Clinical Characteristics and Neuroimaging Findings in 12 Cases of Recurrent Glioblastoma With Communicating Hydrocephalus

Onuma, Kuniyuki; Ishikawa, Eiichi; Matsuda, Masahide; Hirata, Koji; Osuka, Satoru; Yamamoto, Tetsuya; Masumoto, T.; Zaboronok, Alexander; Matsumura, Akira

doi:10.2176/nmc.53.474

Cited by 11 publications

(10 citation statements)

References 15 publications

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“…RPA is considered to be a machine learning method and usually requires a large sample to establish a classification model from a training data and verify this model by another test sample. RPA can be realized through computer and many medical care studies have used RPA to detect prognostic and risk factors ( 19 , 20 ), as well as diagnosis in imaging study ( 21 ). Classification and regression tree (CRT) analysis is a kind of tree-building technique from RPA to the generation of clinical decision rules ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

Recursive Partitioning Analysis of Fractional Low-Frequency Fluctuations in Narcolepsy With Cataplexy

Xiao

Zhao

et al. 2018

Front. Neurol.

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Objective: To identify narcolepsy related regional brain activity alterations compared with matched healthy controls. To determine whether these changes can be used to distinguish narcolepsy from healthy controls by recursive partitioning analysis (RPA) and receiver operating characteristic (ROC) curve analysis.Method: Fifty-one narcolepsy with cataplexy patients (26 adults and 25 juveniles) and sixty matched heathy controls (30 adults and 30 juveniles) were recruited. All subjects underwent a resting-state functional magnetic resonance imaging scan. Fractional low-frequency fluctuations (fALFF) was used to investigate narcolepsy induced regional brain activity alterations among adult and juveniles, respectively. Recursive partitioning analysis and Receiver operating curve analysis was used to seek the ability of fALFF values within brain regions in distinguishing narcolepsy from healthy controls.Results: Compared with healthy controls, both adult and juvenile narcolepsy had lower fALFF values in bilateral medial superior frontal gyrus, bilateral inferior parietal lobule and supra-marginal gyrus. Compared with healthy controls, both adult and juvenile narcolepsy had higher fALFF values in bilateral sensorimotor cortex and middle temporal gyrus. Also juvenile narcolepsy had higher fALFF in right putamen and right thalamus compared with healthy controls. Based on RPA and ROC curve analysis, in adult participants, fALFF differences in right medial superior frontal gyrus can discriminate narcolepsy from healthy controls with high degree of sensitivity (100%) and specificity (88.9%). In juvenile participants, fALFF differences in left superior frontal gyrus can discriminate narcolepsy from healthy controls with moderate degree of sensitivity (57.1%) and specificity (88.9%).Conclusion: Compared with healthy controls, both the adult and juvenile narcolepsy showed overlap brain regions in fALFF differences after case-control comparison. Furthermore, we propose that fALFF value can be a helpful imaging biomarker in distinguishing narcolepsy from healthy controls among both adults and juveniles.

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Section: Introductionmentioning

confidence: 99%

Recursive Partitioning Analysis of Fractional Low-Frequency Fluctuations in Narcolepsy With Cataplexy

Xiao

Zhao

et al. 2018

Front. Neurol.

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“…Notably, Onuma et al reported that median survival in GBM patients with LMD is longer in patients without communicating hydrocephalus [38]. Treatment of hydrocephalus with VP or lumboperitoneal shunt in patients with LMD has been shown to improve survival [39].…”

Section: Surgical Treatment Of Lmd In Gbm Hydrocephalus Vp Shuntmentioning

confidence: 99%

Leptomeningeal disease in glioblastoma: endgame or opportunity?

et al. 2021

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Introduction: Glioblastoma is an aggressive cancer with a notoriously poor prognosis. Recent advances in treatment have increased overall survival, though this may be accompanied by an increased incidence of leptomeningeal disease (LMD). LMD carries a particularly severe prognosis and remains a late stage manifestation of glioblastoma without satisfactory treatment. The objective of this review is to survey the literature on treatment of LMD in glioblastoma and to more fully characterize the current therapeutic strategies.Methods: The authors performed a systematic review following PRISMA criteria on PubMed. Articles that included adult patients with LMD from glioblastoma multiforme were retrieved and reviewed.Results: LMD in glioblastoma patients is increasing in incidence, with reports of up to 21%. The overall survival without treatment is alarmingly brief, with patients surviving between 1.6-3.8 months. All studies showed that treatment does improve overall survival signi cantly, increasing to 11.7 months in one study. However, no one adjuvant or surgical therapy has been shown to improve survival in LMD signi cantly over another. Direct treatment methods include chemotherapy (standard, anti-angiogenic, intrathecal, immunotherapy), and radiation. Hydrocephalus is a complication in LMD that can be treated with ventriculoperitoneal shunt placement, however treating hydrocephalus and delivering intrathecal chemotherapy is a challenge. Conclusion: Though evidence remains lacking and there is no consensus, treatments show a trend towards improving survival and should be considered on a case-by-case basis. Further studies are necessary in the pursuit of a standard of care.

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“…Patients with LMS can suffer from cranial nerve palsies, increased intracranial pressure syndrome, hydrocephalus, meningism, and/or focal neurological deficits [1, 7, 15, 20, 33, 71–76]. Seizure frequency does not seem to increase during LMS development [77].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Of note, although LMS may manifest as communicating hydrocephalus [33], only 25%–40% of patients with LMS present this complication [75, 91].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Ventricular opening during surgery and repeated surgeries, even more in patients treated with radiotherapy or chemotherapy [5, 89], have been proposed as risk factors of LMS [15, 65, 94, 95]. However, none has been clearly validated [1, 14, 29, 75, 92–97], and prophylactic radiotherapy in these cases does not bring supplementary benefit [98]. Persistence of preoperative leptomeningeal enhancement after initial surgical resection was also correlated with a higher LMS incidence in recurrence [99].…”

Section: Risk Factorsmentioning

confidence: 99%

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Leptomeningeal Spread in Glioblastoma: Diagnostic and Therapeutic Challenges

et al. 2020

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Background Glioblastoma (GBM) is the most common and aggressive primary malignant brain tumor. Leptomeningeal spread (LMS) is a severe complication of GBM, raising diagnostic and therapeutic challenges in clinical routine. Methods We performed a review of the literature focused on LMS in GBM. MEDLINE and EMBASE databases were queried from 1989 to 2019 for articles describing diagnosis and therapeutic options in GBM LMS, as well as risk factors and pathogenic mechanisms. Results We retrieved 155 articles, including retrospective series, case reports, and early phase clinical trials, as well as preclinical studies. These articles confirmed that LMS in GBM remains (a) a diagnostic challenge with cytological proof of LMS obtained in only 35% of cases and (b) a therapeutic challenge with a median overall survival below 2 months with best supportive care alone. For patients faced with suggestive clinical symptoms, whole neuroaxis magnetic resonance imaging and cerebrospinal fluid analysis are both recommended. Liquid biopsies are under investigation and may help prompt a reliable diagnosis. Based on the literature, a multimodal and personalized therapeutic approach of LMS, including surgery, radiotherapy, systemic cytotoxic chemotherapy, and intrathecal chemotherapies, may provide benefits to selected patients. Interestingly, molecular targeted therapies appear promising in case of actionable molecular target and should be considered. Conclusion As the prognosis of glioblastoma is improving over time, LMS becomes a more common complication. Our review highlights the need for translational studies and clinical trials dedicated to this challenging condition in order to improve diagnostic and therapeutic strategies. Implications for Practice This review summarizes the diagnostic tools and applied treatments for leptomeningeal spread, a complication of glioblastoma, as well as their outcomes. The importance of exhaustive molecular testing for molecular targeted therapies is discussed. New diagnostic and therapeutic strategies are outlined, and the need for translational studies and clinical trials dedicated to this challenging condition is highlighted.

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Clinical Characteristics and Neuroimaging Findings in 12 Cases of Recurrent Glioblastoma With Communicating Hydrocephalus

Cited by 11 publications

References 15 publications

Recursive Partitioning Analysis of Fractional Low-Frequency Fluctuations in Narcolepsy With Cataplexy

Recursive Partitioning Analysis of Fractional Low-Frequency Fluctuations in Narcolepsy With Cataplexy

Leptomeningeal disease in glioblastoma: endgame or opportunity?

Leptomeningeal Spread in Glioblastoma: Diagnostic and Therapeutic Challenges

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