Magnetic resonance elastography of brain tumors: preliminary results

Xu, Lei; Yang, Lin; Han, Junhee; Xi, Z. N.; Shen, Hao; Gao, Peiyi

doi:10.1080/02841850701199967

Cited by 108 publications

(94 citation statements)

References 9 publications

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“…Although many of these studies have shown that tumors are stiffer than normal brain (Xu et al, 2007;Scholz et al, 2007Scholz et al, , 2005Chauvet et al, 2015), some have shown the opposite (Reiss- Zimmermann et al, 2015;Streitberger et al, 2014), and determination of stiffness differences between tumor grades has been inconclusive using this technique. Consistent with observations of stiffening of brain tumors, increased diffusion of water within a tumor, as measured by magnetic resonance imaging (MRI), is prognostic of poor outcome and is correlated with increased expression of ECM genes whose products are expected to stiffen a tissue (Pope et al, 2012(Pope et al, , 2009.…”

Section: Mechanical Properties Of Brain Tumor Subtypesmentioning

confidence: 99%

Tissue mechanics regulate brain development, homeostasis and disease

Barnes

Przybyla

Weaver

2017

Journal of Cell Science

270

245

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All cells sense and integrate mechanical and biochemical cues from their environment to orchestrate organismal development and maintain tissue homeostasis. Mechanotransduction is the evolutionarily conserved process whereby mechanical force is translated into biochemical signals that can influence cell differentiation, survival, proliferation and migration to change tissue behavior. Not surprisingly, disease develops if these mechanical cues are abnormal or are misinterpreted by the cells – for example, when interstitial pressure or compression force aberrantly increases, or the extracellular matrix (ECM) abnormally stiffens. Disease might also develop if the ability of cells to regulate their contractility becomes corrupted. Consistently, disease states, such as cardiovascular disease, fibrosis and cancer, are characterized by dramatic changes in cell and tissue mechanics, and dysregulation of forces at the cell and tissue level can activate mechanosignaling to compromise tissue integrity and function, and promote disease progression. In this Commentary, we discuss the impact of cell and tissue mechanics on tissue homeostasis and disease, focusing on their role in brain development, homeostasis and neural degeneration, as well as in brain cancer.

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Section: Mechanical Properties Of Brain Tumor Subtypesmentioning

confidence: 99%

Tissue mechanics regulate brain development, homeostasis and disease

Barnes

Przybyla

Weaver

2017

Journal of Cell Science

270

245

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“…In other applications, MRE has been found to have promise for differentiating benign breast lesions from malignant tumors [16,17]. Aside from one publication describing MRE of the brain tumors [18], there have been few reports of the use of MRE to evaluate masses in other parts of the body.…”

Section: Introductionmentioning

confidence: 99%

MR Elastography of Liver Tumors: Preliminary Results

Venkatesh

Yin

Glockner

et al. 2008

American Journal of Roentgenology

285

189

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Aim-To evaluate the potential value of magnetic resonance elastography (MRE) for characterizing solid liver tumors.Materials and Methods-Forty-four liver tumors (metastases-14, hepatocellular carcinoma-12, hemangioma-9, cholangiocarcinoma-5, focal nodular hyperplasia-3, and hepatic adenoma-1) were evaluated with MRE. MRE was performed on a 1.5 T scanner with a modified phase-contrast, gradient echo sequence to collect axial wave images sensitized along the through-plane motion direction. The tumors were identified in T2-, T1-weighted and gadolinium enhanced T1-weighted images and the MRE images were obtained through the tumor. A stiffness map (elastogram) was generated by an automated process using an inversion algorithm. The mean shear stiffness of the tumor was calculated using a manually specified region of interest placed over the tumor in the stiffness map. The stiffness value of non-tumor bearing hepatic parenchyma was also calculated. Statistical analysis was performed on the stiffness values for differentiation between normal liver, fibrotic liver, benign tumors and malignant tumors.Results-Malignant liver tumors had significantly higher mean shear stiffness than benign tumors, fibrotic liver and normal liver (10.1kPa vs. 2.7kpa (p<0.001), vs. 5.9kPa (p<0.001) and vs. 2.3kPa (p<0.001) respectively). Fibrotic livers had stiffness values overlapping both the benign and malignant tumors. Cut-off values of 5kPa accurately differentiate malignant tumors from benign tumors and normal liver parenchyma in this preliminary investigation.Conclusions-MR elastography is a promising, non-invasive technique for assessing solid liver tumors. MRE may provide new, quantitative tissue characterization parameters for differentiating benign and malignant liver tumors.

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“…4,11,14,30,32,59,62 Promising modalities for predicting tumor consistency include MR imaging or ultrasound elastography. 44,60,61 In the future, a priori knowledge of tumor consistency may lend major support to the selection of a skull base approach from above versus below and warrants further research.…”

Section: Lateral Extension Beyond the Cavernous Sinusmentioning

confidence: 99%

Defining the “edge of the envelope”: patient selection in treating complex sellar-based neoplasms via transsphenoidal versus open craniotomy

Zada¹,

Du²,

Laws³

2011

JNS

121

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Since the reemergence of the transsphenoidal approach as a primary means of accessing and resecting sellar region tumors in the 1960s by Hardy and Guiot, several key advances have improved the ability to safely treat patients with larger and increasingly complex tumors of the anterior and middle skull base. 28,43 In particular, the operating microscope, extended transsphenoidal approaches, advanced neuroimaging, intraoperative neuronavigation, and neuroendoscopy have collectively improved the ability to safely treat many of these lesions. The evolution of extended transsphenoidal approaches and endoscopic instrumentation has facilitated surgical access to lesions of the midline skull base via natural corridors, along a wide arc from the frontal sinus to the odontoid process. 9,31,34,53 Equally important are recent developments in effectively reconstructing the skull base after tumor resection, thereby reducing the incidence of CSF leakage and associated infection, which has traditionally been one of the major pitfalls associated with transsphenoidal and related skull base approaches.As the subspecialty of endoscopic skull base surgery continues to "push the edge of the envelope" in regard to the spectrum of lesions that can be effectively and safely treated, the key limitations to the types and extent of tumor pathology that can be optimally resected via these approaches must be continuously reassessed. In some instances, these limitations are inherent to an individual tumor's biology and pose a surgical challenge regardless of the operative approach that is undertaken. Nevertheless, patient selection remains of paramount importance Results. Thirteen cases exemplifying some of the existing limitations to achieving optimal surgical outcomes via transsphenoidal-based approaches are presented. The following 8 factors are separately discussed that repeatedly limited the extent of resection, increased the risk of the operation, and contributed to perioperative complications: significant suprasellar extension, lateral extension, retrosellar extension, brain invasion with edema, firm tumor consistency, involvement or vasospasm of the arteries of the circle of Willis, and encasement of the optic apparatus or invasion of the optic foramina.Conclusions. Although the ability to approach and resect complex tumors using endonasal skull base techniques has evolved dramatically in recent years, several inherent tumor characteristics mandate extensive preoperative consideration. In selected cases these characteristics may lend support to selecting an open craniotomy as the initial operation. (DOI: 10.3171/2010.8.JNS10520) Key words • transsphenoidal approach • endoscopic surgery • skull base surgery • pituitary adenoma • meningioma • craniopharyngioma • invasionAbbreviations used in this paper: ACA = anterior cerebral artery; DI = diabetes insipidus; EBRT = external-beam radiation therapy; FSH = follicle-stimulating hormone; GTR = gross-total resection; ICA = internal carotid artery; PBRT = proton-beam radiation therapy; P...

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Magnetic resonance elastography of brain tumors: preliminary results

Abstract: MRE could be used as an imaging technique for noninvasive assessment of the consistency of brain tumor in vivo.

Cited by 108 publications

References 9 publications

Tissue mechanics regulate brain development, homeostasis and disease

Tissue mechanics regulate brain development, homeostasis and disease

MR Elastography of Liver Tumors: Preliminary Results

Defining the “edge of the envelope”: patient selection in treating complex sellar-based neoplasms via transsphenoidal versus open craniotomy

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