Detecting IDH and TERTp mutations in diffuse gliomas using H-MRS with attention deep-shallow networks.

Background: Preoperative and noninvasive detection of isocitrate dehydrogenase (IDH) and telomerase reverse transcriptase gene promoter (TERTp) mutations in glioma is critical for prognosis and treatment planning. This study aims to develop deep learning classifiers to identify IDH and TERTp mutations using proton magnetic resonance spectroscopy (H-MRS) and a one-dimensional convolutional neural network (1D-CNN) architecture.

Methods: This study included H-MRS data from 225 adult patients with hemispheric diffuse glioma (117 IDH mutants and 108 IDH wild-type; 99 TERTp mutants and 100 TERTp wild-type).

Topographic anatomy of the lateral surface of the parietal lobe and its relationship with white matter tracts.

Aim of this study was to define sulcal and gyral variations of the lateral parietal cortex and underlying white matter tracts and emphasize the importance of relationship between topographic anatomy of parietal lobe and white matter tracts underlying it in approaches to deep parietal and atrial lesions. Twenty-eight formalin-fixed cerebral hemispheres of 14 adult cadavers were used. Ten hemispheres were dissected from lateral to medial by fiber dissection and all stages were photographed.

Exploring arterial anatomy of the internal capsule: an analysis of the deep vascular structures and related white matter pathways.

Background And Objectives: The internal capsule is supplied by perforators originating from the internal carotid artery, middle cerebral artery, anterior choroidal artery and anterior cerebral artery. The aim of this study is to examine the vascular anatomy of the internal capsule, along with its related white matter anatomy, in order to prevent potential risks and complications during surgical interventions.

Methods: Twenty injected hemispheres prepared according to the Klingler method were dissected.

Endoscopy-assisted high cervical anterolateral retropharyngeal approach to clivus: a cadaveric study.

Introduction: The surgical management of pathologies involving the clivus and craniocervical junction has always been considered a complex procedure because of the deeply located surgical targets and the surrounding complex neural and vascular anatomical structures. The most commonly used approaches to reach this area are the transnasal, transoral, and transcervical approaches.

Material And Methods: This approach was performed unilaterally on five cadaver heads and bilaterally on one cadaver head.

Susceptibility-Weighted MRI for Predicting NF-2 Mutations and S100 Protein Expression in Meningiomas.

S100 protein expression levels and neurofibromatosis type 2 (NF-2) mutations result in different disease courses in meningiomas. This study aimed to investigate non-invasive biomarkers of NF-2 copy number loss and S100 protein expression in meningiomas using morphological, radiomics, and deep learning-based features of susceptibility-weighted MRI (SWI). This retrospective study included 99 patients with S100 protein expression data and 92 patients with NF-2 copy number loss information.

Identification of IDH and TERTp mutations using dynamic susceptibility contrast MRI with deep learning in 162 gliomas.

Purpose: Isocitrate dehydrogenase (IDH) and telomerase reverse transcriptase gene promoter (TERTp) mutations play crucial roles in glioma biology. Such genetic information is typically obtained invasively from excised tumor tissue; however, these mutations need to be identified preoperatively for better treatment planning. The relative cerebral blood volume (rCBV) information derived from dynamic susceptibility contrast MRI (DSC-MRI) has been demonstrated to correlate with tumor vascularity, functionality, and biology, and might provide some information about the genetic alterations in gliomas before surgery.

Super-enhancer hijacking drives ectopic expression of hedgehog pathway ligands in meningiomas.

Hedgehog signaling mediates embryologic development of the central nervous system and other tissues and is frequently hijacked by neoplasia to facilitate uncontrolled cellular proliferation. Meningiomas, the most common primary brain tumor, exhibit Hedgehog signaling activation in 6.5% of cases, triggered by recurrent mutations in pathway mediators such as SMO.

Magnetic resonance spectroscopic correlates of progression free and overall survival in "glioblastoma, IDH-wildtype, WHO grade-4".

Background: The 2021 World Health Organization (WHO) Central Nervous System (CNS) Tumor Classification has suggested that isocitrate dehydrogenase wildtype (IDH-wt) WHO grade-2/3 astrocytomas with molecular features of glioblastoma should be designated as "Glioblastoma, IDH-wildtype, WHO grade-4." This study analyzed the metabolic correlates of progression free and overall survival in "Glioblastoma, IDH-wildtype, WHO grade-4" patients using short echo time single voxel H-MRS.

Methods: Fifty-seven adult patients with hemispheric glioma fulfilling the 2021 WHO CNS Tumor Classification criteria for "Glioblastoma, IDH-wildtype, WHO grade-4" at presurgery time point were included.

Associating and Mutations in Glioma with Diffusion Anisotropy in Normal-Appearing White Matter.

Background And Purpose: and mutations might infiltratively manifest within normal-appearing white matter with specific phenotypes such as microstructural changes undetectable by standard MR imaging contrasts but potentially associable with DTI variables. The aim of this retrospective glioma study was to statistically investigate and associations and classifications with DTI reported microstructure in normal-appearing white matter.

Materials And Methods: Retrospective data from patients imaged between March 2012 and February 2016 were analyzed by grouping them as - subgroups and by and mutation status.

Arterial Supply of the Basal Ganglia: A Fiber Dissection Study.

Background: The basal ganglia, a group of subcortical nuclei located deep in the insular cortex, are responsible for many functions such as motor learning, emotion, and behavior control. Nowadays, because it has been shown that deep brain stimulation and insular tumor surgery can be performed by endovascular treatment, the importance of the vascular anatomy of the basal ganglia is being increasingly recognized.

Objective: To explain the arterial blood supply of the basal ganglia using white matter dissection.

The effect of tumor shape irregularity on Gamma Knife treatment plan quality and treatment outcome: an analysis of 234 vestibular schwannomas.

The primary aim of Gamma Knife (GK) radiosurgery is to deliver high-dose radiation precisely to a target while conforming to the target shape. In this study, the effects of tumor shape irregularity (TSI) on GK dose-plan quality and treatment outcomes were analyzed in 234 vestibular schwannomas. TSI was quantified using seven different metrics including volumetric index of sphericity (VioS).

MEOX2 homeobox gene promotes growth of malignant gliomas.

Background: Glioblastoma (GBM) is an aggressive tumor that frequently exhibits gain of chromosome 7, loss of chromosome 10, and aberrantly activated receptor tyrosine kinase signaling pathways. Previously, we identified Mesenchyme Homeobox 2 (MEOX2), a gene located on chromosome 7, as an upregulated transcription factor in GBM. Overexpressed transcription factors can be involved in driving GBM.

Information theory approaches to improve glioma diagnostic workflows in surgical neuropathology.

Aims: Resource-strained healthcare ecosystems often struggle with the adoption of the World Health Organization (WHO) recommendations for the classification of central nervous system (CNS) tumors. The generation of robust clinical diagnostic aids and the advancement of simple solutions to inform investment strategies in surgical neuropathology would improve patient care in these settings.

Methods: We used simple information theory calculations on a brain cancer simulation model and real-world data sets to compare contributions of clinical, histologic, immunohistochemical, and molecular information.

The reliability and interobserver reproducibility of T2/FLAIR mismatch in the diagnosis of IDH-mutant astrocytomas.

Purpose: The reliability and reproducibility of T2-weighted imaging/ fluid-attenuated inversion recovery (T2/FLAIR) mismatch were investigated in the diagnosis of isocitrate dehydrogenase (IDH) mutant astrocytoma between WHO grade II and III diffuse hemispheric gliomas.

Methods: WHO grade II and grade III diffuse hemispheric gliomas (n=133) treated in our institute were included in the study. Pathological findings and molecular markers of the cases were reviewed with the criteria of WHO 2016.

Intradiscal vacuum phenomenon and spinal degeneration: a cross-sectional analysis of 219 subjects.

Introduction: Intradiscal vacuum phenomenon (IVP) is the collection of gas within the intervertebral discs. It has been reported with various spinal disorders. The exact role of IVP in spinal degeneration leading to low back pain (LBP) is unclear.

Treatment and follow-up results of WHO grade II meningiomas.

Meningiomas are the most common primary intracranial tumors. They have three pathologic grades. Surgical resection aiming Simpson I resection is the standard treatment for meningiomas.

Neurosurgical follow-up and treatment of a series of 26 WHO grade III meningiomas.

Meningiomas are the most common primary intracranial tumors. They have three pathologic grades. Surgical resection aiming Simpson I resection is the standard treatment for meningiomas.

Correlation of anatomical involvement patterns of insular gliomas with subnetworks of the limbic system.

Objective: Gliomas frequently involve the insula both primarily and secondarily by invasion. Despite the high connectivity of the human insula, gliomas do not spread randomly to or from the insula but follow stereotypical anatomical involvement patterns. In the majority of cases, these patterns correspond to the intrinsic connectivity of the limbic system, except for tumors with aggressive biology.

Analysis of Mitochondrial DNA Control Region D-Loop in Gliomas: Result of 52 Patients.

Aim: To investigate the effect of mitochondrial DNA (mtDNA) variants mainly in D-loop on glioma biology.

Material And Methods: Sanger sequencing of D-loop (15971?16451 bp) for 52 glioma patients was performed and the variations were statistically analyzed for gender, WHO classification, morphological grade, IDH/TERT status.

Results: Total of 122 variations (51 unique) were identified in 52 patients.

Sequential filtering for clinically relevant variants as a method for clinical interpretation of whole exome sequencing findings in glioma.

Background: In the clinical setting, workflows for analyzing individual genomics data should be both comprehensive and convenient for clinical interpretation. In an effort for comprehensiveness and practicality, we attempted to create a clinical individual whole exome sequencing (WES) analysis workflow, allowing identification of genomic alterations and presentation of neurooncologically-relevant findings.

Methods: The analysis workflow detects germline and somatic variants and presents: (1) germline variants, (2) somatic short variants, (3) tumor mutational burden (TMB), (4) microsatellite instability (MSI), (5) somatic copy number alterations (SCNA), (6) SCNA burden, (7) loss of heterozygosity, (8) genes with double-hit, (9) mutational signatures, and (10) pathway enrichment analyses.

The Carotid Endarterectomy Cadaveric Investigation for Cranial Nerve Injuries: Anatomical Study.

Cerebral stroke continues to be one of the leading causes of mortality and long-term morbidity; therefore, carotid endarterectomy (CEA) remains to be a popular treatment for both symptomatic and asymptomatic patients with carotid stenosis. Cranial nerve injuries remain one of the major contributor to the postoperative morbidities. Anatomical dissections were carried out on 44 sides of 22 cadaveric heads following the classical CEA procedure to investigate the variations of the local anatomy as a contributing factor to cranial nerve injuries.

Association between facet joint orientation/tropism and lumbar intervertebral disc degeneration.

The aim of this study was to understand how facet joint orientation (FJO) and facet joint tropism (FJT) affected severe intervertebral disc degeneration (IVDD) process at lower lumbar levels in patients with LBP. This study is a cross-sectional analysis of a retrospective database. Patients were evaluated in terms of IVDD, FJO, and FJT at all lumbar levels on magnetic resonance imaging.

Mutations and Copy Number Alterations in Wild-Type Glioblastomas Are Shaped by Different Oncogenic Mechanisms.

Little is known about the mutational processes that shape the genetic landscape of gliomas. Numerous mutational processes leave marks on the genome in the form of mutations, copy number alterations, rearrangements or their combinations. To explore gliomagenesis, we hypothesized that gliomas with different underlying oncogenic mechanisms would have differences in the burden of various forms of these genomic alterations.

Lumbar intervertebral disc degeneration, end-plates and paraspinal muscle changes in children and adolescents with low-back pain.

The prevalence of low-back pain (LBP) in adolescents ranges from 7 to 72%. We aimed to define the radiologic characteristics of the lumbar spine in children and adolescents with LBP with/without leg pain. Two hundred and fourteen children and adolescents, who were born between 2001 and 2009 and had lumbar spine MRI for LBP with/without leg pain, were evaluated in terms of intervertebral disc degeneration (IVDD), end-plates and paraspinal muscle changes on lumbar spine MRIs.