The Treatment of Gliomas in Adulthood

Goldbrunner, Roland; Ruge, Maximilian I.; Köcher, Martin; Lucas, Carolin Weiß; Galldiks, Norbert; Grau, Stefan

doi:10.3238/arztebl.2018.0356

Cited by 18 publications

(19 citation statements)

References 43 publications

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“…[3] Ipsilesional Exclusive (IE), ROI—ipsilesional hemisphere WM bundle; ROA—contralesional hemisphere and tumor segmentation. [4] Ipsilesional Inclusive (II), ROI—ipsilesional hemisphere WM bundle and tumor segmentation; ROA—contralesional hemisphere. For all fiber tracking recipes, tracking parameters were identical to those described in the previous section.…”

Section: Methodsmentioning

confidence: 99%

“…Gliomas are the most prevalent form of intrinsic brain tumor [1] originating from neural tissue composed primarily of astrocytes, oligodendrocytes, and ependymal cells [2] with varying symptoms depending on the extent of invasion and location in the brain [3,4]. Surgical resection of the tumor area remains a mainstay of conventional therapy, and extent of resection is a well-established predictor of patient survival [5–7].…”

Section: Introductionmentioning

confidence: 99%

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Fiber-tract localized diffusion coefficients highlight patterns of white matter disruption induced by proximity to glioma

et al. 2019

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Gliomas account for 26.5% of all primary central nervous system tumors. Recent studies have used diffusion tensor imaging (DTI) to extract white matter fibers and the diffusion coefficients derived from MR processing to provide useful, non-invasive insights into the extent of tumor invasion, axonal integrity, and gross differentiation of glioma from metastasis. Here, we extend this work by examining whether a tract-based analysis can improve non-invasive localization of tumor impact on white matter integrity. This study retrospectively analyzed preoperative magnetic resonance sequences highlighting contrast enhancement and DTI scans of 13 subjects that were biopsy-confirmed to have either high or low-grade glioma. We reconstructed the corticospinal tract and superior longitudinal fasciculus by applying atlas-based regions of interest to fibers derived from whole-brain deterministic streamline tractography. Within-subject comparison of hemispheric diffusion coefficients (e.g., fractional anisotropy and mean diffusivity) indicated higher levels of white matter degradation in the ipsilesional hemisphere. Novel application of along-tract analyses revealed that tracts traversing the tumor region showed significant white matter degradation compared to the contralesional hemisphere and ipsilesional tracts displaced by the tumor.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fiber-tract localized diffusion coefficients highlight patterns of white matter disruption induced by proximity to glioma

et al. 2019

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“…Glioma is the most common type of brain tumor, with an incidence of 6 per 100,000 annually, worldwide (23). Numerous studies have focused on the effects of miRNA dysregulation in various types of human cancer.…”

Section: Discussionmentioning

confidence: 99%

miR‑9‑3p inhibits glioma cell proliferation and apoptosis by directly targeting FOXG1

et al. 2020

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There is accumulating evidence indicating that microRNA (miR)-9-3p expression is abnormal in patients with glioma; however, the role of miR-9-3p in glioma remains unclear. In the present study, reverse transcription-quantitative PCR and immunohistochemical assays were conducted to assess miR-9-3p and forkhead box G1 (FOXG1) expression, respectively. A luciferase reporter assay was performed to confirm the target of miR-9-3p. Moreover, cell counting kit-8 and flow cytometry assays were used to assess proliferation and apoptosis, respectively. The present study demonstrated that miR-9-3p is significantly downregulated, and FOXG1 is significantly upregulated, in patients with glioma. miR-9-3p overexpression inhibited proliferation and increased the apoptosis of both U87MG and TG-905 cells. In addition, FOXG1 was identified as a direct target of miR-9-3p, and FOXG1 silencing enhanced the inhibitory effect of miR-9-3p on proliferation and apoptosis in U87 MG and TG-905 cells. In conclusion, the present results suggest that miR-9-3p may suppress malignant biological properties by targeting FOXG1. Thus, miR-9-3p may serve as a diagnostic target and novel prognostic marker in patients with glioma.

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“…For the neurosurgical treatment of HGG, total resection of the tumor while not causing new neurological deficits is the primary goal (4,5). For this matter, the use of five-aminolevulinic acid (5-ALA) (6) in fluorescence-guided surgery (FGS) has significantly improved HGG therapy (7).…”

Section: Introductionmentioning

confidence: 99%

“…Apart from the use of radio- and chemotherapy, survival, neurological function, and the patients' quality of life highly depend on the extent and safety of neurosurgical resection ( 3 , 4 ). For the neurosurgical treatment of HGG, total resection of the tumor while not causing new neurological deficits is the primary goal ( 4 , 5 ). For this matter, the use of five-aminolevulinic acid (5-ALA) ( 6 ) in fluorescence-guided surgery (FGS) has significantly improved HGG therapy ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

5-Aminolevulinic Acid Multispectral Imaging for the Fluorescence-Guided Resection of Brain Tumors: A Prospective Observational Study

et al. 2020

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Fluorescence-guided surgery with five-aminolevulinic acid (5-ALA) is the state-of-the-art treatment of high-grade gliomas. However, intraoperative visualization of 5-ALA under blue light remains challenging, especially when blood covers the surgical field and thereby fluorescence. To overcome this problem and combine the brightness of visible light with the information delivered with fluorescence, we implemented multispectral fluorescence (MFL) in a surgical microscope, a technique that is able to project both information in real-time. We prospectively examined 25 patients with brain tumors. One patient was operated on two different lesions in the same setting. The tumors comprised: six glioblastomas, four anaplastic astrocytomas, one anaplastic oligodendroglioma, two meningiomas, 11 metastatic tumors, one acoustic neuroma, and one ependymoma. The MFL technique with a real-time overlay of fluorescence and white light was compared intraoperatively to the classic blue filter. All lesions were clearly visible and highlighted from the surrounding tissue. The pseudocolor we chose was green, representing fluorescence, with the surrounding brain tissue remaining in its original color. When blood was covering the surgical field, orientation was easy to maintain. The MFL technique opens the way for precise and clear visualization of fluorescence in real-time under white light. It can be easily used for the resection of all tumors accumulating 5-ALA. Drawbacks of classic PpIX fluorescence such as hidden fluorescence, intraoperative changes could be overcome with the presence of additional white light in MFL technique.

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The Treatment of Gliomas in Adulthood

Cited by 18 publications

References 43 publications

Fiber-tract localized diffusion coefficients highlight patterns of white matter disruption induced by proximity to glioma

Fiber-tract localized diffusion coefficients highlight patterns of white matter disruption induced by proximity to glioma

miR‑9‑3p inhibits glioma cell proliferation and apoptosis by directly targeting FOXG1

5-Aminolevulinic Acid Multispectral Imaging for the Fluorescence-Guided Resection of Brain Tumors: A Prospective Observational Study

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