Estimation of proliferative potentiality of central neurocytoma: correlational analysis of minimum ADC and maximum SUV with MIB-1 labeling index

Sakamoto, Ryo; Okada, Tomohisa; Kanagaki, Mitsunori; Yamamoto, Akira; Fushimi, Yasutaka; Kakigi, Takahide; Arakawa, Yoshiki; Takahashi, Jun; Mikami, Yoshiki; Togashi, Kaori

doi:10.1177/0284185114521187

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…attempted to estimate the proliferative potentiality of CNs by using preoperative CT scan, DWI, and fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET). [ 16 ] The study results did not show significant correlation of morphological appearance of CNs with MIB-1 LI, except strong enhancement of the tumors with high MIB-1 LI. Another important observation was that MIB-1 LI showed linear correlation with both minimum apparent diffusion coefficien (ADCmin) and the maximum standardized uptake value (SUVmax), although only the ADCmin was statistically significant.…”

Section: Discussionmentioning

confidence: 59%

Atypical Neurocytoma: Dilemma in diagnosis and management

Vajrala

Surana

et al. 2014

Surg Neurol Int

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Background:Central neurocytoma is an uncommon benign tumor of the central nervous system. A section of these tumors have unusual aggressiveness and are termed as “atypical central neurocytomas,” the definition of which is debated. Many studies in the available literature define them as tumors with elevated MIB-1 labeling index (MIB-1 LI) >2%, while some associate them with higher values of MIB-1 LI or those with histological atypical features. Newer parameters also have been identified and correlated with MIB-1 LI to differentiate atypical from benign neurocytoma cases. A recent analysis of the atypical neurocytoma cases with malignant behavior revealed their increased tendency of spread through the cerebrospinal fluid causing craniospinal axis dissemination. However, limited studies document the appropriate indications and usefulness of additional therapeutic modalities, such as upfront craniospinal irradiation (CSI) or adjuvant chemotherapy, in countering the aggressive behavior of such tumors.Case Description:We present two such rare cases of atypical neurocytoma with elevated MIB-1 LI, of 3% and 4%, respectively, without histological atypia. Since there is insufficient evidence documenting advantages of any additional measures in the adjuvant management of atypical cases, both patients were treated with localized cranial radiotherapy alone, as per the evidence available in the literature currently.Conclusion:We propose that future studies must aptly redefine these atypical neurocytomas with malignant potential and provide guidance to identify aggressiveness of these tumors early in the course of management. Lastly, strong evidence to provide specific adjuvant therapy is also warranted.

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Section: Discussionmentioning

confidence: 59%

Atypical Neurocytoma: Dilemma in diagnosis and management

Vajrala

Surana

et al. 2014

Surg Neurol Int

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“…Sakamoto et al . estimated that the aCNs (MIB-1 LI > 2%) could be differentiated with 100% sensitivity (95% CI 47.8–100%) and 100% specificity (39–100%) if the threshold value of ADCmin is set at 0.55 × 10 –3 mm 2 per second ( P < 0.0001) [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to benign course of CNs exhibiting the cold foci, the only one with rCM-RGI equivalent to the gray matter presented regrowth 4 months after the STR [21]. Sakamoto et al estimated that the aCNs (MIB-1 LI > 2%) could be differentiated with 100% sensitivity (95% CI 47.8-100%) and 100% specificity (39-100%) if the threshold value of ADCmin is set at 0.55 × 10 -3 mm 2 per second (P < 0.0001) [23].…”

Section: Other Imaging Methods Showing the High Tumor Proliferative A...mentioning

confidence: 99%

The role of single fraction Gamma Knife radiosurgery for intraventricular central neurocytomas and the utility of F-18 fluroethyltyrosine: two case reports

et al. 2022

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Background Primary treatment of central neurocytomas is surgical resection. Gamma Knife surgery is considered a valuable therapeutic option in case of residual (after subtotal resection) or recurrent central neurocytomas. Here, we focused on the role of F-18 fluroethyltyrosine as a marker to document tumor progression after initial resection, in the context of an atypical central neurocytoma. We also describe MIB-1’s role in evaluating therapeutic decision-making. Case presentation Two patients with central neurocytomas were treated by Gamma Knife surgery in our center. The first case (31-year-old Caucasian male) had atypical central neurocytoma. Four and a half years after surgical resection, magnetic resonance imaging and F-18 fluroethyltyrosine documented clear progression of residual central neurocytoma, further treated by Gamma Knife surgery (18 Gy at 50%, target volume 1.4 cc, and prescription isodose volume 1.8 cc). The initial post-Gamma Knife surgery clinical course was uneventful, with progressive volumetric reduction of residual tumor up to 4.5 years, when out-of-field recurrence was suspected and confirmed by local F-18 fluroethyltyrosine hyperactivity. Second single-fraction Gamma Knife surgery was performed (18 Gy at 50%, target volume 0.49 cc, prescription isodose volume 0.72 cc). The second (32-year-old Caucasian female) had previous subtotal resection and typical central neurocytoma. Seven years later, she had residual tumor progression. Single-fraction Gamma Knife surgery was performed (16 Gy at 50% isodose line, target volume 1.7 cc, and prescription isodose volume 2.5 cc). Last follow-up showed tumor volume reduction. Follow-up magnetic resonance imaging showed important volumetric reduction of both treated lesions. Conclusions In atypical central neurocytomas, F-18 fluroethyltyrosine could be used as postoperative examination to detect small tumor remnants, follow-up evaluation following the Gamma Knife surgery or, in select cases, following surgical resection. The role of MIB-1 is important in therapeutic decision-making, as tumors with MIB-1 exceeding 2% are characterized by more aggressive clinical course. Single-fraction Gamma Knife surgery remains a valuable therapeutic option for postoperative residual atypical central neurocytomas and central neurocytoma recurrences.

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