University of California; San Francisco CA
| | - Tarik Tihan
- Department of Pathology; University of California; San Francisco CA
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging; University of California; San Francisco CA
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Chang P, Grinband J, Weinberg BD, Bardis M, Khy M, Cadena G, Su MY, Cha S, Filippi CG, Bota D, Baldi P, Poisson LM, Jain R, Chow D. Deep-Learning Convolutional Neural Networks Accurately Classify Genetic Mutations in Gliomas. AJNR Am J Neuroradiol 2018; 39:1201-1207. [PMID: 29748206 DOI: 10.3174/ajnr.a5667] [Citation(s) in RCA: 228] [Impact Index Per Article: 38.0] [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: 11/29/2017] [Accepted: 03/20/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE The World Health Organization has recently placed new emphasis on the integration of genetic information for gliomas. While tissue sampling remains the criterion standard, noninvasive imaging techniques may provide complimentary insight into clinically relevant genetic mutations. Our aim was to train a convolutional neural network to independently predict underlying molecular genetic mutation status in gliomas with high accuracy and identify the most predictive imaging features for each mutation. MATERIALS AND METHODS MR imaging data and molecular information were retrospectively obtained from The Cancer Imaging Archives for 259 patients with either low- or high-grade gliomas. A convolutional neural network was trained to classify isocitrate dehydrogenase 1 (IDH1) mutation status, 1p/19q codeletion, and O6-methylguanine-DNA methyltransferase (MGMT) promotor methylation status. Principal component analysis of the final convolutional neural network layer was used to extract the key imaging features critical for successful classification. RESULTS Classification had high accuracy: IDH1 mutation status, 94%; 1p/19q codeletion, 92%; and MGMT promotor methylation status, 83%. Each genetic category was also associated with distinctive imaging features such as definition of tumor margins, T1 and FLAIR suppression, extent of edema, extent of necrosis, and textural features. CONCLUSIONS Our results indicate that for The Cancer Imaging Archives dataset, machine-learning approaches allow classification of individual genetic mutations of both low- and high-grade gliomas. We show that relevant MR imaging features acquired from an added dimensionality-reduction technique demonstrate that neural networks are capable of learning key imaging components without prior feature selection or human-directed training.
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Affiliation(s)
- P Chang
- From the Department of Radiology (P.C., S.C.), University of California, San Francisco, San Francisco, California
| | - J Grinband
- Department of Radiology (J.G.), Columbia University, New York, New York
| | - B D Weinberg
- Department of Radiology (B.D.W.), Emory University School of Medicine, Atlanta, Georgia
| | - M Bardis
- Departments of Radiology (M.B., M.K., M.-Y.S., D.C.)
| | - M Khy
- Departments of Radiology (M.B., M.K., M.-Y.S., D.C.)
| | | | - M-Y Su
- Departments of Radiology (M.B., M.K., M.-Y.S., D.C.)
| | - S Cha
- From the Department of Radiology (P.C., S.C.), University of California, San Francisco, San Francisco, California
| | - C G Filippi
- Department of Radiology (C.G.F.), North Shore University Hospital, Long Island, New York
| | | | - P Baldi
- School of Information and Computer Sciences (P.B.), University of California, Irvine, Irvine, California
| | - L M Poisson
- Department of Public Health Sciences (L.M.P.), Henry Ford Health System, Detroit, Michigan
| | - R Jain
- Departments of Radiology and Neurosurgery (R.J.), New York University, New York, New York
| | - D Chow
- Departments of Radiology (M.B., M.K., M.-Y.S., D.C.)
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Jiang L, Qu W, Oh T, Vincent A, Mohabbat A, Mauck W, Law L, Cha S. Sex-related demographic and symptomatologic characteristics of patients with fibromyalgia. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.230] [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: 11/15/2022]
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