Advanced magnetic resonance imaging biomarkers of cerebral metastases

Mills, Samantha J.; Thompson, G; Jackson, Alan

doi:10.1102/1470-7330.2012.0012

Cited by 14 publications

(8 citation statements)

References 59 publications

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“…The MRI characteristics of the peritumoral region of cerebral metastases have previously been examined only in order to distinguish these tumors from glioma and abscess [ 15 , 41 , 42 ]. In this context the contrast enhancing margin has been taken as the reference and the near peritumoral region has been taken as being within 1 cm of this edge.…”

Section: Discussionmentioning

confidence: 99%

Diffusion-weighted MRI characteristics of the cerebral metastasis to brain boundary predicts patient outcomes

et al. 2014

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BackgroundDiffusion-weighted MRI (DWI) has been used in neurosurgical practice mainly to distinguish cerebral metastases from abscess and glioma. There is evidence from other solid organ cancers and metastases that DWI may be used as a biomarker of prognosis and treatment response. We therefore investigated DWI characteristics of cerebral metastases and their peritumoral region recorded pre-operatively and related these to patient outcomes.MethodsRetrospective analysis of 76 cases operated upon at a single institution with DWI performed pre-operatively at 1.5T. Maps of apparent diffusion coefficient (ADC) were generated using standard protocols. Readings were taken from the tumor, peritumoral region and across the brain-tumor interface. Patient outcomes were overall survival and time to local recurrence.ResultsA minimum ADC greater than 919.4 × 10-6 mm2/s within a metastasis predicted longer overall survival regardless of adjuvant therapies. This was not simply due to differences between the types of primary cancer because the effect was observed even in a subgroup of 36 patients with the same primary, non-small cell lung cancer. The change in diffusion across the tumor border and into peritumoral brain was measured by the “ADC transition coefficient” or ATC and this was more strongly predictive than ADC readings alone. Metastases with a sharp change in diffusion across their border (ATC >0.279) showed shorter overall survival compared to those with a more diffuse edge. The ATC was the only imaging measurement which independently predicted overall survival in multivariate analysis (hazard ratio 0.54, 95% CI 0.3 – 0.97, p = 0.04).ConclusionsDWI demonstrates changes in the tumor, across the tumor edge and in the peritumoral region which may not be visible on conventional MRI and this may be useful in predicting patient outcomes for operated cerebral metastases.

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Section: Discussionmentioning

confidence: 99%

Diffusion-weighted MRI characteristics of the cerebral metastasis to brain boundary predicts patient outcomes

et al. 2014

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“…Thus, diagnosis still relays on patients’ clinical features and imaging techniques (MRI and CT). However, non-neoplastic lesions of the CNS may be radiologically and clinically mistaken as tumors: benign lesions are not always distinguished from malignant tumors, and imaging characteristics often underestimate the degree of malignancies [ 9 ]. Hence, the definitive diagnosis of brain lesions requires histologic examination of multiple samples obtained by either brain biopsy, or brain stereotactic biopsy or open surgery [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

A differentially expressed set of microRNAs in cerebro-spinal fluid (CSF) can diagnose CNS malignancies

et al. 2015

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Central Nervous System malignancies often require stereotactic biopsy or biopsy for differential diagnosis, and for tumor staging and grading. Furthermore, stereotactic biopsy can be non-diagnostic or underestimate grading. Hence, there is a compelling need of new diagnostic biomarkers to avoid such invasive procedures. Several biological markers have been proposed, but they can only identify specific prognostic subtype of Central Nervous System tumors, and none of them has found a standardized clinical application.The aim of the study was to identify a Cerebro-Spinal Fluid microRNA signature that could differentiate among Central Nervous System malignancies.CSF total RNA of 34 neoplastic and of 14 non-diseased patients was processed by NanoString. Comparison among groups (Normal, Benign, Glioblastoma, Medulloblastoma, Metastasis and Lymphoma) lead to the identification of a microRNA profile that was further confirmed by RT-PCR and in situ hybridization.Hsa-miR-451, -711, 935, -223 and -125b were significantly differentially expressed among the above mentioned groups, allowing us to draw an hypothetical diagnostic chart for Central Nervous System malignancies.This is the first study to employ the NanoString technique for Cerebro-Spinal Fluid microRNA profiling. In this article, we demonstrated that Cerebro-Spinal Fluid microRNA profiling mirrors Central Nervous System physiologic or pathologic conditions. Although more cases need to be tested, we identified a diagnostic Cerebro-Spinal Fluid microRNA signature with good perspectives for future diagnostic clinical applications.

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“…Disproportionate prelesional edema was seen in 42 cases as compared to that of the size of the lesion in our study. In a study done by Mills SJ et al [12] the degree of peritumoural oedema varies from virtually none to (more commonly) extensive surrounding oedema in metastases. A greater degree of perilesional signal change, commonly referred to as oedema although the underlying content in glioma is more complex, is reportedly indicative of metastatic disease rather than glioma.…”

Section: Discussionmentioning

confidence: 96%

“…Out of 50 cases 16 cases showed increased lipid lactate peak, in 9 cases increased choline and lipid lactate peak, 9 cases showed increased choline peak and in 16 cases MRS was non-contributory. In a study done by Mills SJ et al [12] MRS in comparing lipid and macromolecule signals in cerebral metastases (n¼34) and GBM (n¼25) and reported significantly higher values in metastases.…”

Section: Discussionmentioning

confidence: 99%

Radiologic clues to differentiate metastases from other brain pathologies with histopathological correlation

Sajjan¹,

Maralihalli²

2019

Int. J. Radiol. Diagn. Imaging

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Introduction:The dissemination of tumour cells to the brain parenchyma does solely occur via the blood stream, as the brain lacks lymphatic vessels. Therefore, tumour cells have to manage survival and adapt to the changed microenvironment within the bloodstream. Several preclinical studies indicate that tumour cells might aggregate with platelets and leucocytes in order to survive. Methodology: This study was performed at the Department of Radio-diagnosis, and the patients selected for the study were referred from Neurosurgery/Neurology OPD or Emergency department at our hospital, who were clinically suspected to have a space occupying lesion or having history suggestive of metastases. The patients presented with symptoms like headache, motor weakness, diminished vision, double vision, seizure. All patients were seen by appointment, except for the emergency cases. Relevant history of illness and significant clinical findings of all patients were recorded. Results: Out of 50 cases adenocarcinoma (66%) was the most common histopathology metastasized to the brain followed by squamous cell type (16%), Melanoma (6%), GBM (2%), Oligodendroglioma (2%), liposarcoma (2%) and choriocarcinoma (2%). Conclusion: In our study most common primary site of metastases was from lung (60%), site of origin of primary was not identified in the 10% cases, third common primary was from breast (6%), kidney (6%), Melanoma(6%) followed by brain (2%), thyroid(2%), Cervix (1%) and uterus(1%).

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Advanced magnetic resonance imaging biomarkers of cerebral metastases

Cited by 14 publications

References 59 publications

Diffusion-weighted MRI characteristics of the cerebral metastasis to brain boundary predicts patient outcomes

Diffusion-weighted MRI characteristics of the cerebral metastasis to brain boundary predicts patient outcomes

A differentially expressed set of microRNAs in cerebro-spinal fluid (CSF) can diagnose CNS malignancies

Radiologic clues to differentiate metastases from other brain pathologies with histopathological correlation

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