Randomized phase III study of high-dose methotrexate and whole-brain radiotherapy with/without temozolomide for newly diagnosed primary CNS lymphoma: JCOG1114C.

Background: The goal was to determine whether the addition of temozolomide (TMZ) to the standard treatment of high-dose methotrexate (HD-MTX) and whole-brain radiotherapy (WBRT) for primary central nervous system lymphoma (PCNSL) improves survival.

Methods: An open-label, randomized, phase III trial was conducted in Japan, enrolling immunocompetent patients aged 20-70 years with histologically confirmed, newly diagnosed PCNSL. After administration of HD-MTX, patients were randomly assigned to receive WBRT (30 Gy) ± 10 Gy boost (arm A) or WBRT ± boost with concomitant and maintenance TMZ for 2 years (arm B).

IgG4-related brain pseudotumor mimicking CNS lymphoma. A case report.

Here, we report a case of IgG4-related brain pseudotumor (IgG4-BP) in a 39-year-old woman, mimicking central nervous system (CNS) lymphoma. She presented with headache, fever, and fatigue. Her medical history was notable for appearance of a tumefactive brain lesion seven years before.

Glycated Tryptophan PHP-THC Incorporated into Various Chicken Embryonic Cells Constitutes Cellular Proteins.

Glycation is a non-enzymatic reaction, and amino acids are glycated by glucose in vivo. Tryptophan is glycated with glucose to form two types of glycated compounds, tryptophan-Amadori product and (1R, 3S)-1-(D-gluco-1, 2, 3, 4, 5-pentahydroxypentyl)-1, 2, 3, 4-tetrahydro--carboline-3-carboxylic acid (PHP-THC). Although PHP-THC can be incorporated into various chicken embryonic cells, the mechanism of its incorporation into intracellular fluids has not been clarified.

Mucosal thickening of the maxillary sinus is frequently associated with diffuse glioma patients and correlates with poor survival prognosis of GBM patients: comparative analysis to meningioma patients.

Glioma patients were frequently associated with mucosal thickening of the maxillary sinus (MTMS), which reflects mucosal inflammation. We suspected that MTMS is associated with impaired mucosal immune response and correlated with dysfunction in the anti-tumor immune response in diffuse glioma patients. Therefore, the aim of this study was to determine whether the occurrence of diffuse glioma is correlated with MTMS compared to meningioma and control groups.

Computed tomography perfusion in patients of stroke with left ventricular assist device.

Left ventricular assist devices (LVAD) are widely applied for patients with severe heart failure as a bridge to heart transplantation as well as destination therapy. Patients with implanted LVAD have an increased risk of cerebral thrombosis and computed tomographic perfusion (CTP) has the potential to be performed for early diagnosis and treatment of acute ischemic stroke (AIS), including interventional thrombectomy. Here, we report our series of CTP examination in patients having suspected AIS after LVAD implantation.

Improved visualization of diffusion-prepared MR neurography (SHINKEI) in the lumbosacral plexus combining high-intensity reduction (HIRE) technique.

Purpose: This study attempted to improve visualization of the pelvic nervous system using the high-intensity reduction (HIRE)-nerve-SHeath signal increased with INKed rest-tissue RARE Imaging (SHINKEI) technique that involves subtracting signals of 3D heavily T2W images from SHINKEI images. We identified the optimum TE value for 3D heavily T2W images and assessed the usefulness of the HIRE-SHINKEI technique.

Materials And Methods: Coronal lumbosacral plexus images were acquired from six healthy volunteers at 3 T.

Pulvinar Locus is Highly Relevant to Patients' Outcomes in Surgically Resected Thalamic Gliomas in Children.

Objective: Thalamic gliomas in children are less suitable for surgical resection because of their location. In cases of unavoidable resection, careful surgical planning in addition to histology and extent of resection affects prognosis.

Methods: A cohort of 10 pediatric patients with thalamic glioma underwent surgical resection at our department.

Dual-Phase Computed Tomography Angiography Enhances Detection of Contrast Extravasation in Subarachnoid Hemorrhage.

Background: Contrast-enhanced computed tomography angiography (CTA) can be used to detect contrast extravasation in intracerebral hemorrhage. However, investigation for contrast extravasation in subarachnoid hemorrhage (SAH) is insufficient. We evaluated the efficacy of dual-phase CTA to improve evaluation of contrast extravasation in SAH.

Proton magnetic resonance spectroscopy differentiates tumefactive demyelinating lesions from gliomas.

Background: It is often difficult to accurately differentiate tumefactive demyelinating lesions (TDLs) from gliomas using MRI.

Objective: To investigate the utility of proton magnetic resonance spectroscopy (MRS) in differentiating TDLs from gliomas.

Methods: Cohort 1 included 6 patients with TDLs and 5 with gliomas (3 high-grade), as assessed using a 1.

Imaging of Intracranial Gliomas.

Combined use of contemporary radiological modalities, particularly integration of structural, metabolic, and functional imaging, provides optimal multifaceted information for detailed characterization of intracranial gliomas. It allows differentiation of the tumor from non-neoplastic pathology, its non-invasive histopathological typing and grading, prediction of patient prognosis and clinical course of the disease, detailed planning of surgical resection or biopsy, critical postoperative assessment of the residual lesion, effective surveillance during follow-up with evaluation of effectiveness of the adjuvant therapy and timely identification of recurrence, and even insights into molecular signatures of the neoplasms. Therefore, advanced neuroimaging is one of the most important cornerstones of the modern neuro-oncology.

The effect of scan interval and bolus length on the quantitative accuracy of cerebral computed tomography perfusion analysis using a hollow-fiber phantom.

The shuttle scan technique is expected to extend scan range in cerebral computed tomography (CT) perfusion by 16- or 64-row multidetector CT (MDCT), but it may affect quantitative accuracy. This study aims to evaluate the effect of long scan interval and bolus length on the quantitative accuracy of perfusion indices using an innovative hollow-fiber phantom.We used an originally developed hollow-fiber hemodialyzer covered with polyurethane resin as a perfusion phantom.

Quantitative accuracy of computed tomography perfusion under low-dose conditions, measured using a hollow-fiber phantom.

Purpose: The purpose of this study was to investigate the quantitative accuracy under low-dose conditions on computed tomography (CT) perfusion using a hollow-fiber phantom that had the theoretical absolute values of perfusion indices.

Materials And Methods: Our phantom comprised two components, i.e.

Carnosine activates the CREB pathway in Caco-2 cells.

Imidazole dipeptide, carnosine, is a versatile compound composed of β-Ala and L-His. A recent study showed that carnosine might benefit the treatment of Alzheimer's disease and the maintenance of cognitive function. Based on the observation that carnosine is immediately degraded by serum carnosinase, we hypothesized that carnosine improves brain function by promoting brain-gut interaction.

[Technique and Theory of Hollow-fiber Phantom for Cerebral CT Perfusion].

We developed a phantom using a hollow-fiber hemodialyzer to evaluate the quantitative reliability of cerebral computed tomography (CT) perfusion. Our phantom consisted of a hollow-fiber hemodialyzer and a syringe-shaped X-ray device made up of resin. The phantom can give theoretical true values for cerebral blood volume, cerebral blood flow, and mean transit time.

Roles of the Wada Test and Functional Magnetic Resonance Imaging in Identifying the Language-dominant Hemisphere among Patients with Gliomas Located near Speech Areas.

This study examined the accuracy of functional magnetic resonance imaging (fMRI) in identifying the language-dominant hemisphere and the situations in which the Wada test can be skipped among patients with gliomas located near speech areas. We examined 74 patients [48 men (64.9%); mean ± standard deviation age of 42.

The role of 4D CT angiography for preoperative screening in patients with intracranial tumors.

Introduction: Four-dimensional computed tomography angiography (4D CTA) is now becoming an often used diagnostic imaging modality for the assessment of patients with intracranial tumors. The purpose of this study was to demonstrate the utility of 4D CTA for preoperative screening in patients with intracranial tumors as well as to examine the correlation between perfusion data and grading of gliomas.

Methods: We performed preoperative screening using 320-row detector CT scanner in 186 patients with intracranial tumors, and 115 patients were finally included in the study.

Comparison between Ki67 labeling index determined using image analysis software with virtual slide system and that determined visually in breast cancer.

Background: In recent papers, Ki67 labeling index (LI) has been used to classify breast cancer patients into the low and high Ki67LI groups for comparison studies, which showed significant differences in many prognostic factors. It has not been clarified whether image analysis software can be used for calculating LI in breast cancer. In our study, we examined whether Ki67LI in breast cancer calculated using image analysis software correlates with that measured on the basis of visual.

Subpial Hematoma and Extravasation in the Interhemispheric Fissure with Subarachnoid Hemorrhage.

A recent report on computed tomography (CT) findings of contrast extravasation in subarachnoid hemorrhage (SAH) with Sylvian hematoma suggests that the occurrence of the hematoma is secondary to bleeding in the subpial space. Our patient was in his sixties and was admitted to the hospital because of loss of consciousness (Glasgow Coma Scale E4V1M4). SAH was diagnosed in plain head CT, and growing hematomas were observed in the Sylvian and interhemispheric fissures following a subarachnoid hemorrhage.

[Optimal imaging parameters and the advantage of cerebrospinal fluid flow image using time-spatial labeling inversion pulse at 3 tesla magnetic resonance imaging: comparison of image quality for 1.5 tesla magnetic resonance imaging].

Cerebrospinal fluid (CSF) imaging by time-spatial labeling inversion pulse (Time-SLIP) technique is labeled by CSF with a selective inversion recovery (IR) pulse as internal tracer, thus making it possible to visualize CSF dynamics non-invasively. The purpose of this study was to clarify labeled CSF signals during various black blood time to inversion (BBTI) values at 3 tesla (T) and 1.5 T magnetic resonance imaging (MRI) and to determine appropriate CSF imaging parameters at 3 T MRI in 10 healthy volunteers.

Assessment of cerebrospinal fluid flow patterns using the time-spatial labeling inversion pulse technique with 3T MRI: early clinical experiences.

CSF imaging using the time-spatial labeling inversion pulse (time-SLIP) technique at 3T magnetic resonance imaging (MRI) was performed to assess cerebrospinal fluid (CSF) dynamics. The study population comprised 15 healthy volunteers and five patients with MR findings showing expansive dilation of the third and lateral ventricles suggesting aqueductal stenosis (AS). Signal intensity changes were evaluated in the tag-labeled CSF, untagged brain parenchyma, and untagged CSF of healthy volunteers by changing of black-blood time-inversion pulse (BBTI).

Brain natriuretic peptide in acute ischemic stroke.

Elevated serum brain natriuretic peptide (BNP) levels are associated with cardioembolic stroke mainly because of atrial fibrillation (AF). However, the mechanisms of increased serum BNP levels are hitherto unclear. We aimed to identify the factors associated with increased BNP levels in patients with acute ischemic stroke.

Differentiation of tumor progression and radiation-induced effects after intracranial radiosurgery.

A number of intracranial tumors demonstrate some degree of enlargement after stereotactic radiosurgery (SRS). It necessitates differentiation of their regrowth and various treatment-induced effects. Introduction of low-dose standards for SRS of benign neoplasms significantly decreased the risk of the radiation-induced necrosis after -management of schwannomas and meningiomas.

Optimal visualization of multiple brain metastases for gamma knife radiosurgery.

Background: Optimal management of metastatic brain disease requires precise detection and detailed characterization of all intracranial lesions.

Methods: We analyzed an experience with 3200 brain MRI investigations performed at 1.5 T and 3.

Selection of the antifungal agent decides prognosis of invasive aspergillosis: case report of a successful outcome with voriconazole.

Invasive aspergillosis is a rare disease and is often misdiagnosed. The clinical course is quite aggressive and it is a potentially fatal disease. We report a case of invasive aspergillosis involving the dura mater and optic nerves which was successfully treated with voriconazole, even though the patient had residual monocular blindness.

Early metabolic changes in metastatic brain tumors after Gamma Knife radiosurgery: 1H-MRS study.

Evaluation of early metabolic changes in metastatic brain tumors after Gamma Knife radiosurgery was performed by long-echo (TR, 2000ms; TE, 136ms; 128-236 acquisitions) volume-selected single-voxel proton magnetic resonance spectroscopy (MRS). Eighty-five brain metastases in 81 patients were investigated before treatment and 16-18h thereafter. Standard metabolic ratios, namely N-acetylaspartate (NAA)/creatine (Cr), phosphorylcholine/glycerophosphorylcholine (Cho)/Cr, NAA/Cho, lactate (Lac)/Cr, and mobile lipids (Lip)/Cr, were calculated, and comparison of their values before and after irradiation was done.