The Role of Blood-Brain Barrier Permeability in Brain Tumor Imaging and Therapeutics

Provenzale, James M.; Mukundan, Srinivasan; Dewhirst, Mark W.

doi:10.2214/ajr.185.3.01850763

Cited by 83 publications

(67 citation statements)

References 19 publications

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“…The selective accumulation of these particles in the neovasculature of the growing cTVT had the effect of increasing the local optical extinction leading to increased deposition of photon energy in neovascularized tissue leading to tissue-specific ablation. The high gold concentration in viable cTVT additionally shows that cTVT microvasculature possesses pores or fenestrations into which the 150-nm nanoshells may be inserted (25). Primary glioblastomas also possess microvasculature pores, which may, depending on their size and the specific tumor type, be exploited by PEGylated nanoparticles (26).…”

Section: Discussionmentioning

confidence: 99%

Feasibility Study of Particle-Assisted Laser Ablation of Brain Tumors in Orthotopic Canine Model

et al. 2009

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We report on a pilot study showing a proof of concept for the passive delivery of nanoshells to an orthotopic tumor where they induce a local, confined therapeutic response distinct from that of normal brain resulting in the photothermal ablation of canine transmissible venereal tumor (cTVT) in a canine brain model. cTVT fragments grown in severe combined immunodeficient mice were successfully inoculated in the parietal lobe of immunosuppressed, mixed-breed hound dogs. A single dose of near-IR (NIR)-absorbing, 150-nm nanoshells was infused i.v. and allowed time to passively accumulate in the intracranial tumors, which served as a proxy for an orthotopic brain metastasis. The nanoshells accumulated within the intracranial cTVT, suggesting that its neovasculature represented an interruption of the normal blood-brain barrier.

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Section: Discussionmentioning

confidence: 99%

Feasibility Study of Particle-Assisted Laser Ablation of Brain Tumors in Orthotopic Canine Model

et al. 2009

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“…Эти опухоли могут поражать не-сколько долей мозга одновременно, что обусловлено их медленным и зачастую бессимптомным ростом до позд-них стадий развития процесса [1,[5][6][7]. Как правило, ДА контраст-негативны, но при долгом наблюдении и бы-стром прогредиентном росте отмечено присоединение контрастного усиления разных типов -от диффузного мелкоочагового до кистозно-солидного [3,5,6,14]. Воз-можно развитие масс-эффекта в виде смещения окружаю-щих структур и сужения близлежащих субарахноидаль-ных пространств.…”

Section: Discussionunclassified

MRI-characteristics of epileptogenic supratentorial brain tumors in children

Khalilov¹,

Холин²,

Medvedeva³

et al. 2016

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Цель исследования -анализ результатов магнитно-резонансной томографии (МРТ) у пациентов с симптоматической эпилепсией, ассоциированной с опухолью. Материал и методы. Были проанализированы данные МРТ 52 пациентов с симптоматической эпилепсией, проходивших лечение по поводу опухолей супратенториальной локализации. Были выявлены наиболее эпилептогенные опухоли. Особое внимание было уделено опухолям со стертой клинической картиной и не имевшим типичных МРТ-признаков. Все пациенты с опухолями были прооперированы с применением различных методик хирургического вмешательства. Результаты. Наиболее эпилептогенными опухолями оказались дизэмбриопластические нейроэпителиальные опухоли (ДНЭО), диффузные астроцитомы (ДА) и ганглиоглиомы (ГГ). Во всех случаях ДНЭО и у 4 пациентов с ГГ эпилептические приступы являлись дебютным, а в 4 из 5 случаев ДНЭО -единственным клиническим признаком наличия опухоли. При МРТ в случаях ДНЭО, ДА и ГГ выявлялись изо/ гипоинтенсивный сигнал на Т1-ВИ и варьирующий по интенсивности от умеренного до гиперинтенсивного сигнала на Т2-и FLAIR-ВИ, при этом в случаях с ДНЭО и ГГ практически отсутствовали масс-эффект и перифокальный отек, а на FLAIR-ВИ наиболее четко прослеживалась так называемая пеноподобная (мультикистозная) структура. Не отмечено существенного изменения размеров ДНЭО и ГГ. В 1 случае отмечено сочетание ДНЭО с корковой дисплазией. При ДА трудно отличить перифокальный отек от туморозной ткани и неизмененных тканей головного мозга, и, как правило, рост опухоли замедлен. Заключение. Эпилептогенные опухоли могут копировать рентгенологические характеристики друг друга, а также мимикрировать ганглиоглиомы, олигодендроглиомы и астроцитомы Gr I, II и др. Они являются наиболее частыми причинами возникновения симптоматической фокальной эпилепсии. Эти образования необходимо в первую очередь исключать в случаях фармакорезистентной эпилепсии. Ключевые слова: опухоли головного мозга у детей, симптоматическая фокальная эпилепсия, эпилептическая хирургия, нейровизуализация.Objective -to analyze MR-images in patients with symptomatic epilepsy associated with the brain tumor. Material and methods. MRI results of 52 patients with symptomatic epilepsy operated for tumors of supratentorial localization were analyzed. The most epileptogenic tumors with atypical MRI signs and subtle clinical presentation were identified. All patients with tumors were operated using different methods of surgical intervention. Results. Dysembryoplastic neuroepithelial tumors (DNET), diffuse astrocytomas (DA) and gangliogliomas (GG) were the most frequent epileptogenic tumors. In all the cases of DNET and in 4 patients with GG, epileptic seizures were the first, and in 4 of 5 cases of DIO were the only clinical sign of tumor presence. In DNET, DA and GG, there was an iso-or hypointensive signal on T1 WI and a signal varying in intensity from moderate to hyperintense in T2 and FLAIR WI, while in cases with DNET and GG, no mass effect and perifocal edema was practically seen. The so-called «spume-like» (multicystic) structure was m...

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“…6 Assessment of the tumor vascular permeability can help in understanding the mechanism of the entry of therapeutic agents into the CNS and in developing methods to selectively alter the BBB to enhance drug delivery. 62 Studies have shown that microvascular density could indicate total tumor vasculature, including both mature and immature vessels within the tumor. On the other hand, microvascular cellular proliferation could be an imaging biomarker of active angiogenesis and more immature and leaky blood vessels.…”

Section: Tumor Vascular Permeabilitymentioning

confidence: 99%

Clinical application of perfusion computed tomography in neurosurgery

Huang

Tsai

Kuo

et al. 2014

JNS

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Object Currently, perfusion CT (PCT) is a valuable imaging technique that has been successfully applied to the clinical management of patients with ischemic stroke and aneurysmal subarachnoid hemorrhage (SAH). However, recent literature and the authors' experience have shown that PCT has many more important clinical applications in a variety of neurosurgical conditions. Therefore, the authors share their experiences of its application in various diseases of the cerebrovascular, neurotraumatology, and neurooncology fields and review the pertinent literature regarding expanding PCT applications for neurosurgical conditions, including pitfalls and future developments. Methods A pertinent literature search was conducted of English-language articles describing original research, case series, and case reports from 1990 to 2011 involving PCT and with relevance and applicability to neurosurgical disorders. Results In the cerebrovascular field, PCT is already in use as a diagnostic tool for patients suspected of having an ischemic stroke. Perfusion CT can be used to identify and define the extent of the infarct core and ischemic penumbra core, and thus aid patient selection for acute reperfusion therapy. For patients with aneurysmal SAH, PCT provides assessment of early brain injury, cerebral ischemia, and infarction, in addition to vasospasm. It may also be used to aid case selection for aggressive treatment of patients with poor SAH grade. In terms of oncological applications, PCT can be used as an imaging biomarker to assess angiogenesis and response to antiangiogenetic treatments, differentiate between glioma grades, and distinguish recurrent tumor from radiation necrosis. In the setting of traumatic brain injury, PCT can detect and delineate contusions at an early stage. In patients with mild head injury, PCT results have been shown to correlate with the severity and duration of postconcussion syndrome. In patients with moderate or severe head injury, PCT results have been shown to correlate with patients' functional outcome. Conclusions Perfusion CT provides quantitative and qualitative data that can add diagnostic and prognostic value in a number of neurosurgical disorders, and also help with clinical decision making. With emerging new technical developments in PCT, such as characterization of blood-brain barrier permeability and whole-brain PCT, this technique is expected to provide more and more insight into the pathophysiology of many neurosurgical conditions.

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The Role of Blood-Brain Barrier Permeability in Brain Tumor Imaging and Therapeutics

Cited by 83 publications

References 19 publications

Feasibility Study of Particle-Assisted Laser Ablation of Brain Tumors in Orthotopic Canine Model

Feasibility Study of Particle-Assisted Laser Ablation of Brain Tumors in Orthotopic Canine Model

MRI-characteristics of epileptogenic supratentorial brain tumors in children

Clinical application of perfusion computed tomography in neurosurgery

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