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PubMed1998

Lymphoid lesions of the gastrointestinal tract: a histologic, immunophenotypic, and genotypic analysis of 49 cases.

The diagnosis of gastrointestinal (GI) lymphoid infiltrates can be challenging when based only on conventional microscopic assessment. When marked cytologic atypia is present, a diagnosis of malignant neoplasm is readily made; however, the distinction between a low-grade malignant neoplasm and a reactive process is much more difficult. If unfixed tissue is available, immunohistologic or genotypic methods that are usually aimed at defining B-lymphocytic monotypism can be applied. However, paraffin-embedded tissue has generally been deemed unsuitable for these techniques. We assessed the value of a panel of immunohistochemical stains and a seminested polymerase chain reaction (PCR) for the analysis of lymphoid infiltrates in routinely processed GI biopsy specimens from 49 archival cases, including morphologically benign, indeterminate, and overtly malignant lesions. Clinical outcome was used as the retrospective diagnostic standard; end points were death (of lymphomatous disease or otherwise) and clinical evidence of lymphoma. According to light microscopic criteria, 19 cases were classified as benign, 17 as malignant, and 13 as atypical. Immunophenotyping correctly identified 28 of 31 benign and 14 of 18 malignant lesions (7 cases had an indeterminate immunoprofile). Genotypic analysis correctly identified 12 of 18 malignant and 29 of 31 benign lesions, but spurious monoclonal bands were produced by PCR amplification of 2 of the latter 31 cases. No single technique exists for correct categorization of all paraffin-embedded specimens of GI lymphoid infiltrates. We recommend a sequential approach to the use of available diagnostic modalities.

Antigens, CD↗

PubMed1980

The Torre syndrome with gastrointestinal polyposis.

Multiple cutaneous sebaceous neoplasms with or without keratocanthomas are associated with internal low-grade malignant neoplasms, usually of the gastrointestinal (GI) tract (Torre syndrome). We describe a 75-year-old man with multiple sebaceous adenomas, sebaceous epithellomas, and keratoacanthomas in association with multiple colonic polyps. In one polypoid lesion, an adenocarcinoma was noted histologically. Although GI tract carcinoma is clearly established with the Torre syndrome, the occurrence of multiple GI polyps has not been recognized to our knowledge.

Adenocarcinoma↗

PubMedDate not supplied

Treatment of canine mast cell tumors with CCNU (lomustine).

The efficacy and toxicity of CCNU (1-[2-chloroethyl]3-cyclohexyl-1-nitrosourea) were evaluated in 23 dogs with measurable mast cell tumors (MCT). Twenty-two dogs had cutaneous MCT and 1 dog had an intranasal MCT Nineteen (83%) dogs had biopsy of their original mass performed and 4 (17%) had aspiration cytology of masses. Of the 19 tumors histologically graded, 1 (5%) neoplasm was classified as grade I, 10 (53%) were grade II, and the remaining 8 (42%) were grade III. Dogs were treated with CCNU at a dosage of 90 mg/m2 body surface area every 3 weeks. Response could be evaluated in 19 dogs. Eight of the 19 dogs (42%) had a measurable response to CCNU. One dog had a durable complete response for 440 days. Seven dogs (37%) had a partial response for a median and mean duration of 77 days and 109 days, respectively (range, 21-254 days). Treatment with CCNU resulted in stable disease in 6 dogs (32%) for a median and mean duration of 78 days and 122 days, respectively (range, 42-347 days). The acute dose-limiting toxicity was neutropenia 7 days after administration of CCNU. The median and mean neutrophil counts 7 days after CCNU were 1,452 cells/microL and 1,683 cells/microL, respectively (n = 17). Other toxicoses were uncommon. CCNU should be considered an active agent in the treatment of MCT in dogs.

Animals↗

PubMed2004

Correlation of MR perfusion imaging and vessel tortuosity parameters in assessment of intracranial neoplasms.

Advances in noninvasive imaging techniques such as magnetic resonance perfusion imaging have been found useful in grading cerebral neoplasms and have potential for significant clinical benefit. The purpose of this study was to determine the correlation between tumor vessel tortuosity as measured from vessels extracted from magnetic resonance angiograms (MRA) and perfusion parameters of cerebral blood flow (CBF) and cerebral blood volume (CBV) in intracranial neoplasms. We hypothesized that tumor blood vessel tortuosity measures and perfusion measures would be correlated, since both are increased by tumor angiogenesis. 18 patients with 19 cerebral neoplasms were evaluated with conventional MR imaging and dynamic contrast-enhanced T2-weighted perfusion MR imaging (PWI). Both benign and malignant lesions were included, as were hyper- and hypovascular tumors. Regions of interest were plotted within the tumor area to locate foci of maximum CBV and CBF. CBV and CBF measurements were also recorded in contralateral normal appearing white matter to calculate relative CBV (rCBV) and relative CBF (rCBF). Vessel tortuosity analyses were conducted upon vessels segmented from MRA images of the same patients using two tortuosity descriptors (SOAM and ICM), which have previously been demonstrated to have efficacy in separating benign from malignant disease. Linear regression analyses were conducted to determine if correlations exist between CBV or CBF and the two tortuosity measurements. For the overall set of tumors, no significant correlations were found between flow or volume measures and the tortuosity measures. However, when the 7 glioblastoma multiforme tumors were examined as a subgroup, the following significant correlations were found: rCBV and SOAM (R2=0.799), rCBV and ICM (R2=0.214). Our results demonstrate that MR perfusion imaging data do not correlate significantly with vessel tortuosity parameters as determined from the larger vessels seen by MRA. However, for subgroups of a particular tumor type such as GBM, there may be significant correlations. It appears that perfusion and tortuosity data may provide independently useful data in the assessment of cerebral neoplasms.

Brain Neoplasms↗

PubMed2026

MRI-based radiomics model for predicting VEGFA expression and prognosis in lower-grade glioma.

BACKGROUND: Gliomas are the most common primary tumors of the central nervous system. Their treatment remains highly challenging, with high rates of associated disability and mortality. Conventional prognostic indicators no longer adequately satisfy the clinical demands of precision medicine. Therefore, it is essential to further explore novel prognostic biomarkers to enable accurate risk stratification and to provide new reference indicators for personalized precision therapy. PURPOSES: This study aimed to investigate the prognostic significance of vascular endothelial growth factor A (VEGFA) in patients diag nosed with lower-grade gliomas (LGGs) using an MRI based radiomics model. METHODS: Data regarding VEGFA expression and clinical records of LGG patients were retrieved from The Cancer Genome Atlas (TCGA). Corresponding preoperative MRI data were obtained from The Cancer Imaging Archive (TCIA) for radiomic feature extraction. Patients were stratified into high- and low- VEGFA expression groups based on survival information from the current cohort using the survminer package. The overall survival (OS) was assessed using Kaplan-Meier analysis and Cox proportional hazards regression. Predictive models were developed using logistic regression (LR), and model performance was evaluated via receiver operating characteristic (ROC) curve analysis, with area under the curve (AUC) values reported. An optimized model incorporating the Akaike information criterion (AIC) was also constructed (AIC-LR). RESULTS: VEGFA expression was significantly associated with OS (P = 0.002). Multivariate Cox regression confirmed VEGFA as an independent prognostic factor (hazard ratio [HR] = 2.545, 95% confidence interval: 1.422-4.555). Furthermore, VEGFA expression correlated with immune infiltration levels, particularly of M1 and M2 macrophages and T follicular helper cells, and was associated with enrichment in Wnt signaling and B cell receptor signaling pathways. The LR and AIC-LR models demonstrated acceptable predictive performance, with AUCs of 0.728 (95% CI: 0.612-0.843) and 0.725(95% CI: 0.612-0.839) in the training cohort, and 0.704 (95% CI: 0.562-0.847) and 0.718(95% CI: 0.576-0.861) in the validation cohort, respectively. CONCLUSIONS: The MRI based radiomics model showed potential for noninvasive assessment of VEGFA expression and may provide auxiliary information for prognostic evaluation in LGG. Further validation in larger samples and independent external cohorts is required before clinical application.

Radiomics↗

PubMed1995

[Revised WHO classification and new developments in diagnosis of central nervous system tumors].

In recent years there has been considerable progress in brain tumor neuropathology. Several new diagnostic entities have been recognized, subclassification schemes have been modified, and new concepts on the histogenesis and cell biology of brain tumors have emerged. In 1993, a revised WHO classification of brain tumors was published by an international committee. This article summarizes the pertinent new aspects. As novel tumor entities, the central neurocytoma, the dysembryoplastic neuroepithelial tumor (DNT), desmoplastic infantile ganglioglioma (DIG) and pleomorphic xanthoastrocytoma (PXA) have been included. Several histopathological variants of meningiomas have been added of which only the papillary meningioma and the atypical meningioma are characterized by an increased rate of recurrence. Meningeal hemangiopericytomas and hemangioblastomas are classified as tumors of non-meningothelial origin. The glioblastoma multiforme, which had previously been listed as an embryonal tumor, is now recognized as an astrocytic glioma. Immunohistochemistry has greatly advanced the practical diagnosis and classification of brain tumors. There are specific markers for all normal and neoplastic cell types except for oligodendroglioma cells. The prognosis of and therapeutic approaches to brain tumors greatly depend on histopathological grading. The WHO proposes four tumor grades, i.e., I, II, III, and IV. As a rule, grades I and II tumors are viewed as benign or semi-benign neoplasms and grades III and IV tumors as malignant. There are attempts to use new biological parameters for the grading of brain tumors. Antibodies to proliferation-associated proteins reflect tumor growth. Molecular genetic approaches to tumor-associated genes and gene loci are particularly promising new tools for the future.

Biomarkers, Tumor↗

PubMed2003

Colorectal neoplasms: role of intravenous contrast-enhanced CT colonography.

PURPOSE: To evaluate whether computed tomographic (CT) colonography with intravenously administered contrast material can help predict malignant differentiation of colorectal neoplasms (> or =10 mm in diameter). MATERIALS AND METHODS: Enhancement of 29 consecutive colorectal neoplasms on pre- and postcontrast CT colonographic images was retrospectively measured. The neoplasms were subsequently resected. Enhancement was calculated by subtraction of attenuation values (in Hounsfield units) obtained with precontrast and postcontrast 45-second-delay prone CT colonographic sequences. The neoplasms were graded as follows: grade 1, adenoma; grade 2, adenoma with high-grade dysplasia; grade 3, well-differentiated adenocarcinoma; grade 4, moderately differentiated adenocarcinoma; and grade 5, poorly differentiated adenocarcinoma. Correlation among size, histologic grade, and degree of enhancement was made with Pearson and Spearman coefficients. The ability of the degree of enhancement to help predict adenocarcinoma (histologic grade, > or =3) was calculated. RESULTS: Histologic-CT colonographic correlation was performed in 29 neoplasms (mean diameter, 27.9 mm; range, 10-65 mm). There was no correlation between size and degree of enhancement, size and histologic grade (R = -0.17, P =.33), or histologic grade and degree of enhancement (R = 0.23, P =.23). However, increasing enhancement was noted between grades 2 and 5. When an enhancement threshold of 40 HU was used for the diagnosis of adenocarcinoma (grades 3-5), sensitivity was 92%, specificity was 20%, positive predictive value was 50%, and negative predictive value was 75%. CONCLUSION: The degree of contrast enhancement on a 45-second-delay CT colonographic image does not correlate with size or degree of histologic differentiation, although increasing enhancement with lesser degrees of differentiation was noted.

Adenocarcinoma↗

PubMed2002

Prognostic significance of atypical papillary urothelial hyperplasia.

Typical papillary hyperplasia, a recently recognized precursor lesion to low-grade papillary urothelial neoplasms, consists of undulating folds of cytologically benign urothelium. Well-developed, branching fibrovascular cores of a papillary neoplasm are not evident. We have noted lesions with the architectural pattern of papillary hyperplasia; however, the overlying urothelium demonstrated varying degrees of cytologic atypia. We identified 15 cases of atypical papillary hyperplasia (13 males, 2 females, age 55 to 92) with overlying urothelium showing cytologic atypia. Of these cases, 8 (53%) were received in consultation. Of the 15 cases, 8 exhibited overlying flat carcinoma in situ (CIS), 4 had overlying dysplasia, and 3 were transitional between papillary hyperplasia with atypia and the earliest lesions of papillary neoplasia. Of these cases, 5 patients had multiple specimens with atypical papillary hyperplasia (range, 2 to 8) over time. Concurrent to the diagnosis of atypical papillary hyperplasia, there were 25 different urothelial lesions: CIS (n = 11), papilloma (n = 1), papillary neoplasm of low malignant potential with CIS (n = 1), high-grade papillary urothelial carcinoma (n = 10; 3 with CIS), small-cell carcinoma (n = 1), and infiltrating urothelial carcinoma (n = 1). Of 11 patients with known prior history, 2 had 12 prior urothelial neoplasms (9 low-grade papillary neoplasms, 2 papillary urothelial neoplasms of low malignant potential, and 1 high-grade papillary cancer). Of 10 patients with atypical papillary hyperplasia and a minimum of 1 year of follow-up, 9 had 19 recurrences: CIS (n = 4), papilloma (n = 1), papillary neoplasm of low malignant potential (n = 1), infiltrating urothelial carcinoma (n = 3; 1 with CIS), and high-grade papillary urothelial carcinoma (n = 10; 5 with invasion and 2 with CIS). Whether the papillary hyperplasia had overlying CIS or dysplasia did not affect the correlation with urothelial neoplasms. Immunohistochemical analysis of p53 and Ki-67 expression in 8 cases demonstrated overexpression of p53 (n = 2; 1 with overlying dysplasia and 1 with overlying CIS), and Ki-67 (n = 5; 2 with overlying dysplasia and 3 with overlying CIS). Taken together, these results suggest that atypical papillary hyperplasia is most frequently associated with CIS and high-grade papillary cancer. In some cases, CIS or dysplasia may evolve into atypical papillary hyperplasia, with further progression to high-grade papillary cancer. This process may be analogous to papillary hyperplasia without cytologic atypia progressing to low-grade papillary urothelial neoplasms.

Aged↗

PubMed2003

Classification and grading of the non-invasive urothelial neoplasms: recent advances and controversies.

The classification and grading of the non-invasive, intraepithelial neoplasms of the urothelium are based on the morphological pattern of growth-that is, papillary or flat (and endophytic)-and on their degree of architectural and cytological abnormalities. Recent advances in the morphological, molecular, and quantitative evaluation of these lesions have contributed to the refinement of the current classification and grading schemes. However, some controversies on the precise criteria and terminology, especially when the papillary lesions are concerned, are still present.

Carcinoma in Situ↗

PubMed2004

Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCBV of oligodendrogliomas [corrected].

BACKGROUND AND PURPOSE: The MR imaging characteristics of oligodendrogliomas and astrocytomas on spin-echo (SE), echo-planar relative cerebral blood volume (rCBV) maps, to our knowledge, have not previously been emphasized. We compared the specificity of SE rCBV mapping with that of conventional, contrast material-enhanced MR imaging in differentiating high- from low-grade glial tumors and in predicting survival of patients with these lesions. METHODS: Thirty consecutive adult patients with suspected gliomas underwent conventional and rCBV MR imaging. Representative maximal rCBV regions of interest were chosen from each lesion. Resultant values were normalized to those of corresponding, contralateral, uninvolved regions. These normalized CBV (nCBV) values were correlated with degree of contrast enhancement, histopathologic tumor grade, and survival. RESULTS: Twenty-two patients had astroctyomas and eight had oligodendrogliomas. With an nCBV cutoff ratio of 1.5, 13 of 13 high-grade astrocytomas were correctly categorized, three of which did not enhance. Seven of nine low-grade astrocytomas were correctly classified by their nCBV values, including one enhancing lesion. Of eight oligodendrogliomas, four of four high-grade and two of four low-grade tumors had elevated nCBV values; two low-grade oligodendrogliomas enhanced, one with nCBV greater than 1.5 and one with nCBV less than 1.5. In 19 patients with astrocytoma for whom survival data were available, correlation with survival was better for nCBV (mean survival 91 +/- 14 months for nCBV < 1.5 versus 24 +/- 27 months for nCBV > 1.5, P <.0001) than for enhancement (mean survival 61 +/- 35 months without enhancement versus 22 +/- 29 months with enhancement, P =.03). CONCLUSION: Elevated SE rCBV was a sensitive, but not specific, marker for high-grade histopathology: all high-grade tumors had nCBV foci values greater than 1.5. No tumor with nCBV region of interest less than 1.5 was high grade (100% predictive value for excluding high grade). Degree of nCBV elevation was a stronger predictor of both tumor grade and survival than was degree of enhancement. A significant proportion of low-grade glial neoplasms, most notably oligodendrogliomas, may display high rCBV foci not reflective of high-grade histopathology.

Adolescent↗

PubMed1984

Canine cutaneous mast cell tumor: morphologic grading and survival time in 83 dogs.

Eighty-three cutaneous mast cell tumors in the dog were classified morphologically into three grades. The neoplasms were excised surgically, and the dogs were followed for 1500 days. Comparison of morphologic grade of tumor with survival time revealed significant differences among the three groups (p less than 0.00010). Comparison of sex and age (above and below ten years) with morphologic grade of tumor revealed no significant differences.

Animals↗

PubMed1990

Current status of urinary cytology in the evaluation of bladder neoplasms.

Pathologic examination of urinary specimens is increasingly recognized as an essential component of detection and monitoring for patients with bladder neoplasms. Among the available techniques, urinary cytology is the most useful. The current status of urinary cytology can be summarized as follows: 1. The demand for urinary cytology is steadily increasing as clinicians have realized the limitations of cystoscopy and even biopsy for monitoring bladder cancer patients, especially those having carcinoma in situ or receiving topical therapy. 2. Urinary cytology is currently an essential procedure for monitoring all patients with urothelial neoplasms and, if consistently used, can actually decrease the frequency with which patients need to be subjected to cystoscopy. 3. Even in moderately experienced hands, urinary cytology can detect almost all high-grade urothelial neoplasms. 4. The cytologic interpretation of low-grade transitional cell neoplasia requires expertise. These cells lack many of the features of malignancy, a source of confusion for the diagnostician but a positive factor for the patient since neoplasms composed of these cells are almost never aggressive. 5. The most useful type of urinary specimen for routine diagnostic interpretation is freshly voided, randomly collected urine. Catheterized specimens and bladder washings may yield more and better preserved cells, but no patient should be catheterized solely to obtain diagnostic material. 6. Preservation of urinary specimens in alcohols is not necessary unless prolonged storage is contemplated. Refrigeration to prevent bacterial growth and inhibit further cellular degeneration is required, however. 7. Cytologic details are best displayed with membrane filtration but other types of processing are adequate. The computer-programmed cytocentrifuge is currently most popular. 8. Optimal recognition of cytologic details requires some form of Papanicolaou staining; Romanovsky dyes are less desirable. 9. Urothelial cells with nuclear:cytoplasmic ratios of 1:2 or less should not be interpreted as malignant regardless of the degree of anaplasia of their nuclei. 10. Papillary aggregation is not a reliable feature of low-grade neoplasia in urinary samples. 11. Using appropriate criteria, the differential diagnosis of urothelial neoplasia versus the reactive/regenerative/reparative changes secondary to urinary stones can almost always be accomplished. 12. Alkylating agents such as Cytoxan, thio-TEPA, and mitomycin C produce characteristic but nonspecific changes in urothelial cells. These changes rarely mimic those of carcinoma. The diagnosis of urothelial neoplasia need not be confounded by previous treatment. 13. Flow cytometry and digitized image analysis are currently used for diagnostic interpretations of urinary specimens in selected centers. Their routine use must await further refinements in instrumentation and the formulation of more searching questions.

Cytodiagnosis↗

PubMed1987

Late considerations in the treatment of low-grade malignancy cerebral tumors with iodine-125 brachytherapy.

The authors report their series of 45 patients harboring inoperable, low-grade cerebral neoplasms, treated in the past 6 years with 125I stereotactic brachytherapy. The majority of these tumors were grade I and II astrocytomas and oligodendrogliomas (82.2%). A 2.6- to 6-year follow-up shows good results in 65.6% with reduction or disappearance of the lesions on CT images and good social reentry. Nine patients (23.7%) died prior to follow-up. Young patients (less than 40 years) responded well to interstitial radiotherapy, while patients over 40 with the same histological findings of low-grade tumors responded poorly to this type of treatment. Diffuse infiltrating cortico-subcortical tumors, optochiasmatic gliomas, hypothalamic and lower brainstem neoplasms do not respond satisfactorily to 125I radioisotope implantations.

Brachytherapy↗

PubMed2004

Histopathological and immunohistochemical study of papillary urothelial neoplasms of low malignant potential and grade associated with extensive invasive low-grade urothelial carcinoma.

OBJECTIVE: To report five cases of papillary urothelial neoplasm of low malignant potential (UNLMP) and papillary urothelial carcinoma of low grade (UCLG) associated with extensive muscle invasion, and to investigate the clinical and histopathological presentation and their immunohistochemical properties. MATERIALS AND METHODS: Consecutive cystectomy and correlating transurethral resection (TUR) of urinary bladder tumour specimens were reviewed to identify cases of UCLG having extensive invasion into the urinary bladder wall. All specimens were stained immunohistochemically, as were those from 10 control cases having reactive urothelium or superficial UNLMP. The clinical charts were reviewed. RESULTS: Of a total of 95 cystectomy cases there were four of UNLMP or UCLG with extensive invasion. An additional case was added from our consultation file. All five cases had biopsies misdiagnosed as benign lesions or prostatic adenocarcinoma. The superficial invasive components consisted of UCLG conforming to the previously described entities of nested transitional cell carcinoma (TCC), microcystic or deceptively benign-appearing TCC. Immunostaining for cytokeratin 20, MIB-1 and p53 was similar to reactive epithelia, whereas E-cadherin immunoreactivity was slightly different, with focal negativity compared with extensive immunoreactivity in invasive vs noninvasive UCLG. Four patients developed distant metastases; three died within a follow-up of 3 years. CONCLUSIONS: UNLMP and UCLG that widely and deeply invade the bladder accounted for 4% of urothelial carcinoma (UC) in cystectomy specimens and commonly pose diagnostic problems in superficial TUR specimens. From this study with few cases the diagnosis of this entity in superficial biopsies is aided by an awareness of it and by identifying 'benign appearing' nests of urothelial cells which are deeply seated in the stroma. Immunostaining is unlikely to be very useful.

Aged↗

PubMed1980

Malignant tumors of nerve sheath origin.

A clinicopathologic study of malignant nerve sheath tumors diagnosed between 1962 and 1979 at the Massachusetts General Hospital was undertaken. During this 17-year period, 24 patients with such a neoplasm were seen while 607 patients were treated for schwannoma or neurofibroma. Criteria were developed for establishing the nerve sheath origin and malignancy of a given neoplasm which allowed a secure diagnosis of malignant nerve sheath tumor to be made in 11 of the 24 cases. In 7 of the remaining cases, the malignant tumors were of uncertain histogenesis and in 6 cases, a new diagnosis was made. The malignant tumors constituted 2% of all neoplasms of the nerve sheath origin diagnosed during this period. An attempt was made to grade these neoplasms, but clinical and histologic parameters were only approximately predictive of their behavior. The treatment and survival or the 11 patients with malignant nerve sheath tumors and the 7 with malignant neoplasms of uncertain histogenesis are detailed and compared. In the former group, 4 patients died within four and a half years and there were eight recurrences in 4 patients. In the latter group, 4 died within three and a half years and there were five recurrences in 3 patients.

Adult↗

PubMed2002

Urothelial papillary (exophytic) neoplasms.

The contemporary classification and grading of human papillary urothelial neoplasms remains unsettled, with multiple recent suggestions by groups of pathologists with little or no clinical input. One of the chief motivations for these new approaches was to avoid use of the term "cancer" for neoplasms with a low likelihood of invasion, recurrence, and death. Also, critics contended that earlier grading schemes were too imprecise to be clinically useful. We summarize the work carried out by the majority of members of Committee No. 1 at the International Consultation on the Diagnosis of Non-Invasive Urothelial Neoplasms held in Ancona, Italy (11-12 May 2001). Our deliberations represent a multidisciplinary international effort based on the best available data and the perception of existing practical methods of classification by clinicians, pathologists, and cancer registrars. The WHO 1973 classification for papillary urothelial neoplasms (papilloma, grade 1, grade 2, and grade 3 carcinoma) is still superior to all existing alternatives (such as WHO/ISUP 1998 and WHO 1999), although some refinement of diagnostic criteria would be useful. Some pathologists may prefer additionally to report synonymous classification in other schemes, but this is discouraged owing to variations and difficulties in translations.

Carcinoma, Papillary↗

PubMedDate not supplied

Magnetic resonance spectroscopy study of low grade extra and intracerebral human neoplasms.

In this study we report an in vitro 1H magnetic resonance spectroscopy (MRS) characterization of water soluble metabolites obtained from 17 low grade extra and intracerebral human tumors (8 meningiomas, 5 oligodendrogliomas, 2 subependimomas and 2 ependimomas). In addition, the in vivo localized 1H MRS results for 4 of the meningiomas are reported. The main metabolic features characterizing low grade tumors were investigated. Meningiomas are characterized by high Cho/Cr and Ala/Cr ratios; in many cases both in the in vitro and the in vivo spectra these ratios cannot be evaluated, due to the absence of the Cr metabolite. Low grade oligodendrogliomas are characterized by low Cho/Cr ratios. High amounts of myo-inositol are found in the spectra of ependimomas and subependimomas which are distinguished by different Cho/Cr ratio values and by a different Ala content.

Brain Neoplasms↗

PubMed2026

Toward precision prognosis: Predicting recurrence-free survival in high-grade serous ovarian cancer patients using multi-time point clinical and computed tomography radiomics data.

OBJECTIVE: To evaluate the predictive value of clinical, genomic, and radiomics features in estimating recurrence-free survival (RFS) in patients with high-grade serous ovarian carcinoma (HGSOC) treated with neoadjuvant chemotherapy (NACT). METHODS: This single-center, retrospective study included 91 patients with HGSOC who underwent treatment with NACT followed by surgery, and who had portal venous phase contrast enhanced CT imaging at baseline and after NACT. First-order texture features based on 2D segmentation were extracted from baseline and post-NACT CT images for selected disease sites using commercially available texture software. Multivariate Cox models assessed the prognostic significance of features at baseline, after NACT, and post-surgery time points, and model performance in predicting RFS was evaluated using C-statistics. RESULTS: A model including only baseline clinical data had C-statistic 0.53, while a model including both clinical and radiomics features at baseline had C-statistic 0.63. After NACT, a model including all baseline data plus the change in radiomics features between baseline and post-NACT had C-statistic 0.63. Post-surgery, a model including all baseline data plus surgical outcome had C-statistic 0.69. Incorporating changes in radiomic features between time points did not measurably enhance model performance in the post-surgery data set (C-statistic 0.7). Age, residual disease at surgery, and kurtosis were individually associated with shorter RFS. CONCLUSIONS: Radiomic features extracted from CT imaging may offer additive prognostic value for predicting RFS in HGSOC when integrated with clinical and genetic data. Our results support the potential integration of radiomic analysis with clinical data to improve outcome prediction in HGSOC.

Humans↗