Journal articles on the topic 'Peritumoral'
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Péley, Gábor, István Sinkovics, József Tóth, Emil Farkas, Sándor Keresztes, and István Köves. "Subareolar Injection of Radioactive Colloid for Sentinel Lymph Node Identification in Breast Cancer Patients." American Surgeon 70, no. 7 (July 2004): 625–29. http://dx.doi.org/10.1177/000313480407000713.
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Sentinel lymph node biopsy (SLNB) is becoming the standard for staging the axilla in breast cancer patients in many institutions. The best method of injection is still questionable. The purpose of this study was to compare the results of SLNB using the peritumoral or the subareolar injection site. Between December 1997 and March 2000, we performed 100 SLNBs. Technecium-labeled colloidal human serum albumin was injected peritumorally (Group A, 31 patients; Group B, 31 patients) or subareolarly (Group C, 38 patients). Patent blue dye was given periareolarly (Group A) or peritumorally (Groups B and C). Preoperative lymphoscintigraphy was performed in all patients. SLNB was successful in 94 patients (94%). The identification rate improved from 80 per cent (first 25 patients) to 99 per cent (last 75). The subareolar injection of the colloid did not adversely influence the results of SLNB compared with the peritumoral injection (identification rate, 100% vs 97%; false negative rate, 6% vs 14%). The subareolar injection of colloid is a simple and at least as accurate technique as the peritumoral one. This technique can also improve the identification rate of SLNB for breast cancer patients.
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Mao, Jiaji, Minghui Cao, Fang Zhang, Jingzhong Zhang, Xiaohui Duan, Liejing Lu, Zehong Yang, et al. "Peritumoral administration of IFNβ upregulated mesenchymal stem cells inhibits tumor growth in an orthotopic, immunocompetent rat glioma model." Journal for ImmunoTherapy of Cancer 8, no. 1 (March 2020): e000164. http://dx.doi.org/10.1136/jitc-2019-000164.
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BackgroundImmunotherapy with IFNβ is a promising strategy for treating malignant glioma. However, systemic administration of IFNβ is inadequate because of low intratumoral concentration and major adverse effects. This study aimed to determine whether mesenchymal stem cells (MSCs) can be used as cellular vehicles to locally deliver IFNβ for glioma therapy by using in vivo MRI tracking.MethodsA recombinant lentiviral vector encoding IFNβ and ferritin heavy chain (FTH) reporter genes was constructed to transduce MSCs. The effectiveness and safety of transduction were assessed. After the IFNβ and FTH overexpressed MSCs (IFNβ-FTH-MSCs) were transplanted into intracranial orthotopic rat F98 gliomas via peritumoral, intracerebral, intratumoral or intra-arterial injection, MRI was performed to track IFNβ-FTH-MSCs and to evaluate their therapeutic effect on glioma in vivo, as validated by histologic analysis, quantitative PCR and ELISA assays.ResultsMSCs were efficiently and safely transduced to upregulate their IFNβ secretion and FTH expression by the constructed lentivirus. After peritumoral injection, IFNβ-FTH-MSCs appeared as hypointense signals on MRI, which gradually diminished but remained visible until 11 days. Compared with other administration routes, only peritumoral injection of IFNβ-FTH-MSCs showed a remarkable inhibition on the glioma growth. Nearly 30% of IFNβ-FTH-MSCs survived up to 11 days after peritumoral injection, while most of IFNβ-FTH-MSCs injected via other routes died within 11 days. IFNβ-FTH-MSCs grafted peritumorally secreted IFNβ persistently, leading to pronounced Batf3+dendritic cells and CD8+T lymphocyte infiltration within the glioma.ConclusionsMSCs can be used as cellular vehicles of IFNβ to treat malignant glioma effectively via peritumoral injection.
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Kanomata, Naoki. "Peritumoral Muciphage." American Journal of Surgical Pathology 23, no. 7 (July 1999): 863. http://dx.doi.org/10.1097/00000478-199907000-00021.
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Lev, Robert, and Giovanni DePetris. "Peritumoral Muciphage." American Journal of Surgical Pathology 23, no. 7 (July 1999): 863. http://dx.doi.org/10.1097/00000478-199907000-00022.
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Vladimirova, Lyubov, Yevgeniya Nepomnyashchaya, Natalya Podzorova, Inna Novikova, Yelena Ulyanova, and Nataliya Abramova. "RECOMBINANT TUMOR NECROSIS FACTOR-THYMOSIN-A1: THE IMPACT ON THE EFFECTIVENESS OF NEOADJUVANT CHEMOTHERAPY AND ANGIOGENESIS IN BREAST CANCER." Problems in oncology 63, no. 1 (January 1, 2017): 76–81. http://dx.doi.org/10.37469/0507-3758-2017-63-1-76-81.
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The article covers the results of clinical application of a domestic drug based on recombinant tumor necrosis factor-alpha-thymosin-alpha1 (TNF-T) combined with chemotherapy FAC and РА during neoadjuvant treatment of patients with breast cancer IIB-IIIB stage. In contrast to the standard subcutaneous application method, the authors proposed peritumoral administration of TNF-T to maximize the drug's action directly on the tumor, peritumoral tissue. TNF-T 200000 IU peritumorally on days 1-5 of each treatment course showed significant increase in objective effect rate, including increase in frequency of complete regressions, and decrease in frequency and intensity of chemotherapy complications. Morphological examination revealed an increase rate of medical pathomorphosis grade III-IV, decreased number of microvessels in tumor in comparison with primary tumors
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IKEDA, Yukio, and Kiyoshi MATSUMOTO. "Peritumoral Brain Edema." Showa University Journal of Medical Sciences 11, no. 3 (1999): 149–54. http://dx.doi.org/10.15369/sujms1989.11.149.
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Stöcklein, R., R. Dorn, H. Vogt, A. Wischnik, J. Sciuk, and G. Holl. "Influence of the injection technique on the false negative rate of SLNE in multifocal breast cancer." Nuklearmedizin 47, no. 05 (2008): 216–19. http://dx.doi.org/10.3413/nukmed-0174.
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Summary Aim: We investigated the influence of the injection technique on the false negative rate in identifying the sentinel lymph node in multifocal breast cancer. Patients, methods: 958 consecutive patients were divided into unifocal and multifocal breast cancer patients. The scintigrafic and intraoperative detection rate as well as the false negatives were calculated in relation to peritumoral or subareolar injection. Results: In all patients the scintigrafic and intraoperative detection rate exceeded 99%, except in patients with multifocal cancer, who were injected peritumorally. In this group the intraoperative detection rate declined to 96%. In patients with unifocal breast cancer the false negative rate was below 5%, independent of the injection technique. Multifocal breast cancer patients showed a significant dependence on the injection technique. The false negative rate was 26.3% in patients with peritumoral injection and 5.6% in those with subareolar injection. Conclusion: The results clearly demonstrate that in multifocal breast cancer a reliable detection of a SLN is impossible with the peritumoral injection technique. Subareolar injection seems to be a way to operate on multifocal breast cancer with SLNE, but the number of investigated patients is too low for statistic approval. So, prospective studies should be performed to validate these preliminary results before SLNE becomes routine in multifocal breast cancer.
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Chen, Jiao, Xianfang Ming, Zhen Wang, and Yu Ye. "Analysis of the Performance of Gadoxetic Acid Disodium MRI in Predicting Microvascular Invasion of Hepatocellular Carcinoma." Contrast Media & Molecular Imaging 2022 (September 28, 2022): 1–5. http://dx.doi.org/10.1155/2022/6128845.
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Objective. This study aimed to evaluate the predictive value of gadoxetic acid disodium magnetic resonance imaging (MRI) in the microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods. 87 HCC patients (2019-01–2022-01) admitted to the hospital were selected for retrospective analysis, gadoxetic acid disodium MRI scan was performed before surgery, and the patients were divided into two groups according to whether the MVI occurred, including the invasion group (n = 47) and the non-invasion group (n = 40). The influencing factors of MVI in HCC patients were explored, independent risk factors were determined, and the correlation between independent risk factors and MVI in HCC patients was analyzed. Results. There were significant differences in tumor margin, peritumoral low signal (hepatobiliary phase), peritumoral enhancement (arterial phase), and peritumoral hyperintensity ring (arterial phase) between the two groups ( P < 0.05 ). Logistic regression analysis showed that unsmooth tumor margin, peritumoral low signal (hepatobiliary phase), peritumoral enhancement (arterial phase), and peritumoral hyperintensity ring (arterial phase) were independent risk factors for MVI in HCC patients ( P < 0.05 ). The results of Spearman correlation analysis showed that unsmooth tumor margin was negatively correlated with MVI in HCC patients (r = −0.66, P = 0.037 ). Moreover, peritumoral low signal (hepatobiliary phase), peritumoral enhancement (arterial phase), and peritumoral hyperintensity ring (arterial phase) were positively correlated with MVI in HCC patients (r1 = 0.63, r2 = 0.68, r3 = 0.72, P 1 = 0.030, P 2 = 0.023, P 3 = 0.017). Conclusion. Unsmooth tumor margin, peritumoral low signal (hepatobiliary phase), peritumoral enhancement (arterial phase), and peritumoral hyperintensity ring (arterial phase) are significantly correlated with MVI in patients with HCC, which can provide a reference for the formulation and implementation of clinical interventions.
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Gao, Xiang, Haiyan Wang, Shanbao Cai, M. Reza Saadatzadeh, Helmut Hanenberg, Karen E. Pollok, Aaron A. Cohen-Gadol, and Jinhui Chen. "Phosphorylation of NMDA 2B at S1303 in human glioma peritumoral tissue: implications for glioma epileptogenesis." Neurosurgical Focus 37, no. 6 (December 2014): E17. http://dx.doi.org/10.3171/2014.9.focus14485.
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Object Peritumoral seizures are an early symptom of a glioma. To gain a better understanding of the molecular mechanism underlying tumor-induced epileptogenesis, the authors studied modulation of the N-methyl-d-aspartate (NMDA) receptor in peritumoral tissue. Methods To study the possible etiology of peritumoral seizures, NMDA receptor expression, posttranslational modification, and function were analyzed in an orthotopic mouse model of human gliomas and primary patient glioma tissue in which the peritumoral border (tumor-brain interface) was preserved in a tissue block during surgery. Results The authors found that the NMDA receptor containing the 2B subunit (NR2B), a predominantly extrasynaptic receptor, is highly phosphorylated at S1013 in the neurons located in the periglioma area of the mouse brain. NR2B is also highly phosphorylated at S1013 in the neurons located in the peritumoral area from human brain tissue containing a glioma. The phosphorylation of the extrasynaptic NMDA receptor increases its permeability for Ca2+ influx and subsequently mediates neuronal overexcitation and seizure activity. Conclusions These data suggest that overexcitation of the extrasynaptic NMDA receptors in the peritumoral neurons may contribute to the development of peritumoral seizures and that the phosphorylated NR2B may be a therapeutic target for blocking primary brain tumor–induced peritumoral seizures.
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Dai, Xiao-Meng, Tao Huang, Sheng-Li Yang, Xiu-Mei Zheng, George G. Chen, and Tao Zhang. "Peritumoral EpCAM Is an Independent Prognostic Marker after Curative Resection of HBV-Related Hepatocellular Carcinoma." Disease Markers 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/8495326.
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Accumulating evidence suggests that the tumor microenvironment has a profound influence on tumor initiation and progression, opening a new avenue for studying tumor biology. Nonetheless, the prognostic values of the peritumoral expression of EpCAM and CD13 remain to be elucidated in hepatocellular carcinoma (HCC) patients. In this study, the expression of EpCAM and CD13 was assessed by immunohistochemistry in peritumoral liver hepatocytes from 106 hepatitis B virus- (HBV-) related HCC patients who had undergone curative hepatectomy. The peritumoral EpCAM-positive group had a significantly worse overall survival (OS) (p=0.003) and recurrence-free survival (RFS) (p=0.022) compared to the negative group. Peritumoral CD13-positive patients were also associated with poor OS (p=0.038), while not significantly associated with RFS. The adjusted multivariate COX proportional hazard regression analysis suggested that only the positive expression of peritumoral EpCAM precisely predicted poor OS. Being peritumoral EpCAM positive was also significantly associated with a larger tumor size, liver cirrhosis, and more frequent vascular invasion; however, no statistically significant association was observed between CD13 and any clinicopathological features. Taken together, peritumoral EpCAM and CD13 expression was associated with a poor prognosis, but EpCAM may be a better prognostic marker than CD13 in HBV-related HCC patients. In the future, peritumoral EpCAM could be a good target for adjuvant therapy after curative hepatectomy.
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Taylor, Kirsty, Michal Kazmierski, Astrid Billfalk-Kelly, Farnoosh Khodakarami, Brandon Driscoll, Lisa Wang, Scott Victor Bratman, Benjamin Haibe-Kains, and Lillian L. Siu. "Radiomic response evaluation of recurrent or metastatic head and neck squamous cell cancer (R/M HNSCC) patients receiving pembrolizumab on KEYNOTE-012 study." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 6545. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.6545.
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6545 Background: Immunotherapy has become a standard of care in the treatment of R/M HNSCC, however only a subset of patients respond, highlighting the need for predictive and prognostic biomarkers. Radiomics is a non-invasive method to quantitatively analyze tumors through conventional imaging. Methods: The pre-treatment and first-on-treatment (after 8 weeks) computed tomography (CT) scans from 132 R/M HNSCC patients treated with single-agent Pembrolizumab (10mg/kg Q2W or 200mg Q3W IV) on the KEYNOTE-012 study were analyzed. Identified target lesions, per RECIST 1.1, were manually contoured, and radiomic features from the tumor and peritumoral region (3 mm expansion of the tumor) were extracted using PyRadiomics. All combinations of image filters and feature classes, not including shape descriptors of peritumoral region, were extracted. Feature space dimensionality was reduced by clustering features (hierarchical clustering using Pearson-based distance and complete linkage) and selecting the medoid of each cluster. Correlation with lesion-level response (LLR) at first-on-treatment CT and overall response (OR) was evaluated using concordance index (CI) with Benjamini-Hochberg multiple testing correction. Results: A total of 406 lesions were included (45 head & neck (HN), 207 lung, 57 liver, 86 lymph nodes (LN), 11 other). 3562 features were extracted from pre-treatment scans (2246 tumor, 1316 peritumor). Considering all lesion sites collectively, 27 of 110 feature clusters were significantly correlated with LLR (false discovery rate (FDR) < 0.05) but not with best overall RECIST response per patient on study. However, when grouped by organ, a number of feature cluster medoids were significantly associated (FDR < 0.05) with LLR (HN: 1, lung: 28, liver: 8, LN: 1) and OR (liver: 18). Feature clusters predictive of LLR and OR included descriptors of both tumor-specific and tumor/peritumoral gray-level intensity and texture (e.g. 74% tumor and 26% peritumoral features in clusters significantly associated with OR in liver). Conclusions: Tumor and peritumoral radiomic features at baseline correlate with LLR and OR to immunotherapy in R/M HNSCC. Despite significant heterogeneity in lesion site, both global and site-specific significant feature clusters could be identified.
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Cvetkovic, Danijela, Bojan Milosevic, Aleksandar Cvetkovic, Srdjan Ninkovic, Jovana Jovankic, Dalibor Jovanovic, and Snezana Markovic. "The concentration of matrix metalloproteinase 9 in the tumor and peritumoral tissue as prognostic marker in breast cancer patients." Vojnosanitetski pregled 76, no. 5 (2019): 476–84. http://dx.doi.org/10.2298/vsp170313118c.
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Background/Aim. Breast cancer is one of the most common malignancies among women all over the world. Tumor microenvironment represents one of the main regulators of tumorigenesis. We investigated the role of matrix metalloproteinases 9 (MMP-9) concentration in peritumoral tissue as a prognostic marker in the breast cancer patients. Methods. The ELISA test was used to determine a total MMP-9 concentration in carcinoma and peritumoral tissue sample in the patients with breast cancer. Comparison of MMP-9 protein expression with the clinicopathological parameters was evaluated. Results. Peritumoral tissue at 3 cm distance from the tumor produces more MMP-9 than the tumor itself. The ratio of concentrations of MMP-9 in the tumor and peritumoral tissue considerably changes in favor of peritumoral tissue with the increase of tumor size and the involvement of axillary lymph nodes. In N0 stage, the concentration ratio of MMP-9 in the tumor and peritumoral tissues was 1 : 1.44, but in the N2 stage, the ratio was 1 : 26.5. Conclusion. In patients with breast cancer even in an early stadium there is a change in MMP-9 concentration in peritumoral tissue. We can extract the group of patients at increased risk for the development of lymph node metastasis. A statistically significant difference between the concentrations of MMP-9 in the peritumoral tissue and cancer tissue exists only in case of metastatic disease not in MO stadium implying need for early detection of still unknown metastases in such patients.
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Herde, Ryan F., Nguyen Hoang, Diem Kieu Tran, Genevieve Couldwell, William T. Couldwell, and Anne G. Osborn. "Peritumoral cysts associated with pituitary macroadenoma." Journal of Neurosurgery 123, no. 3 (September 2015): 789–93. http://dx.doi.org/10.3171/2014.12.jns141031.
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OBJECT Peritumoral cysts are benign nonneoplastic cysts that are found adjacent to extraaxial brain tumors such as meningiomas, schwannomas, craniopharyngiomas, and esthesioneuroblastomas. Peritumoral cysts associated with pituitary macroadenomas have not been previously described in the literature. The authors report 6 cases of giant macroadenoma-associated peritumoral cysts and delineate their imaging spectrum. METHODS The authors retrospectively reviewed the records of 179 patients diagnosed with pituitary macroadenomas who underwent tumor resection at their institution and had preoperative MRI scans available for review. The patients were evaluated for the presence of associated peritumoral cysts. Clinical presentation, histopathology, follow-up time, tumor and peritumoral cyst dimensions were recorded. Signal intensity on T1-weighted, T2-weighted, diffusion-weighted, and FLAIR sequences, as well as pre- and postcontrast appearance, were determined. RESULTS Six patients (3.4%) with associated peritumoral cysts were identified in our cohort of 179 patients with pituitary macroadenoma. Twelve patients in the cohort had giant macroadenomas (≥ 4.0 cm), and 50% of these tumors had associated peritumoral cysts with significant extrasellar extension of the macroadenoma. Only tumors with craniocaudal, transverse, and anteroposterior diameters of 3.6 × 3.4 × 4.2 cm to 7.0 × 7.4 × 6.8 cm (mean 5.3 × 5.1 × 5.6 cm), respectively, had associated peritumoral cysts. The growth pattern in all tumors was suprasellar, with predominant anterior and lateral extension. Cysts showed T1-weighted, T2-weighted, and FLAIR hyperintensity in 67%, 67%, and 60% of patients, respectively. There was no contrast enhancement of the cyst wall or fluid contents in any patient. Postoperatively, cysts had completely resolved (4 of 5) or significantly decreased in size (1 of 5). One patient was lost to follow-up. CONCLUSIONS Macroadenoma-associated peritumoral cysts are rare, benign, and likely nonneoplastic fluid collections that do not represent neoplasm. These cysts display a predictable pattern of hyperintensity on T1-weighted, T2-weighted, and FLAIR sequences and do not enhance. They most likely represent proteinaceous CSF in a sulcus or cistern that becomes trapped (encysted) by anterolateral extension of unusually large macroadenomas. Peritumoral cysts may facilitate resection of the associated macroadenoma by providing a cleavage plane.
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Simis, André, Paulo Henrique Pires De Aguiar, Pedro Augustto Santana Junior, and Clemar Corrêa Da Silva. "Edema peritumoral em meningiomas." JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 18, no. 3 (March 6, 2018): 40–49. http://dx.doi.org/10.22290/jbnc.v18i3.637.
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Objetivos: Edema peritumoral (EP) está presente em 60% dos meningiomas intracranianos. Ao contrário dos tumores intra-axiais, cuja fisiopatologia do edema é creditada a uma desordem da barreira hêmato-encefálica, o real mecanismo de formação do edema perilesional nos meningiomas aindaé desconhecido. Revisar as teorias de formação do EP, assim como suas diversas características são os objetivos deste artigo. Métodos: Os autores discutem, através de revisão de literatura, a associação do EP em meningiomas com fatores clínicos, radiológicos, cirúrgicos, histopatológicos e com recorrência tumoral. Resultados: Vários fatores causais têm sido discutidos nosdiversos artigos, como a quebra da barreira hêmato-encefálica, compressão mecânica e vascular, a secreção de fatores produtores de edema, relacionado a hipoplasia de veias de drenagem e ao padrão de vascularização pial.Conclusão: A causa da formação de edema peritumoral em meningiomas é provavelmente multifatorial e pode estar associada a um maior potencial invasivo do tumor. O seu estudo aprofundado poderá trazer dados adicionais para o esclarecimento dos mecanismos de formação dos meningiomas e deseu comportamento biológico levando ao melhor manejo clínico dos pacientes.
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De Petris, Giovanni, Robert Lev, and Shirley Siew. "Peritumoral and Nodal Muciphages." American Journal of Surgical Pathology 22, no. 5 (May 1998): 545–49. http://dx.doi.org/10.1097/00000478-199805000-00004.
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Lamovec, Janez, and Andreja Zidar. "Peritumoral and Nodal Muciphages." American Journal of Surgical Pathology 23, no. 10 (October 1999): 1307. http://dx.doi.org/10.1097/00000478-199910000-00020.
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Bradac, G. B., R. Ferszt, A. Bender, and W. Sch�rner. "Peritumoral edema in meningiomas." Neuroradiology 28, no. 4 (July 1986): 304–12. http://dx.doi.org/10.1007/bf00333435.
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Salpietro, Francesco M., Cetty Alafaci, Sebastiano Lucerna, Domenico G. Iacopino, Carlo Todaro, and Francesco Tomasello. "Peritumoral Edema in Meningiomas." Neurosurgery 35, no. 4 (October 1, 1994): 638–42. http://dx.doi.org/10.1227/00006123-199410000-00009.
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Salpietro, Francesco M., Cetty Alafaci, Sebastiano Lucerna, Domenico G. Iacopino, Carlo Todaro, and Francesco Tomasello. "Peritumoral Edema in Meningiomas." Neurosurgery 35, no. 4 (October 1994): 638???642. http://dx.doi.org/10.1097/00006123-199410000-00009.
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Bova, Philip S. "Prognostic significance of the evaluation of expression of the gene PCA3 in urine in patients with localized prostate cancer and histomorphological changes in the peritumoral zone." Urologicheskie vedomosti 8, no. 3 (December 15, 2018): 11–19. http://dx.doi.org/10.17816/uroved8311-19.
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Aim. To determine the prognostic significance PCA3 gene expression in urine sediment and exosomes in patients with localized prostate cancer (PC) and associated histologic changes in the peritumoral zone as a predictor of biochemical recurrence after radical prostatectomy (RPE).
Materials and methods. Of 148 patients with localized PC, 96 (65%) had high-grade prostatic intraepithelial neoplasia (PIN-2) in the peritumoral zone. The other 52 (35%) had no pathologic tissue of the peritumoral zone. PDA3 expression in urine sediment and exosomes was determined with real-time PCR with respect to the reference gene KLK3.
Results. The PCA3 gene expression level in urine exosomes in patients with PIN-2 in the prostatic peritumoral zone and synchronous pancreatic adenocarcinoma was higher among patients with subsequent disease recurrence. Increased PCA3 gene expression in the urine sediment was also predictive of the risk of recurrence of a prostatic tumor with PIN-2 in the peritumoral zone, although to a lesser degree than the results with urine exosomes. When the ∆Ct РСА3-KLK3 was ≥1,86 in the urine sediment, biochemical recurrence of PC and PIN-2 developed more frequently in the peritumoral zone (84% versus 51%, p = 0,013).
Conclusions. Increased PCA3 gene expression in urine sediment and exosomes is a predictor of increased risk of biochemical recurrence after RPE in patients with localized PC and PIN-2 in the peritumoral zone.
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Zhu, Xiao-Dong, Ju-Bo Zhang, Peng-Yuan Zhuang, Hong-Guang Zhu, Wei Zhang, Yu-Quan Xiong, Wei-Zhong Wu, Lu Wang, Zhao-You Tang, and Hui-Chuan Sun. "High Expression of Macrophage Colony-Stimulating Factor in Peritumoral Liver Tissue Is Associated With Poor Survival After Curative Resection of Hepatocellular Carcinoma." Journal of Clinical Oncology 26, no. 16 (June 1, 2008): 2707–16. http://dx.doi.org/10.1200/jco.2007.15.6521.
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Purpose To investigate prognostic values of the intratumoral and peritumoral expression of macrophage colony-stimulating factors (M-CSF) in hepatocellular carcinoma (HCC) patients after curative resection. Patients and Methods Expression of M-CSF and density of macrophages (MΦ) were assessed by immunohistochemistry in tissue microarrays containing paired tumor and peritumoral liver tissue from 105 patients who had undergone hepatectomy for histologically proven HCC. Prognostic value of these and other clinicopathologic factors was evaluated. Results Neither intratumoral M-CSF nor MΦ density was associated with overall survival (OS) or disease-free survival (DFS). High peritumoral M-CSF and MΦ density, which correlated with large tumor size, presence of intrahepatic metastasis, and high TNM stage, were independent prognostic factors for both OS (P = .001 and P < .001, respectively) and DFS (P = .001 and P = .003, respectively) and affected incidence of early recurrence. In a small HCC subset, peritumoral M-CSF was also correlated with both OS and DFS (P = .038 and P = .001, respectively). The combination of peritumoral M-CSF and MΦ had a better power to predict the patients' death and disease recurrence (P < .001 for both). Conclusion High peritumoral M-CSF and MΦ were associated with HCC progression, disease recurrence, and poor survival after hepatectomy, highlighting the importance of peritumoral tissue in the recurrence and metastasis of HCC. M-CSF and MΦ may be targets of postoperative adjuvant therapy.
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López, Carlos, Ramón Bosch-Príncep, Guifré Orero, Laia Fontoura Balagueró, Anna Korzynska, Marcial García-Rojo, Gloria Bueno, et al. "Peritumoral immune infiltrates in primary tumours are not associated with the presence of axillary lymph node metastasis in breast cancer: a retrospective cohort study." PeerJ 8 (September 2, 2020): e9779. http://dx.doi.org/10.7717/peerj.9779.
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Background The axillary lymph nodes (ALNs) in breast cancer patients are the body regions to where tumoral cells most often first disseminate. The tumour immune response is important for breast cancer patient outcome, and some studies have evaluated its involvement in ALN metastasis development. Most studies have focused on the intratumoral immune response, but very few have evaluated the peritumoral immune response. The aim of the present article is to evaluate the immune infiltrates of the peritumoral area and their association with the presence of ALN metastases. Methods The concentration of 11 immune markers in the peritumoral areas was studied in 149 patients diagnosed with invasive breast carcinoma of no special type (half of whom had ALN metastasis at diagnosis) using tissue microarrays, immunohistochemistry and digital image analysis procedures. The differences in the concentration of the immune response of peritumoral areas between patients diagnosed with and without metastasis in their ALNs were evaluated. A multivariate logistic regression model was developed to identify the clinical-pathological variables and the peritumoral immune markers independently associated with having or not having ALN metastases at diagnosis. Results No statistically significant differences were found in the concentrations of the 11 immune markers between patients diagnosed with or without ALN metastases. Patients with metastases in their ALNs had a higher histological grade, more lymphovascular and perineural invasion and larger-diameter tumours. The multivariate analysis, after validation by bootstrap simulation, revealed that only tumour diameter (OR = 1.04; 95% CI [1.00–1.07]; p = 0.026), lymphovascular invasion (OR = 25.42; 95% CI [9.57–67.55]; p < 0.001) and histological grades 2 (OR = 3.84; 95% CI [1.11–13.28]; p = 0.033) and 3 (OR = 5.18; 95% CI [1.40–19.17]; p = 0.014) were associated with the presence of ALN metastases at diagnosis. This study is one of the first to study the association of the peritumoral immune response with ALN metastasis. We did not find any association of peritumoral immune infiltrates with the presence of ALN metastasis. Nevertheless, this does not rule out the possibility that other peritumoral immune populations are associated with ALN metastasis. This matter needs to be examined in greater depth, broadening the types of peritumoral immune cells studied, and including new peritumoral areas, such as the germinal centres of the peritumoral tertiary lymphoid structures found in extensively infiltrated neoplastic lesions.
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Tran, David, Jian Campian, Joshua Shimony, Albert Kim, George Ansstas, and Eric Leuthardt. "SCIDOT-43. FINAL DATA ANALYSIS OF A PILOT STUDY TESTING THE EFFICACY OF USING LASER INTERSTITIAL THERMAL THERAPY (LITT) TO INDUCE TEMPORARY DISRUPTION OF THE PERITUMORAL BLOOD BRAIN BARRIER (BBB) TO IMPROVE EFFECTIVENESS OF BBB-IMPERMEANT CHEMOTHERAPY IN RECURRENT GLIOBLASTOMA." Neuro-Oncology 21, Supplement_6 (November 2019): vi280—vi281. http://dx.doi.org/10.1093/neuonc/noz175.1179.
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Abstract BACKGROUND Poor CNS drug delivery is a major limiting factor in GBM therapy. Since most recurrences occur peritumorally where infiltrating glioma cells reside, peritumoral BBB disruption may help improve drug delivery and efficacy. LITT, a minimally invasive cytoreductive treatment for brain tumors, may disrupt BBB as evidenced by post-ablation contrast enhancement. METHODS Patients with recurrent GBM were treated with LITT. The degree of post-LITT peritumoral BBB disruption was measured by the vascular transfer constant (Ktrans) in brain DCE-MRI. Serum levels of brain-specific enolase (BSE) were quantified as an independent measure of BBB disruption. Forty enrollments were planned with equal randomization to weekly low-dose doxorubicin, a BBB-impermeant chemotherapy, either during the BBB-permeable window (Early Dox) or after the resolution of disruption (Late Dox). The primary endpoint is 6-month PFS rate (6-PFS). RESULTS Peritumoral Ktrans peaked immediately post LITT, followed by a gradual decline for the next 4 weeks. Similarly, serum BSE concentrations peaked in 1–3 weeks after LITT before decreasing to baseline by 6 weeks. 41 patients were randomized to Early and Late Dox. 31 patients (14 Early and 17 Late Dox) were evaluable for the primary endpoint. MGMT promoter methylation rate was 28% and 47% in the Early and Late Dox arms, respectively. 6-PFS was 57.1% (8/14) in Early Dox compared to 35.3% (6/17) in Late Dox. PFS was 5.8 (95%CI: 4.1–6.3) months vs. 4.9 (95%CI: 2.4–6.3) months, while OS was 12.8 (95%CI: 7.8–14.5) months vs. 13.6 (95%CI: 10.2–17.1) months, for Early vs. Late Dox, respectively. The most common grade 3–4 toxicities were cytopenia observed in 6 (16%) patients. CONCLUSIONS LITT induces temporary peritumoral BBB disruption lasting 4–6 weeks, providing a rare opportunity to enhance local delivery of potentially efficacious but BBB-impermeant therapeutic agents. 6-PFS strongly favors dox given early during the window of BBB disruption, thus supporting the hypothesis.
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Greco, Federico, Luigi Giuseppe Quarta, Caterina Bernetti, Rosario Francesco Grasso, Mark Ivo van Berge Henegouwen, Bruno Beomonte Zobel, and Carlo Augusto Mallio. "Composition of Perinephric Fat and Fuhrman Grade in Clear Cell Renal Cell Carcinoma: The Role of Peritumoral Collateral Vessels." Applied Sciences 11, no. 9 (April 27, 2021): 3941. http://dx.doi.org/10.3390/app11093941.
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Background: The aim of this study was to investigate whether the presence of peritumoral collateral vessels could be indicative of a high Fuhrman grade (e.g., III and IV) in clear cell renal cell carcinoma (ccRCC). Methods: Between November 2019 and February 2020, a total of 267 ccRCC patients with histology-proven diagnoses were retrospectively analyzed and screened. Imaging analysis was performed on computed tomography (CT) images to assess the presence of peritumoral collateral vessels and understand the potential association with high Fuhrman grades. These vessels are defined as dilated and macroscopically visible peritumoral renal capsular veins. Results: A total of 190 ccRCC patients were included in the study, considering the exclusion criteria. In patients with peritumoral collateral vessels, there was a statistically significant greater presence of ccRCC with a high Fuhrman grade both among the total cohort of patients regardless gender (n = 190) (p < 0.001) as well as among ccRCC male patients only (n = 127) (p < 0.005). Conclusion: Here, we show a novel association between peritumoral collateral vessels and ccRCC with high Fuhrman grades in male patients. The presence of peritumoral collateral vessels in perinephric adipose tissue can be indicative of more aggressive ccRCC.
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Samani, Zahra Riahi, Drew Parker, Jacob Antony Alappatt, Steven Brem, and Ragini Verma. "NIMG-45. DEEP LEARNING-BASED PERITUMORAL MICROSTRUCTURE MAPPING IN GLIOBLASTOMAS USING FREE WATER VOLUME FRACTION." Neuro-Oncology 22, Supplement_2 (November 2020): ii157—ii158. http://dx.doi.org/10.1093/neuonc/noaa215.658.
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Abstract PURPOSE Characterization of the peritumoral microenvironment is a widely researched, but as yet unsolved problem. Determining the tissue microstructure differences between tumor types, arising from differences in infiltration, edema, and disease driven changes in cellularity is important to be able to guide treatment options. Diffusion tensor imaging with characterization of extracellular free water provides unique information of the tissue microstructure. The goal of this work is to leverage this information by applying deep learning on free water maps and create a microstructure map of the peritumoral area, to aid in targeted resection, radiotherapy and treatment management in the form of a crucial supplemental radiomic feature, replacing all other diffusion derived measures. METHOD We leveraged the widely different peritumoral microenvironments of GBMs and Metastatic tumors to create the microstructure maps. Tumor and peritumoral regions were automatically delineated in 143 patients with brain tumors (89 glioblastomas and 54 metastasis, ages 19-87 years, 77 females), and free water maps were computed in the peritumoral regions using their DTI data. We trained a Convolutional Neural Network (CNN) on 32x32 mm patches in the peritumoral area from GBMs and Mets, labeled as non-enhancing tumor (low free-water) and edema (high free-water), respectively. An independent test set was used and the CNN associated a voxel-wise probability to their peritumoral region to produce microstructure maps of GBMs and Mets which were then statistically compared. RESULT For comparison, a t-test was used showing significant group difference in the microstructure map between Mets and GBMs (p< 0.05). CONCLUSION The voxel-wise microstructure map is able to capture the cellularity differences in the peritumoral region, based on DTI-based characterization of the tissue microstructure. CLINICAL IMPORTANCE The microstructure map provides a novel insight into the peritumoral microenvironment using a measure that can be derived from clinically feasible DTI data, replacing pre-existing DTI measures.
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Ly, Ina, Barbara Wichtmann, Susie Yi Huang, Aapo Nummenmaa, Ovidiu Andronesi, Qiuyun Fan, William T. Curry, et al. "Characterizing glioma microenvironment with ultra-high gradient diffusion MRI." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 2050. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.2050.
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2050 Background: The infiltrating nature of gliomas, particularly into the peritumoral area, is a major barrier to improving clinical outcome as microscopic disease remains even after apparent gross total resection. Conventional T1 post-contrast and T2/FLAIR MRI do not capture full tumor extent. A better imaging biomarker is needed to improve differentiation between tumor, peritumoral area and normal brain. Methods: 4 pre-surgical patients with non-enhancing, FLAIR-hyperintense lesions suspicious for glioma underwent ultra-high gradient diffusion MRI on the Connectome MRI scanner, a unique scanner with maximum gradient strength of 300 mT/m enabling mapping of cellular microstructures on a micron-level scale. The FLAIR area was defined as the tumor region of interest (ROI). Radiographically normal appearing brain up to 1 cm around the FLAIR area was defined as the peritumoral ROI. Using a novel 3 compartment diffusion model (Linear Multiscale Model), the volume fraction of water (VFW) was calculated within restricted (intracellular), hindered (extracellular) and free (CSF) spaces. VFW in the tumor, peritumoral ROI, contralateral normal white matter (WM) and cortex were compared. Results: Within the tumor ROI, the median VFW in the restricted compartment was decreased vs. the peritumoral ROI (↓ 34%), WM (↓ 46%) and cortex (↓ 18%) while median VFW in the hindered compartment was increased vs. the peritumoral ROI (↑ 26%), WM (↑ 54%) and cortex (↑ 25%). Within the peritumoral ROI, median VFW in the hindered compartment was increased compared to WM (↑ 23%). 3 patients had available histopathology revealing isocitrate dehydrogenase-mutant gliomas. Conclusions: Using ultra-high gradient diffusion MRI and a novel diffusion model, we detected distinct diffusion patterns in the tumor and peritumoral area not seen on conventional MRI. Lower VFW in the restricted compartment within the tumor may reflect decreased intracellular water mobility due to enlarged nuclei. Higher VFW in the hindered compartment in the tumor and peritumoral area may reflect higher degree of tissue permeability and edema. MRI-pathology and larger cohort validation studies are underway to elucidate microenvironment changes in response to treatment.
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van Dijken, Bart Roelf Jan, Peter Jan van Laar, Chao Li, Jiun-Lin Yan, Natalie Rosella Boonzaier, Stephen John Price, and Anouk van der Hoorn. "Ventricle contact is associated with lower survival and increased peritumoral perfusion in glioblastoma." Journal of Neurosurgery 131, no. 3 (September 2019): 717–23. http://dx.doi.org/10.3171/2018.5.jns18340.
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OBJECTIVEThe purpose of this study was to prospectively investigate outcome and differences in peritumoral MRI characteristics of glioblastomas (GBMs) that were in contact with the ventricles (ventricle-contacting tumors) and those that were not (noncontacting tumors). GBMs are heterogeneous tumors with variable survival. Lower survival is suggested for patients with ventricle-contacting tumors than for those with noncontacting tumors. This might be supported by aggressive peritumoral MRI features. However, differences in MRI characteristics of the peritumoral environment between ventricle-contacting and noncontacting GBMs have not yet been investigated.METHODSPatients with newly diagnosed GBM underwent preoperative MRI with contrast-enhanced T1-weighted, FLAIR, diffusion-weighted, and perfusion-weighted sequences. Tumors were categorized into ventricle-contacting or noncontacting based on contrast enhancement. Survival analysis was performed using log-rank for univariate analysis and Cox regression for multivariate analysis. Normalized perfusion (relative cerebral blood volume [rCBV]) and diffusion (apparent diffusion coefficient [ADC]) values were calculated in 2 regions: the peritumoral nonenhancing FLAIR region overlapping the subventricular zone and the remaining peritumoral nonenhancing FLAIR region.RESULTSOverall survival was significantly lower for patients with contacting tumors than for those with noncontacting tumors (434 vs 747 days, p < 0.001). Progression-free survival showed a comparable trend (260 vs 375 days, p = 0.094). Multivariate analysis confirmed a survival difference for both overall survival (HR 3.930, 95% CI 1.740–8.875, p = 0.001) and progression-free survival (HR 2.506, 95% CI 1.254–5.007, p = 0.009). Peritumoral perfusion was higher in contacting than in noncontacting tumors for both FLAIR regions (p = 0.04). There was no difference in peritumoral ADC values between the 2 groups.CONCLUSIONSPatients with ventricle-contacting tumors had poorer outcomes than patients with noncontacting tumors. This disadvantage of ventricle contact might be explained by higher peritumoral perfusion leading to more aggressive behavior.
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Kimura, Teruo, Masaki Ohkubo, Hironaka Igarashi, Ingrid L. Kwee, and Tsutomu Nakada. "Increase in glutamate as a sensitive indicator of extracellular matrix integrity in peritumoral edema: a 3.0-tesla proton magnetic resonance spectroscopy study." Journal of Neurosurgery 106, no. 4 (April 2007): 609–13. http://dx.doi.org/10.3171/jns.2007.106.4.609.
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Object The authors of previous studies based on diffusion tensor imaging have indicated that there are two types of peritumoral edema—namely, edema with preserved structural integrity of the glial matrix and edema with compromised glial matrix. The authors of this study hypothesized that functionality of the glutamate (Glu)–glutamine shuttle, a vital neuron–glia interaction, may be differentially affected by peritumoral edema. They tested this hypothesis using proton magnetic resonance (MR) spectroscopy on a 3.0-tesla system that is capable of quantifying Glu without need of editing. Methods Twenty-three patients, each with a single brain tumor mass and peritumoral edema (nine high-grade gliomas, eight metastatic brain tumors, and six meningiomas), and nine healthy individuals participated in this study. Single-voxel proton MR imaging targeting the region of peritumoral edema was performed using a 3.0-tesla system. Glutamate levels in the peritumoral edema of nonglial tumors was significantly elevated (p < 0.01) compared with edema associated with glial tumors or normal white matter. The finding confirmed that peritumoral edema in nonglial tumors is distinct from that of glial tumors, as previously indicated in diffusion tensor imaging studies. The authors hypothesized that the former condition represents a compensatory increase in activities of the Glu–glutamine shuttle brought about by simple expansion of the extracellular space due to edema. Conclusions The assessment of Glu concentrations in peritumoral edema using 3.0-tesla proton MR spectroscopy may be developed into an objective index of the structural integrity of the glial matrix.
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Kalkanis, Steven N., Rona S. Carroll, Jianping Zhang, Amir A. Zamani, and Peter McL Black. "Correlation of vascular endothelial growth factor messenger RNA expression with peritumoral vasogenic cerebral edema in meningiomas." Journal of Neurosurgery 85, no. 6 (December 1996): 1095–101. http://dx.doi.org/10.3171/jns.1996.85.6.1095.
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✓ Intracranial meningiomas are often complicated by peritumoral vasogenic cerebral edema, which appears to result from increased microvascular permeability and extravasation of proteinaceous and plasma fluid into the adjacent peritumoral space. The source of such edema has long been mysterious. The contents of this paper support the concept that vascular endothelial growth factor (VEGF) production plays a significant role in edema formation. Vascular endothelial growth factor messenger RNA expression has been found in a wide range of intracranial neoplasms, including malignant gliomas, metastatic melanomas, meningiomas, and other benign tumors. Several studies have confirmed the importance of VEGF in tumorigenesis, neovascularization, and edema production. This study tests the hypothesis that the presence of peritumoral edema in meningiomas is positively correlated with increased expression of VEGF mRNA. To investigate this hypothesis, 31 meningioma specimens were subjected to Northern blot analysis, hybridization with a complementary DNA VEGF probe, and laser densitometry to determine the relative levels of VEGF mRNA expression. Magnetic resonance imaging was then used in a double-blind fashion to correlate the neuropathological tissue samples with the presence of preoperative peritumoral edema. Of 31 patients studied, 14 exhibited no edema and 17 exhibited some level of peritumoral fluid accumulation. There was a marked increase in VEGF expression in patients with edema (p = 0.0004, Wilcoxon-Mann-Whitney rank-sum test). Meningiomas with peritumoral edema exhibited 3.4 times the level of VEGF mRNA as those without edema. These data demonstrate a strong link between VEGF mRNA expression and peritumoral edema and indicate that VEGF expression is an important factor in the etiology of edema around meningiomas.
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Furuse, Motomasa, Hiroko Kuwabara, Naokado Ikeda, Yasuhiko Hattori, Tomotsugu Ichikawa, Naoki Kagawa, Kenichiro Kikuta, et al. "ML-07 High expression of PD-L1 on tumor-associated macrophage is a predictive factor for favorable prognosis in PCNSL." Neuro-Oncology Advances 2, Supplement_3 (November 1, 2020): ii16. http://dx.doi.org/10.1093/noajnl/vdaa143.070.
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Abstract PD-L1 and PD-L2 expression on tumor cells and tumor-infiltrating immune cells in primary central nervous system lymphoma (PCNSL) remains unclear. In the present study, we investigated the expressions of PD-L1 and PD-L2 in surgical specimens from needle biopsies and craniotomies to compare tumor tissue with surrounding tumor tissue (peritumoral tissue) and analyzed the correlation between expression of PD-L1/PD-L2 and survival in patients with PCNSL. We retrospectively analyzed the cases of 70 patients histologically diagnosed with PCNSL (diffuse large B-cell lymphoma). Immunohistochemistry for CD20, CD68, PD-L1, and PD-L2 was performed. In cases with specimens taken by craniotomy, the percentages of PD-L1- and PD-L2-positive macrophages were evaluated in both tumor and peritumoral tissue. The Kaplan-Meier method with log-rank test and Cox proportional hazard model were used for survival analysis. The tumor cells did not express very much PD-L1 and PD-L2, but macrophages expressed PD-L1 and PD-L2 in most of the patients. The median percentage of PD-L2-positive cells was significantly higher among peritumoral macrophages (32.5%; 95%CI: 0–94.6) than intratumoral macrophages (27.5%; 95%CI: 0–81.1, p=0.0014). There was a significant correlation between the percentages of PD-L2-positive intratumoral macrophages and PD-L2-positive peritumoral macrophages (p=0.0429), with very low coefficient correlation (ρ=0.098535). PD-L1 expression on macrophages was significantly associated with biological factors (intratumoral macrophages: better KPS, p=0.0008; better MSKCC score, p=0.0103; peritumoral macrophages: low proportion of LDH elevation, p=0.0064) and longer OS (for intratumoral macrophages: high PD-L1=60 months, 95%CI=30–132.6; low PD-L1=24 months, 95%CI=11–48; p=0.032; for peritumoral macrophages: high PD-L1=60 months, 95%CI=30.7-NR; low PD-L1=14 months, 95%CI=3–26). PD-L1 expression on peritumoral macrophages was strongly predictive of a favorable outcome (HR=0.30, 95%CI=0.12–0.77, p=0.0129). Macrophages in intratumoral and peritumoral tissue expressed PD-L1 and PD-L2 at a higher rate than tumor cells. PD-L1 expression, especially on peritumoral macrophages, seems to be an important prognostic factor in PCNSL.
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Huntoon, Kristin, Tianxia Wu, J. Bradley Elder, John A. Butman, Emily Y. Chew, W. Marston Linehan, Edward H. Oldfield, and Russell R. Lonser. "Biological and clinical impact of hemangioblastoma-associated peritumoral cysts in von Hippel-Lindau disease." Journal of Neurosurgery 124, no. 4 (April 2016): 971–76. http://dx.doi.org/10.3171/2015.4.jns1533.
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OBJECT Peritumoral cysts are frequently associated with CNS hemangioblastomas and often underlie neurological morbidity and mortality. To determine their natural history and clinical impact, the authors prospectively analyzed hemangioblastoma-associated peritumoral cysts in patients with von Hippel-Lindau (VHL) disease. METHODS Patients with VHL disease who had 2 or more years of follow-up and who were enrolled in a prospective study at the National Institutes of Health were included. Serial prospectively acquired laboratory, genetic, imaging, and clinical data were analyzed. RESULTS One hundred thirty-two patients (of 225 in the VHL study with at least 2 years of follow-up) had peritumoral cysts that were followed for more than 2 years (total of 292 CNS peritumoral cysts). The mean age at study entrance was 37.4 ± 13.1 years ([mean ± SD], median 37.9, range 12.3–65.1 years). The mean follow-up was 7.0 ± 1.7 years (median 7.3, range 2.1–9.0 years). Over the study period, 121 of the 292 peritumoral cysts (41.4%) became symptomatic. Development of new cysts was associated with a larger number cysts at study enrollment (p = 0.002) and younger age (p < 0.0001). Cyst growth rate was associated with anatomical location (cerebellum cysts grew faster than spine and brainstem cysts; p = 0.0002 and p = 0.0008), younger age (< 35 years of age; p = 0.0006), and development of new neurological symptoms (p < 0.0001). Cyst size at symptom production depended on anatomical location (p < 0.0001; largest to smallest were found, successively, in the cerebellum, spinal cord, and brainstem). The most common location for peritumoral cysts was the cerebellum (184 cysts [63%]; p < 0.0001). CONCLUSIONS Peritumoral cysts frequently underlie symptom formation that requires surgical intervention in patients with VHL disease. Development of new cysts was associated with a larger number of cysts at study enrollment and younger age. Total peritumoral cyst burden was associated with germline partial deletion of the VHL gene.
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Server, Andres, Roger Josefsen, Bettina Kulle, Jan Mæhlen, Till Schellhorn, Øystein Gadmar, Theresa Kumar, Monika Haakonsen, Carl W. Langberg, and Per H. Nakstad. "Proton magnetic resonance spectroscopy in the distinction of high-grade cerebral gliomas from single metastatic brain tumors." Acta Radiologica 51, no. 3 (April 2010): 316–25. http://dx.doi.org/10.3109/02841850903482901.
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Background: Brain metastases and primary high-grade gliomas, including glioblastomas multiforme (GBM) and anaplastic astrocytomas (AA), may be indistinguishable by conventional magnetic resonance (MR) imaging. Identification of these tumors may have therapeutic consequences. Purpose: To assess the value of MR spectroscopy (MRS) using short and intermediate echo time (TE) in differentiating solitary brain metastases and high-grade gliomas on the basis of differences in metabolite ratios in the intratumoral and peritumoral region. Material and Methods: We performed MR imaging and MRS in 73 patients with histologically verified intraaxial brain tumors: 53 patients with high-grade gliomas (34 GBM and 19 AA) and 20 patients with metastatic brain tumors. The metabolite ratios of Cho/Cr, Cho/NAA, and NAA/Cr at intermediate TE and the presence of lipids at short TE were assessed from spectral maps in the tumoral core, peritumoral edema, and contralateral normal-appearing white matter. The differences in the metabolite ratios between high-grade gliomas/GBM/AA and metastases were analyzed statistically. Cutoff values of Cho/Cr, Cho/NAA, and NAA/Cr ratios in the peritumoral edema, as well as Cho/Cr and NAA/Cr ratios in the tumoral core for distinguishing high-grade gliomas/GBM/AA from metastases were determined by receiver operating characteristic (ROC) curve analysis. Results: Significant differences were noted in the peritumoral Cho/Cr, Cho/NAA, and NAA/ Cr ratios between high-grade gliomas/GBM/AA and metastases. ROC analysis demonstrated a cutoff value of 1.24 for peritumoral Cho/Cr ratio to provide sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of 100%, 88.9%, 80.0%, and 100%, respectively, for discrimination between high-grade gliomas and metastases. By using a cutoff value of 1.11 for peritumoral Cho/NAA ratio, the sensitivity was 100%, the specificity was 91.1%, the PPV was 83.3%, and the NPV was 100%. Conclusion: The results of this study demonstrate that MRS can differentiate high-grade gliomas from metastases, especially with peritumoral measurements, supporting the hypothesis that MRS can detect infiltration of tumor cells in the peritumoral edema.
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Samani, Zahra Riahi, Drew Parker, Ronald Wolf, Steven Brem, and Ragini Verma. "BRMP-04. AI-based biomarker of the peritumoral region using tissue microstructure." Neuro-Oncology 23, Supplement_6 (November 2, 2021): vi223—vi224. http://dx.doi.org/10.1093/neuonc/noab196.897.
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Abstract PURPOSE Glioblastomas, the most common malignant brain tumor [BS1], infiltrate into peritumoral brain structures, making clinical management challenging. An unmet need is to develop a biomarker that reliably characterize infiltration in the peritumoral region, where surgical biopsy or resection may be hazardous. Diffusion tensor imaging (DTI) with multicompartment modeling can characterize extracellular free water, providing unique information of the tissue microstructure that is able to capture this heterogeneity. We propose a novel biomarker based on peritumoral tissue microstructure, using deep-learning on DTI-based free water map. METHOD Peritumoral regions were automatically segmented for 136 patients with brain tumors (86 glioblastomas and 50 metastases, ages 23–87 years, 65 females). We trained a Convolutional Neural Network (CNN) on free-water maps using automatically defined patches in the peritumoral area from glioblastomas and metastases, labeled as low free-water and high free-water to extract a microstructural index for each voxel. To extract the biomarker, we grouped peritumoral voxels into connected components (CCs) where adjacent voxels have high (>0.9) microstructural index values. Two independent test sets related to two clinically significant problems were evaluated: i) metastases vs. glioblastomas; ii) glioma patients categorized into short and long survival groups and the number of CCs were statistically compared. RESULT Two-sample t-tests showed significant group difference in the number of CCs between metastases and glioblastomas (p< 0.05), and short and long-survivals (p<0.05) with higher number of CCs in metastases and long-survivals, which suggests smaller number of voxels in CCs. CONCLUSION The proposed biomarker based on CCs of microstructural index captures the differences in infiltration of the peritumoral region, showing larger CCs in glioblastomas and short-survivals corresponding to higher infiltration. CLINICAL IMPORTANCE The proposed biomarker provides a novel insight into the peritumoral microenvironment and can be derived from clinically feasible DTI data, providing new possibilities for the diagnosis and treatment of glioblastoma.
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Moreno-Eutimio, Mario Adan, Raul Aragon-Franco, Constantino Lopez-Macias, Alejandro J. Silva, and Horacio Astudillo. "Toll-like receptor 7 and 9 (TLR 7 and TLR 9) expression in biopsies of in situ cervical cancer." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e15584-e15584. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e15584.
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e15584 Background: In order to analyze the expression of TLR 7 and TLR 9 in cervix biopsies, we evaluated the expression of these TLRs in cervical carcinoma in situ tissue and peritumoral inflammatory tissue biopsies by immunohistochemistry. Methods: We reviewed 276 uterine cervix biopsies of Clinical Specialties Women's Health Directorate of the Ministry of National Defense (between 2009-2010); the biopsies have the following histopathological diagnosis: 124 CIN I, 68 CIN II, 34 CIN III, 21 invasive cancer and 29 cancer in situ. Results: It was observed that peritumoral inflammatory tissue receptor was expressed positively in 89.6% in cervical cancer tissue in situ, the receptor was expressed positively in 68.9% and the negative expression was 31.1%, proving that in the peritumoral inflammatory tissue compared with in situ cervical cancer was increased expression of TLR 7. In the case of the expression of TLR 9, peritumoral inflammatory tissue, expressed positively in 24 samples and 5 samples were negative expression in the tissue in situ cervical cancer samples identified 20 positive and 9 negative samples. By analyzing the intensity of the expression of TLR 7 in cervical cancer tissue in situ, we found 16 samples with focal positive (+), 3 samples with diffuse positive (+ +) and 1 sample with positive (+ + + ), while in peritumoral inflammatory tissue found 13 samples with focal positive (+), 10 samples with diffuse positive (+ +) and 3 samples with positive results (+++). By analyzing the intensity of the expression of TLR 9 in cervical cancer tissue in situ, we found 14 samples with focal positive (+), 5 samples with diffuse positive (+ +) and 1 sample with positive (+), in contrast to the peritumoral inflammatory tissue was found 7 samples with focal positive (+), 13 samples tested positive diffuse (+ +) and 4 samples with positive results (+++). Conclusions: These results show that no significant difference between the expression of TLR 7 () and TLR 9 () in the peritumoral inflammatory tissue and tissue in situ cervical cancer found a decrease in the expression of TLR 7 and TLR 9 in tissue in situ cervical cancer compared with the expression in the peritumoral tissue inflammation.
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Kaur, Manpreet, Gabriel Cassinelli Petersen, Marc von Reppert, Leon Jekel, Irene Dixe oliveira de Santo, Sunitha Varghese, Veronica Chiang, and Mariam Aboian. "NIMG-04. LONGITUDINAL TRACKING OF PERITUMORAL EDEMA VOLUME USING PACS-INTEGRATED TOOLS PROVIDES CRITICAL INFORMATION IN TREATMENT ASSESSMENT OF NSCLC BRAIN METASTASES AFTER RADIOSURGERY." Neuro-Oncology 24, Supplement_7 (November 1, 2022): vii162. http://dx.doi.org/10.1093/neuonc/noac209.624.
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Abstract PURPOSE Brain metastases (BM) are the most common intracranial malignancies in adults and mostly originate from lung cancer. Gamma Knife (GK) has become standard of care for BM, however there is insufficient knowledge of the posttreatment volumetric changes of peritumoral edema of BM due to paucity of tools for volumetric segmentation in neuroradiology practice. Recently PACS-integrated tools have become available in select clinical practices facilitating the comparison of posttreatment peritumoral edema volume changes and 2D-based measurements of CE tumor core. METHODS Patients with NSCLC BM ≥ 10 mm on T1c+ treated with GK had volumetric measurements for up to 7 follow-ups using a PACS-integrated tool that segments the FLAIR hyperintense region surrounding and including the CE lesion. The 2D and volumetric measurements were compared by creating treatment response curves with incorporation of clinical information including steroid timing. RESULTS 50 NSCLC BM were included. The median pretreatment peritumoral volume was 8.5 cm3 (IQR 1–47 cm3, n= 36). The volume significantly decreased at 0–90 days (median 1.2 cm3, IQR 0.5–6.1 cm3, n= 31) and between 0-90 and 91-180 days (median 0.8 cm3, IQR 0.3-2.3 cm3, n= 26) post-GK. The time of peak median peritumoral volume increase was at > 365 days (median 1.4 cm3, IQR 0.4–8.1 cm3, n= 19). There was a positive correlation between longest diameter (LD) and peritumoral edema volume (rs= .75, p< .05). At 181–270 days post-GK 50% of BM showed incongruent response course for LD and peritumoral edema volume. The congruence/incongruence ratio of edema/enhancing portion of BM changed over follow-up time. CONCLUSION Half of the BM in our study did not show congruent response when comparing posttreatment peritumoral edema volume course to CE lesions in longitudinal assessment. Therefore, there is a critical need for quantitative tools that are incorporated into clinical practice to assess peritumoral edema treatment response.
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Osokin, R. A., I. A. Aboyan, E. F. Komarova, A. Yu Maksimov, and E. Yu Komarova. "Tissue synthesis of some components of the renin-angiotensin system in hypertensive patients with localized kidney cancer." Cancer Urology 16, no. 1 (April 23, 2020): 27–34. http://dx.doi.org/10.17650/1726-9776-2020-16-1-27-34.
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Background. In the last decade, the relationship between arterial hypertension and the risk of developing kidney cancer (KC) has been pointed out. Some studies have shown that the metabolic imbalance of the components of the renal renin-angiotensin system (RAS) is associated with the development and progression of KC.Objective: to study the state of RAS in tumor and peritumoral tissues in patients with KC on the background of arterial hypertension. Materials and methods. In patients with localized KC T1N0M0 and grade I–II arterial hypertension without special treatment (n = 40) in the samples of tumor, peritumoral and histologically unchanged tissue, the levels of angiotensins 1, 2, 1–7 (AT1, AT2, AT(1–7)) of angiotensin-converting enzymes (ACE, ACE2) were determined by ELISA. The comparison group consisted of patients with RC without impaired blood pressure (n = 55).Results. In patients with KC, the level of AT1 is 1.5 times higher (p <0.05), and AT2 is 1.6 times higher (p <0.05) in tumor tissue against the background of unchanged content in peritumoral tissue compared with histologically unchanged tissue. The level of ACE is higher than histologically unchanged tissue by 2.7 times, ACE2 – by 1.6 times (in all cases p <0.05), and in peritumoral tissue it is identical in histologically unchanged tissue.In patients with KC and arterial hypertension, the level of AT1 and AT2 in the tumor tissue is 1.8 times higher (p <0.05) and 2.1 times (p <0.01), respectively, the content of AT(1–7) is 1.6 times (p <0.01). In peritumoral tissue, AT1 is 1.6 times higher (p <0.01) and AT2 is 1.9 times higher (p <0.05). The level of AT(1–7) in the peritumoral tissue is identical to the values in the histologically unchanged tissue. The content of ACE and ACE2 in tumor tissue is 3.6 and 2.9 times higher, respectively, and in peritumoral tissue is identical to that in tumor tissue. Correlation analysis revealed a reliable direct relationship in the studied groups for all parameters, while in the peritumoral tissue of hypertensive patients, the relationship between the average blood pressure and the RAS peptide and enzymes content had a higher tightness.Conclusion. An increase in the levels of AT1 and AT2, ACE and ACE2 in the tumor tissues and peritumoral tissue in patients with localized KC, regardless of the presence of arterial hypertension at initially higher values in hypertensive patients, was shown. The presence of arterial hypertension in patients with KC changes the metabolism of local RAS in peritumoral tissue and is associated with an increase in the correlation between changes in the components of RAS and arterial hypertension.
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Atkinson, John L. D., and John I. Lane. "Frontal sagittal meningioma: tumor parasitization of cortical vasculature as the etiology of peritumoral edema." Journal of Neurosurgery 81, no. 6 (December 1994): 924–26. http://dx.doi.org/10.3171/jns.1994.81.6.0924.
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✓ Peritumoral edema surrounding meningiomas is poorly understood; however, several theories have been proposed in the literature. A case is presented here of a frontal sagittal meningioma symmetrically effacing both frontal lobes that subsequently evokes peritumoral edema on only one side. The tumor is histologically identical on the left and right sides. Angiograms were obtained that support previous work, which suggests that the degree of cortical parasitization of blood supply correlates with peritumoral edema whether or not tumor secretory factors are involved.
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Samani, Zahra Riahi, Drew Parker, Jacob Antony Alappatt, Steven Brem, and Ragini Verma. "NIMG-21. DIFFERENTIATING TUMOR TYPES BASED ON THE PERITUMORAL MICROENVIRONMENT USING CONVOLUTIONAL NEURAL NETWORKS." Neuro-Oncology 22, Supplement_2 (November 2020): ii151. http://dx.doi.org/10.1093/neuonc/noaa215.634.
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Abstract PURPOSE The differential diagnosis of glioblastoma (GBM) versus single brain metastasis (Met) is clinically important, and is undertaken with a clinical reading of MR images and/or tumor biopsy. We investigate whether Mets and GBMs can be differentiated based on the microstructure of the FLAIR-hyperintense peritumoral region measured by diffusion tensor imaging (DTI). We hypothesize that the peritumoral microstructure differs in extracellular water content, based on whether it is vasogenic edema or infiltrative. We use deep learning trained on DTI-based free-water volume fraction maps to discriminate between the peritumoral regions of Met and GBM neoplasms. Our results are also compared with mean diffusivity (MD), the most commonly used DTI metric. METHOD dMRI data of 143 patients with brain tumors (89 glioblastomas and 54 metastases, ages 19-87 years, 77 females and 66 males) were included. Free-water volume fraction maps were computed for the peritumoral regions (demarcated automatically). We developed a 7-layer convolutional neural network (CNN) architecture to distinguish microstructural patterns of Met and GBM tumors using 32 x 32 mm patches placed at random in the peritumoral area. The CNN was trained on patches from a training set of 113 patients and tested on the remaining 30 patients, where majority voting was applied to predict the tumor type for each patient. Although MD has been previously used in both tumor and peritumoral area for discriminating tumor type, we replicated the same process with MD only in the peritumoral area to provide a stronger comparison. RESULT We predicted tumor type with 93% accuracy, outperforming MD with 84% accuracy. CONCLUSION Our results demonstrate that deep learning with CNN on DTI-based free-water volume fraction map can be a promising tool for automatic distinction of tumor types, and has potential as a tumor biomarker.
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Yamamoto, Junkoh, Shingo Kakeda, Yukunori Korogi, Takeshi Saito, and Yoshiteru Nakano. "MET-04 EVALUATION OF PERITUMORAL BRAIN PARENCHYMA USING CONTRAST-ENHANCED FIESTA IMAGING FOR DIFFERENTIATING METASTATIC BRAIN TUMORS AND GLIOBLASTOMAS." Neuro-Oncology Advances 1, Supplement_2 (December 2019): ii35. http://dx.doi.org/10.1093/noajnl/vdz039.159.
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Abstract Introduction: Metastatic brain tumors and glioblastomas commonly revealed heterogenous enhancement lesions with peritumoral brain edema on magnetic resonance imaging (MRI). In particular, distinguishing solitary metastatic brain tumors from glioblastomas is difficult on conventional MRI. Fast imaging employing steady-state acquisition (FIESTA) can emphasize the water content signal with a high spatial resolution. In this study, we evaluate a role of contrast-enhanced FIESTA(CE-FIESTA) by focusing on the peritumoral brain parenchyma between metastatic brain tumors and glioblastomas. Materials and Methods: We included patients who underwent initial surgery and were histologically diagnosed with metastatic brain tumor (43 cases) or glioblastoma (14 cases) between November 2008 and May 2016. We evaluated CE-FIESTA findings of peritumoral brain parenchyma. Next, we performed an observer performance study with neuroradiologists based on the findings of peritumoral brain parenchyma using conventional MRI and CE-FIESTA. Results: CE-FIESTA revealed hyperintense rim in peritumoral brain parenchyma. We classified hyperintense rim in three groups, as follow: type A, no hyperintense rim; type B, partial hyperintense rim; and type C, extended hyperintense rim. Regarding the diagnosis of metastatic brain tumors, the observer performance demonstrated high sensitivity (95.3%), specificity (85.7%) and accuracy (93.0%) of type C on CE-FIESTA, and thus, CE-FIESTA could distinguish metastatic brain tumors from glioblastomas with high accuracy. Conclusions: CE-FIESTA may provide useful information for distinguish metastatic brain tumors from glioblastomas, focusing on the differences in the peritumoral brain parenchyma.
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Shinonaga, Masamichi, Cha Cheng Chang, Noriyuki Suzuki, Masazumi Sato, and Takeo Kuwabara. "Immunohistological evaluation of macrophage infiltrates in brain tumors." Journal of Neurosurgery 68, no. 2 (February 1988): 259–65. http://dx.doi.org/10.3171/jns.1988.68.2.0259.
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✓ Peritumoral edema is one of the most serious complications of intracranial neoplasms; however, the exact pathogenesis of this condition is still unknown. To explore the effect of macrophages in brain tumors on the pathogenesis of peritumoral edema, 42 specimens of primary or metastatic brain tumors were studied. Frozen sections were examined by an immunoperoxidase staining technique with anti-Leu-M3 monoclonal antibody. Eight of 14 gliomas demonstrated Leu-M3-positive cell (macrophage) infiltration. The two glioblastomas showed a moderate or marked degree of macrophage infiltration. Twelve of 16 meningiomas demonstrated varying degrees of macrophage infiltration. All six metastatic brain tumors exhibited prominent macrophagesin intra- and peritumoral tissues. Four acoustic neurinomas and two hemangioblastomas showed a slight to moderate degree of macrophage infiltration. Excellent correlation was found between the degree of macrophage infiltration seen on immunoperoxidase staining and the peritumoral edema detected on computerized tomography brain scans of patients with supratentorial tumors, especially meningiomas. Macrophages are known to secrete various substances (including arachidonate metabolites) that may interfere with vascular permeability. These data suggest that macrophages infiltrating brain tumors may play an important role in the pathogenesis of peritumoral edema.
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Itai, Yuji. "Peritumoral Sparing of Fatty Liver." American Journal of Roentgenology 174, no. 3 (March 2000): 868–69. http://dx.doi.org/10.2214/ajr.174.3.1740868b.
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Kzyrgalin, S. R. "Peritumoral Lymphangiogenesis in Breast Carcinoma." Journal of Cancer Research Updates 9 (December 25, 2020): 6–10. http://dx.doi.org/10.30683/1929-2279.2020.09.02.
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Kruskal, J. B. "Direct visualization of peritumoral rims." American Journal of Roentgenology 169, no. 2 (August 1997): 595–96. http://dx.doi.org/10.2214/ajr.169.2.9242784.
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Борисов, Eduard Borisov, Сороковиков, Vladimir Sorokovikov, Бывальцев, Vadim Byvaltsev, Степанов, and Ivan Stepanov. "PERITUMORAL EDEMA AT BRAIN MENINGIOMAS." Бюллетень Восточно-Сибирского научного центра Сибирского отделения Российской академии медицинских наук 1, no. 1 (April 22, 2016): 7–11. http://dx.doi.org/10.12737/21472.
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Among edema-producing neoplasms of central neural system, the meningiomas are unique. Meningiomas are histologically
benign, slow growing and originate extracerebrally. The development of accompanying peritumoral brain edema
(PВE) occurs in 40–60 % of meningiomas and often with a high degree of PВE with no obvious relation to the size and
histologic features of the meningioma. The aim of our study was to determine the correlation between such parameters
as gender, age of the patient, localization of the tumor tissue and the presence/severity of PBE. At meningiomas PBE
was present in 70,1 % of patients. Meningioma with the presence of PBE occur more often than tumors without PBE.
Olfactory groove tumors have more pronounced degree of PBE, unlike meningiomas of parasagittal localization and
the region of the wings of the sphenoid bone. Mixed meningiomas had a greater degree of PBE unlike meningotheliomatozic
and fibroblastic variants.
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Hwang, W. Z., H. Ito, T. Hasegawa, T. Shimoji, Sh Kida, H. Fujii, and Sh Yamamoto. "Peritumoral oedema and lipid content." Acta Neurochirurgica 80, no. 3-4 (September 1986): 128–30. http://dx.doi.org/10.1007/bf01812287.
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Souto, Antonio Aversa do, Leila Chimelli, Cristina Maeda Takya, Jorge Marcondes de Souza, Ana Luiza V. Fonseca, and Luís Felipe da Silva. "Edema cerebral em meningiomas: aspectos radiológicos e histopatológicos." Arquivos de Neuro-Psiquiatria 60, no. 3B (September 2002): 807–17. http://dx.doi.org/10.1590/s0004-282x2002000500023.
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Diversos fatores têm sido associados ao desenvolvimento de edema peritumoral nos meningiomas. Foram estudados os aspectos radiológicos e anátomo-patológicos de 51 meningiomas intracranianos operados no Hospital Universitário Clementino Fraga Filho (HUCFF). Dois terços dos meningiomas apresentavam edema perilesional. O tamanho dos meningiomas correlacionou-se com a presença de edema, sendo mais frequente nos meningiomas grandes (>4cm). A localização parece, também, influenciar no desenvolvimento do edema peritumoral, sendo mais acentuado nos meningiomas da asa do esfenóide e incomum nos meningiomas do tubérculo selar. Os subtipos histológicos de meningioma não se correlacionaram com a intensidade do edema peritumoral. Dos diversos mediadores químicos descritos na literatura recente relacionados ao desenvolvimento de edema peritumoral em tumores intracranianos, destaca-se o fator de crescimento do endotélio vascular (VEGF). A expressão nos meningiomas do VEGF e de seu receptor flk-1 foi estudada com técnica imuno-histoquímica, demonstrando a sua expressão nas células tumorais.
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Cucu, Andrei Ionut, Mihaela Dana Turliuc, Alexandru Carauleanu, Ion Poeata, Claudia Florida Costea, Gabriela Florenta Dumitrescu, and Anca Sava. "Chemical Aspects of Peritumoral Cerebral Edema in Atypical Meningiomas." Revista de Chimie 69, no. 10 (November 15, 2018): 2804–7. http://dx.doi.org/10.37358/rc.18.10.6628.
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Aim of this study was to perform a retrospective evaluation of the radiological, clinical and pathological features influencing the occurrence of peritumoral brain edema (PBE) and understanding the responsible chemical mediators involved. We have examined magnetic resonance imaging(MRI), symptoms and pathology for 25 patients with convexity atypical meningiomas (WHO grade II), who underwent surgery at Professor Dr. N. Oblu Emergency Clinical Hospital between 2010 and 2017. We evaluated the possible prognostic factors related to peritumoral edema including: demography (age, gender), pathology (anatomical localization of the tumor, tumor volume, brain invasion, shape of tumor margin), symptoms and neuroimaging characteristics such as high signal intensity of the tumor on T2-weighted images (T2WI), contrast enhancement and heterogeneity. Age, gender, anatomical location of the tumor and brain invasion were not correlated with peritumoral edema. Also, the neuroimaging characteristics (homogeneity, high signal intensity on T2WI, high contrast enhancement) or the presence of motor deficit were not statistically significant regarding the relationship with the edema. Peritumoral edema and irregular tumor margins were statistically significantly (p=0.03). Tumor volume was not associated with the peritumoral edema. We also found other significant statistical correlations of the radiological features, which are worth mentioning: high-contrast enhancement with the age of the patient (p=0.006), high signal intensity on T2WI with tumor volume (p=0.03) and tumor heterogeneity with irregular tumor margins (p=0.002). The results of this study demonstrate that an irregular tumor margin may be an important predictive factor that would influence the occurrence of peritumoral edema in atypical meningiomas.
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En-lin, Song, Yu Wei-wei, Xiong Xiao-liang, and Xu Juan. "Relationship Between High Density of Peritumoral Lymphatic Vessels and Biological Behavior of Cervical Cancer." International Journal of Gynecologic Cancer 22, no. 8 (October 2012): 1435–41. http://dx.doi.org/10.1097/igc.0b013e31826aa702.
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ObjectiveTo investigate the relationship between lymphangiogenesis and lymphatic metastasis in cervical squamous carcinoma.MethodsEighty cases of invasive cervical squamous cancer were selected as objects of our study. Double immunohistochemical staining with antibodies against lymphatic vessel endothelial hyaluronan receptor 1 and Ki-67 was used to label the lymphatic vessels and mark the proliferative lymphatic vessels in cervical squamous cancer. The peritumoral lymphatic vessel density and intratumoral lymphatic vessel density was assessed. The lymphatic vessels proliferation index was evaluated by calculating Ki-67 proliferation index (PI) to reflect the lymphangiogenesis of cervical squamous cancer. Then the correlation between lymphangiogenesis and clinicopathologic features of cervical squamous cancer was analyzed.ResultsThe LVD of cervical cancer (15.23 ± 3.6) was clearly higher than that of the adjacent normal cervical subepithelial tissues (9.9 ± 2.5, P < 0.001). The peritumoral lymphatic vessel density of cervical cancer (18.75 ± 4.3) was significantly higher than the intratumoral lymphatic vessel density of cervical cancer (11.71 ± 4.9, P < 0.001). Lymphatic PI (LPI) of cervical cancer (0.258 ± 0.07) was higher than that of the adjacent normal cervical subepithelial tissues (0.068 ± 0.08, P < 0.001). The peritumoral lymphatic vessel PI of cervical cancer (0.324 ± 0.06) was notably higher than the intratumoral lymphatic vessel PI of cervical cancer (0.232 ± 0.06, P < 0.001). Peritumoral lymphatic vessel density and peritumoral lymphatic vessel were clearly associated with the lymph node metastasis (P = 0.001 and P = 0.002, respectively) and lymphovascular space invasion (P = 0.024 and P = 0.01, respectively).ConclusionsThe high density of peritumoral lymphatic vessels is a potential predictor of more aggressive phenotype of cervical squamous cancer.
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Chiu, Fang-Ying, Nguyen Quoc Khanh Le, and Cheng-Yu Chen. "A Multiparametric MRI-Based Radiomics Analysis to Efficiently Classify Tumor Subregions of Glioblastoma: A Pilot Study in Machine Learning." Journal of Clinical Medicine 10, no. 9 (May 10, 2021): 2030. http://dx.doi.org/10.3390/jcm10092030.
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Glioblastoma multiforme (GBM) carries a poor prognosis and usually presents with heterogenous regions of a necrotic core, solid part, peritumoral tissue, and peritumoral edema. Accurate demarcation on magnetic resonance imaging (MRI) between the active tumor region and perifocal edematous extension is essential for planning stereotactic biopsy, GBM resection, and radiotherapy. We established a set of radiomics features to efficiently classify patients with GBM and retrieved cerebral multiparametric MRI, including contrast-enhanced T1-weighted (T1-CE), T2-weighted, T2-weighted fluid-attenuated inversion recovery, and apparent diffusion coefficient images from local patients with GBM. A total of 1316 features on the raw MR images were selected for each annotated area. A leave-one-out cross-validation was performed on the whole dataset, the different machine learning and deep learning techniques tested; random forest achieved the best performance (average accuracy: 93.6% necrosis, 90.4% solid part, 95.8% peritumoral tissue, and 90.4% peritumoral edema). The features from the enhancing tumor and the tumor shape elongation of peritumoral edema region for high-risk groups from T1-CE. The multiparametric MRI-based radiomics model showed the efficient classification of tumor subregions of GBM and suggests that prognostic radiomic features from a routine MRI exam may also be significantly associated with key biological processes that affect the response to chemotherapy in GBM.
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Stefini, Roberto, Stefano Peron, Alessandro Lacamera, Andrea Cividini, Pietro Fiaschi, and Giovanni Marco Sicuri. "The positive effects of surgery on symptomatic stereotactic radiation-induced peritumoral brain edema: A report of three cases." Surgical Neurology International 12 (July 19, 2021): 358. http://dx.doi.org/10.25259/sni_111_2021.
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Background: Peritumoral brain edema is an uncommon but life-threatening side effect of brain tumors radiosurgery. Medical therapy usually alleviates symptoms until edema spontaneously disappears. However, when peritumoral brain edema endangers the patient’s life or medical therapy fails to guarantee an acceptable quality of life, surgery might be considered. Case Description: Our report focuses on three patients who developed extensive peritumoral brain edema after radiosurgery. Two were affected by vestibular schwannomas and one by a skull-base meningioma. Peritumoral brain edema worsened despite maximal medical therapy in all cases; therefore, surgical removal of the radiated lesion was carried out. In the first patient, surgery was overdue and resulted in a fatal outcome. On the other hand, in the latter two cases surgery was quickly effective. In all three cases, an unmanageable brain swelling was not found at surgery. Conclusion: Surgical removal of brain tumors previously treated with radiosurgery was safe and effective in resolving shortly peritumoral brain edema. This solution should be considered in patients who do not respond to medical therapy and before worsening of clinical conditions. Interestingly, the expected brain swelling was not confirmed intraoperatively. In our experience, this magnetic resonance finding should not be considered a criterion to delay surgery.