Brain Tumors

Chintagumpala, Murali; Gajjar, Amar

doi:10.1016/j.pcl.2014.09.011

Cited by 43 publications

(25 citation statements)

References 51 publications

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“…Although brain regions are generally normoxic, cerebellum was selected because brain tumors in adults are typically supratentorial, and may undergo severe morphologic deformation during disease progression (27) preventing the selection of consistent areas of normoxic brain without infiltrative glioma cells. Additionally, H&N cancer patients often have cerebellum in the FOV, so this region is adequate for both cancers.…”

Section: Methodsmentioning

confidence: 99%

¹⁸F-Fluoromisonidazole Quantification of Hypoxia in Human Cancer Patients Using Image-Derived Blood Surrogate Tissue Reference Regions

et al. 2015

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18F-FMISO is the most widely used PET agent for imaging hypoxia, a condition associated with resistance to tumor therapy. 18F-FMISO equilibrates in normoxic tissues, but is retained under hypoxic conditions because of reduction and binding to macromolecules. A simple tissue-to-blood ratio (TB) is suitable for quantifying hypoxia. A threshold of TB ≥ 1.2 is useful in discriminating the hypoxic volume (HV) of tissue; TBmax is the maximum intensity of the hypoxic region and does not invoke a threshold. Because elimination of blood sampling would simplify clinical use, we tested the validity of using imaging regions as a surrogate for blood sampling. Methods Patients underwent 20 min 18F-FMISO scans during the 90–140 min interval post-injection with venous blood sampling. 223 18F-FMISO patient studies had detectable surrogate blood regions in the field-of-view. Quantitative parameters of hypoxia (TBmax, HV) derived from blood samples were compared to values using surrogate blood regions derived from heart, aorta and/or cerebellum. In a subset of brain cancer patients, parameters from blood samples and from cerebellum were compared for their ability to independently predict outcome. Results Vascular regions of heart showed the highest correlation to measured blood activity (R2 = 0.84). For brain studies, cerebellar activity was similarly correlated to blood samples. In brain cancer patients, Kaplan-Meier analysis showed that image-derived reference regions had nearly identical predictive power as parameters derived from blood, thus obviating the need for venous sampling in these patients. Conclusions Simple static analysis of 18F-FMISO PET captures both the intensity (TBmax) and spatial extent (HV) of tumor hypoxia. An image-derived region to assess blood activity can be used as a surrogate for blood sampling in quantification of hypoxia.

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Section: Methodsmentioning

confidence: 99%

¹⁸F-Fluoromisonidazole Quantification of Hypoxia in Human Cancer Patients Using Image-Derived Blood Surrogate Tissue Reference Regions

et al. 2015

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“…The risk factors influencing the genesis of glioma include exposure to toxins such as vinyl chloride, ionizing radiation, electromagnetic radiation, infection with simian virus 40, gene [3] Ependymoma (2%-6% of glioma) [4,5] Astrocytoma (7% of primary brain tumors and 80%-85% of all gliomas) Juvenile pilocytic, pleo morphic and subependymal giant cell astrocytoma (SEGA) [4,[6][7][8][9] Cerebrum (oligodendrocytes) Monomorphous cells with round, regular nuclei with perinuclear halos. Focal calcifications, interspersed delicate capillaries, nuclear labelling for S100 and diffuse background staining for S100 and GFAP are present.…”

Section: Molecular Transformations As Driving Forces In Glial Tumorigmentioning

confidence: 99%

“…The existence of alternative lengthening of telomeres and explicit gene expression profiles associated with H3F3A/ATRX-DAXX (α-thalassemia/mental retardation syndrome X-linked-deathdomain associated protein)/TP53 mutations have also been reported. The literature reports somatic mutations in 44% of tumor cases (site of mutation ~H3.3-ATRX-DAXX chromatin remodeling pathway) and recurrent mutations in 31% of tumors (site of mutation ~H3F3A) with amino acid substitutions at K27 or G34 and in H3.1 histone genes HIST1H3B and HIST1H3C [4] . A sequencing study revealed that this mutation targets key sites on the histone tail for post-translational modifications.…”

Section: Aspect Of Histone Mutation In Gliomamentioning

confidence: 99%

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Insights into molecular therapy of glioma: current challenges and next generation blueprint

et al. 2017

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Glioma accounts for the majority of human brain tumors. With prevailing treatment regimens, the patients have poor survival rates. In spite of current development in mainstream glioma therapy, a cure for glioma appears to be out of reach. The infiltrative nature of glioma and acquired resistance substancially restrict the therapeutic options. Better elucidation of the complicated pathobiology of glioma and proteogenomic characterization might eventually open novel avenues for the design of more sophisticated and effective combination regimens. This could be accomplished by individually tailoring progressive neuroimaging techniques, terminating DNA synthesis with prodrug-activating genes, silencing gliomagenesis genes (gene therapy), targeting miRNA oncogenic activity (miRNAmRNA interaction), combining Hedgehog-Gli/Akt inhibitors with stem cell therapy, employing tumor lysates as antigen sources for efficient depletion of tumor-specific cancer stem cells by cytotoxic T lymphocytes (dendritic cell vaccination), adoptive transfer of chimeric antigen receptor-modified T cells, and combining immune checkpoint inhibitors with conventional therapeutic modalities. Thus, the present review captures the latest trends associated with the molecular mechanisms involved in glial tumorigenesis as well as the limitations of surgery, radiation and chemotherapy. In this article we also critically discuss the next generation molecular therapeutic strategies and their mechanisms for the successful treatment of glioma.

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“…For WHO grade II and WHO grade III ependymoma an initial attempt at maximal safe surgical resection should be made. The extent of resection is correlated with survival in these patients 89,90 and survival rates are improved in cases where a gross total resection can be achieved 91 . Local post-operative radiation therapy is also employed in these cases.…”

Section: Ependymomamentioning

confidence: 99%

Pediatric Brain Tumors: Current Knowledge and Therapeutic Opportunities

Glod

Rahme

Kaur

et al. 2016

Journal of Pediatric Hematology/Oncology

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Great progress has been made in many areas of pediatric oncology. However, tumors of the central nervous system (CNS) remain a significant challenge. A recent explosion of data has led to an opportunity to understand better the molecular basis of these diseases and is already providing a foundation for the pursuit of rationally chosen therapeutics targeting relevant molecular pathways. The molecular biology of pediatric brain tumors is shifting from a singular focus on basic scientific discovery to a platform upon which insights are being translated into therapies.

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Brain Tumors

Cited by 43 publications

References 51 publications

¹⁸F-Fluoromisonidazole Quantification of Hypoxia in Human Cancer Patients Using Image-Derived Blood Surrogate Tissue Reference Regions

¹⁸F-Fluoromisonidazole Quantification of Hypoxia in Human Cancer Patients Using Image-Derived Blood Surrogate Tissue Reference Regions

Insights into molecular therapy of glioma: current challenges and next generation blueprint

Pediatric Brain Tumors: Current Knowledge and Therapeutic Opportunities

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Brain Tumors

Cited by 43 publications

References 51 publications

18F-Fluoromisonidazole Quantification of Hypoxia in Human Cancer Patients Using Image-Derived Blood Surrogate Tissue Reference Regions

18F-Fluoromisonidazole Quantification of Hypoxia in Human Cancer Patients Using Image-Derived Blood Surrogate Tissue Reference Regions

Insights into molecular therapy of glioma: current challenges and next generation blueprint

Pediatric Brain Tumors: Current Knowledge and Therapeutic Opportunities

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Product

Resources

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¹⁸F-Fluoromisonidazole Quantification of Hypoxia in Human Cancer Patients Using Image-Derived Blood Surrogate Tissue Reference Regions

¹⁸F-Fluoromisonidazole Quantification of Hypoxia in Human Cancer Patients Using Image-Derived Blood Surrogate Tissue Reference Regions