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Cancers
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Neuroradiology in Cancer
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Neuroradiology in Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 18765

Special Issue Editor

Prof. Dr. Marc Brockmann

E-Mail Website
Guest Editor
University Medical Center Mainz, Department of Neuroradiology, Langenbeckstrasse 1 55131 Mainz, Germany
Interests: interventional neuroradiology; neurooncological imaging; radiomics; high resolution CT-imaging; micro-CT; tumor-platelet interaction

Special Issue Information

Dear colleagues,

Neuroradiology is a rapidly evolving, fast-growing field in modern neurosciences. Ongoing developments in imaging and interventional techniques are pacemakers for this development. Focusing on cancer, neuroradiological services provide relevant diagnostic information mainly on tumors of the head, neck, and spine. Apart from detection, classification, staging, and the distinction of malignancies from tumor-mimics, novel techniques provide further insights into tumor biology. Radiomics, for example, is an interesting approach in which a large number of features are extracted from radiographic medical images using data characterization algorithms. Artificial intelligence in neurooncological imaging (including machine-based and deep learning algorithms) may aid in tumor classification, reduction (or even elimination) of the need for contrast agents, or may be used to optimize image quality and/or to reduce scanning time. Furthermore, technological developments like ultra-high resolution CT, photon-counting CT, or ultra-high field MRI at 7.0 Tesla are strongly advancing into the field of neurooncological imaging. Besides these developments in clinical neurooncological imaging, pre-clinical experimental in vivo imaging has also become an integral component in neurooncological research.

Although less rapidly evolving, interventional techniques allow super-selective catheterization and embolization of tumor supplying vasculature in the pre-operative setting to reduce intraoperative blood loss. Furthermore, the super-selective infusion of chemotherapeutics into the ophthalmic artery has become a standard procedure in the treatment of retinoblastoma. Future directions of interventional therapy may aim at the super-selective infusion of, e.g., receptor-specific radionuclides or other drugs in tumor-supplying vessels or at increasing the permeability of the blood-brain barrier to assist tumor treatment with other drugs.

This Special Issue of Cancers focuses on recent advances and future perspectives in neurooncological imaging and interventional techniques for the treatment of patients with cancer of the head, neck, and spine. Both clinical trials and preclinical studies (in vitro and in vivo) are welcome.

Prof. Dr. Marc Brockmann
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neuroradiology
  • radiomics
  • neurooncological imaging
  • computed tomography
  • magnetic resonance imaging
  • deep learning
  • artificial intelligence
  • interventional neuroradiology

Published Papers (7 papers)

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Research

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14 pages, 4871 KiB  
Article
A Rapid Late Enhancement MRI Protocol Improves Differentiation between Brain Tumor Recurrence and Treatment-Related Contrast Enhancement of Brain Parenchyma
by Neda Satvat, Oliver Korczynski, Matthias Müller-Eschner, Ahmed E. Othman, Vanessa Schöffling, Naureen Keric, Florian Ringel, Clemens Sommer, Marc A. Brockmann and Sebastian Reder
Cancers 2022, 14(22), 5523; https://doi.org/10.3390/cancers14225523 - 10 Nov 2022
Cited by 2 | Viewed by 1637
Abstract
Purpose: Differentiation between tumor recurrence and treatment-related contrast enhancement in MRI can be difficult. Late enhancement MRI up to 75 min after contrast agent application has been shown to improve differentiation between tumor recurrence and treatment-related changes. We investigated the diagnostic performance of [...] Read more.
Purpose: Differentiation between tumor recurrence and treatment-related contrast enhancement in MRI can be difficult. Late enhancement MRI up to 75 min after contrast agent application has been shown to improve differentiation between tumor recurrence and treatment-related changes. We investigated the diagnostic performance of late enhancement using a rapid MRI protocol optimized for clinical workflow. Methods: Twenty-three patients with 28 lesions suspected for glioma recurrence underwent MRI including T1-MPRAGE-series acquired 2 and 20 min after contrast agent administration. Early contrast series were subtracted from late contrast series using motion correction. Contrast enhancing lesions were retrospectively and independently evaluated by two readers blinded to the patients’ later clinical course and histology with or without the use of late enhancement series. Sensitivity, specificity, NPV, and PPV were calculated for both readers by comparing results of MRI with histological samples. Results: Using standard MR sequences, sensitivity, specificity, PPV, and NPV were 0.84, 0, 0.875, and 0 (reader 1) and 0.92, 0, 0.885, and 0 (reader 2), respectively. Early late enhancement increased sensitivity, specificity, PPV, and NPV to 1 for each value and for both readers. Inter-reader reliability increased from 0.632 (standard MRI sequences) to 1.0 (with early late enhancement). Conclusion: The described rapid late enhancement MRI protocol improves MRI-based discrimination between tumor tissue and treatment-related changes of the brain parenchyma. Full article
(This article belongs to the Special Issue Neuroradiology in Cancer)
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14 pages, 2401 KiB  
Article
Differences in the MRI Signature and ADC Values of Diffuse Midline Gliomas with H3 K27M Mutation Compared to Midline Glioblastomas
by Peter Raab, Rouzbeh Banan, Arash Akbarian, Majid Esmaeilzadeh, Madjid Samii, Amir Samii, Helmut Bertalanffy, Ulrich Lehmann, Joachim K. Krauss, Heinrich Lanfermann, Christian Hartmann and Roland Brüning
Cancers 2022, 14(6), 1397; https://doi.org/10.3390/cancers14061397 - 9 Mar 2022
Cited by 6 | Viewed by 2082
Abstract
We conducted a two-center retrospective survey on standard MRI features including apparent diffusion coefficient mapping (ADC) of diffuse midline gliomas H3 K27M-mutant (DMG) compared to midline glioblastomas H3 K27M-wildtype (midGBM-H3wt). We identified 39 intracranial DMG and 18 midGBM-H3wt tumors. Samples were microscopically re-evaluated [...] Read more.
We conducted a two-center retrospective survey on standard MRI features including apparent diffusion coefficient mapping (ADC) of diffuse midline gliomas H3 K27M-mutant (DMG) compared to midline glioblastomas H3 K27M-wildtype (midGBM-H3wt). We identified 39 intracranial DMG and 18 midGBM-H3wt tumors. Samples were microscopically re-evaluated for microvascular proliferations and necrosis. Image analysis focused on location, peritumoral edema, degree of contrast enhancement and DWI features. Within DMG, MRI features between tumors with or without histomorphological GBM features were compared. DMG occurred in 15/39 samples from the thalamus (38%), in 23/39 samples from the brainstem (59%) and in 1/39 tumors involving primarily the cerebellum (2%). Edema was present in 3/39 DMG cases (8%) versus 78% in the control (midGBM-H3wt) group (p < 0.001). Contrast enhancement at the tumor rim was detected in 17/39 DMG (44%) versus 67% in control (p = 0.155), and necrosis in 24/39 (62%) versus 89% in control (p = 0.060). Strong contrast enhancement was observed in 15/39 DMG (38%) versus 56% in control (p = 0.262). Apparent diffusion coefficient (ADC) histogram analysis showed significantly higher skewness and kurtosis values in the DMG group compared to the controls (p = 0.0016/p = 0.002). Minimum relative ADC (rADC) values, as well as the 10th and 25th rADC-percentiles, were lower in DMGs with GBM features within the DMG group (p < 0.001/p = 0.012/p = 0.027). In conclusion, DMG cases exhibited markedly less edema than midGBM-H3wt, even if histomorphological malignancy was present. Histologically malignant DMGs and midGBM-H3wt more often displayed strong enhancement, as well as rim enhancement, than DMGs without histomorphological malignancy. DMGs showed higher skewness and kurtosis values on ADC-histogram analysis compared to midGBM-H3wt. Lower minimum rADC values in DMGs indicated malignant histomorphological features, likely representing a more complex tissue microstructure. Full article
(This article belongs to the Special Issue Neuroradiology in Cancer)
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12 pages, 2522 KiB  
Article
Diffusion Microstructure Imaging to Analyze Perilesional T2 Signal Changes in Brain Metastases and Glioblastomas
by Urs Würtemberger, Martin Diebold, Daniel Erny, Jonas A. Hosp, Oliver Schnell, Peter C. Reinacher, Alexander Rau, Elias Kellner, Marco Reisert, Horst Urbach and Theo Demerath
Cancers 2022, 14(5), 1155; https://doi.org/10.3390/cancers14051155 - 23 Feb 2022
Cited by 8 | Viewed by 2409
Abstract
Purpose: Glioblastomas (GBM) and brain metastases are often difficult to differentiate in conventional MRI. Diffusion microstructure imaging (DMI) is a novel MR technique that allows the approximation of the distribution of the intra-axonal compartment, the extra-axonal cellular, and the compartment of interstitial/free water [...] Read more.
Purpose: Glioblastomas (GBM) and brain metastases are often difficult to differentiate in conventional MRI. Diffusion microstructure imaging (DMI) is a novel MR technique that allows the approximation of the distribution of the intra-axonal compartment, the extra-axonal cellular, and the compartment of interstitial/free water within the white matter. We hypothesize that alterations in the T2 hyperintense areas surrounding contrast-enhancing tumor components may be used to differentiate GBM from metastases. Methods: DMI was performed in 19 patients with glioblastomas and 17 with metastatic lesions. DMI metrics were obtained from the T2 hyperintense areas surrounding contrast-enhancing tumor components. Resected brain tissue was assessed in six patients in each group for features of an edema pattern and tumor infiltration in the perilesional interstitium. Results: Within the perimetastatic T2 hyperintensities, we observed a significant increase in free water (p < 0.001) and a decrease in both the intra-axonal (p = 0.006) and extra-axonal compartments (p = 0.024) compared to GBM. Perilesional free water fraction was discriminative regarding the presence of GBM vs. metastasis with a ROC AUC of 0.824. Histologically, features of perilesional edema were present in all assessed metastases and absent or marginal in GBM. Conclusion: Perilesional T2 hyperintensities in brain metastases and GBM differ significantly in DMI-values. The increased free water fraction in brain metastases suits the histopathologically based hypothesis of perimetastatic vasogenic edema, whereas in glioblastomas there is additional tumor infiltration. Full article
(This article belongs to the Special Issue Neuroradiology in Cancer)
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9 pages, 2278 KiB  
Article
The Value of SSTR2 Receptor-Targeted PET/CT in Proton Irradiation of Grade I Meningioma
by Maciej J. Pelak, Birgit Flechl, Marta Mumot, Razvan Galalae, Slavisa Tubin, Eugen Hug and Carola Lütgendorf-Caucig
Cancers 2021, 13(18), 4707; https://doi.org/10.3390/cancers13184707 - 20 Sep 2021
Cited by 8 | Viewed by 1837
Abstract
Grade I meningioma is the most common intracranial tumor in adults. The standard imaging for its radiation treatment planning is MRI, and [68Ga]1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-conjugated PET/CT can further improve delineation. We investigated the impact of PET/CT on interobserver variability in identifying [...] Read more.
Grade I meningioma is the most common intracranial tumor in adults. The standard imaging for its radiation treatment planning is MRI, and [68Ga]1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-conjugated PET/CT can further improve delineation. We investigated the impact of PET/CT on interobserver variability in identifying the tumor in 30 anonymized patients. Four radiation oncologists independently contoured residual tumor volume, first using only MRI and subsequently with the addition of PET/CT. Conformity indices (CIs) were calculated between common volumes, observer pairs and compared to the volumes previously used. Overall, 29/30 tumors (96.6%) showed [68Ga]Ga-DOTA avidity. With help of PET/CT, the participants identified six cases with new lesions not recognized in MRI, including two where new findings would critically alter the target volume used for radiation. The PET/CT-aided series demonstrated superior conformity, as compared to MRI-only between observer pairs (median CI = 0.58 vs. 0.49; p = 0.002), common volumes (CI = 0.34; vs. 0.29; p = 0.002) and matched better the reference volumes actually used for patient treatment (CI = 0.55 vs. 0.39; p = 0.008). Cis in the PET/CT-aided series were lower for meningiomas outside of the skull base (0.2 vs. 0.44; p = 0.03). We conclude that SSTR2 receptor-targeted PET/CT is a valuable tool for planning particle therapy of incompletely resected meningioma. It serves both as a workup procedure and an aid for delineation process that reduces the likelihood of marginal misses. Full article
(This article belongs to the Special Issue Neuroradiology in Cancer)
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Review

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34 pages, 5275 KiB  
Review
Advanced Neuroimaging Approaches to Pediatric Brain Tumors
by Rahul M. Nikam, Xuyi Yue, Gurcharanjeet Kaur, Vinay Kandula, Abdulhafeez Khair, Heidi H. Kecskemethy, Lauren W. Averill and Sigrid A. Langhans
Cancers 2022, 14(14), 3401; https://doi.org/10.3390/cancers14143401 - 13 Jul 2022
Cited by 9 | Viewed by 3964
Abstract
Central nervous system tumors are the most common pediatric solid tumors; they are also the most lethal. Unlike adults, childhood brain tumors are mostly primary in origin and differ in type, location and molecular signature. Tumor characteristics (incidence, location, and type) vary with [...] Read more.
Central nervous system tumors are the most common pediatric solid tumors; they are also the most lethal. Unlike adults, childhood brain tumors are mostly primary in origin and differ in type, location and molecular signature. Tumor characteristics (incidence, location, and type) vary with age. Children present with a variety of symptoms, making early accurate diagnosis challenging. Neuroimaging is key in the initial diagnosis and monitoring of pediatric brain tumors. Conventional anatomic imaging approaches (computed tomography (CT) and magnetic resonance imaging (MRI)) are useful for tumor detection but have limited utility differentiating tumor types and grades. Advanced MRI techniques (diffusion-weighed imaging, diffusion tensor imaging, functional MRI, arterial spin labeling perfusion imaging, MR spectroscopy, and MR elastography) provide additional and improved structural and functional information. Combined with positron emission tomography (PET) and single-photon emission CT (SPECT), advanced techniques provide functional information on tumor metabolism and physiology through the use of radiotracer probes. Radiomics and radiogenomics offer promising insight into the prediction of tumor subtype, post-treatment response to treatment, and prognostication. In this paper, a brief review of pediatric brain cancers, by type, is provided with a comprehensive description of advanced imaging techniques including clinical applications that are currently utilized for the assessment and evaluation of pediatric brain tumors. Full article
(This article belongs to the Special Issue Neuroradiology in Cancer)
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17 pages, 2006 KiB  
Review
What Does PET Imaging Bring to Neuro-Oncology in 2022? A Review
by Jules Tianyu Zhang-Yin, Antoine Girard and Marc Bertaux
Cancers 2022, 14(4), 879; https://doi.org/10.3390/cancers14040879 - 10 Feb 2022
Cited by 21 | Viewed by 3253
Abstract
PET imaging is being increasingly used to supplement MRI in the clinical management of brain tumors. The main radiotracers implemented in clinical practice include [18F]FDG, radiolabeled amino acids ([11C]MET, [18F]FDOPA, [18F]FET) and [68Ga]Ga-DOTA-SSTR, [...] Read more.
PET imaging is being increasingly used to supplement MRI in the clinical management of brain tumors. The main radiotracers implemented in clinical practice include [18F]FDG, radiolabeled amino acids ([11C]MET, [18F]FDOPA, [18F]FET) and [68Ga]Ga-DOTA-SSTR, targeting glucose metabolism, L-amino-acid transport and somatostatin receptors expression, respectively. This review aims at addressing the current place and perspectives of brain PET imaging for patients who suffer from primary or secondary brain tumors, at diagnosis and during follow-up. A special focus is given to the following: radiolabeled amino acids PET imaging for tumor characterization and follow-up in gliomas; the role of amino acid PET and [18F]FDG PET for detecting brain metastases recurrence; [68Ga]Ga-DOTA-SSTR PET for guiding treatment in meningioma and particularly before targeted radiotherapy. Full article
(This article belongs to the Special Issue Neuroradiology in Cancer)
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16 pages, 1325 KiB  
Review
Beyond Glioma: The Utility of Radiomic Analysis for Non-Glial Intracranial Tumors
by Darius Kalasauskas, Michael Kosterhon, Naureen Keric, Oliver Korczynski, Andrea Kronfeld, Florian Ringel, Ahmed Othman and Marc A. Brockmann
Cancers 2022, 14(3), 836; https://doi.org/10.3390/cancers14030836 - 7 Feb 2022
Cited by 4 | Viewed by 2343
Abstract
The field of radiomics is rapidly expanding and gaining a valuable role in neuro-oncology. The possibilities related to the use of radiomic analysis, such as distinguishing types of malignancies, predicting tumor grade, determining the presence of particular molecular markers, consistency, therapy response, and [...] Read more.
The field of radiomics is rapidly expanding and gaining a valuable role in neuro-oncology. The possibilities related to the use of radiomic analysis, such as distinguishing types of malignancies, predicting tumor grade, determining the presence of particular molecular markers, consistency, therapy response, and prognosis, can considerably influence decision-making in medicine in the near future. Even though the main focus of radiomic analyses has been on glial CNS tumors, studies on other intracranial tumors have shown encouraging results. Therefore, as the main focus of this review, we performed an analysis of publications on PubMed and Web of Science databases, focusing on radiomics in CNS metastases, lymphoma, meningioma, medulloblastoma, and pituitary tumors. Full article
(This article belongs to the Special Issue Neuroradiology in Cancer)
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