A Semi-automatic method for segmentation and 3D modeling of glioma tumors from brain MRI

This work presents an efficient method for volume rendering of glioma tumors from segmented 2D MRI Datasets with user interactive control, by replacing manual segmentation required in the state of art methods. The most common primary brain tumors are gliomas, evolving from the cerebral supportive cells. For clinical follow-up, the evaluation of the preoperative tumor volume is essential. Tumor portions were automatically segmented from 2D MR images using morphological filtering techniques. These segmented tumor slices were propagated and modeled with the software package. The 3D modeled tumor consists of gray level values of the original image with exact tumor boundary. Axial slices of FLAIR and T2 weighted images were used for extracting tumors. Volumetric assessment of tumor volume with manual segmentation of its outlines is a time-consuming process and is prone to error. These defects are overcome in this method. Authors verified the performance of our method on several sets of MRI scans. The 3D modeling was also done using segmented 2D slices with the help of medical software package called 3D DOCTOR for verification purposes. The results were validated with the ground truth models by the Radiologist.

Effects of salidroside on glioma formation and growth inhibition together with improvement of tumor microenvironment

Objective：To test the effects of salidroside on formation and growth of glioma together with tumor microenvironment.Methods：Salidroside extracted from Rhodiola rosea was purified and treated on human glioma cells U251 at the concentration of 20 μg/mL.3-（4,5-dimethylthiazol-2-yl）-2,5-dephenyltetrazolium bromide （MTT） assay for cytotoxicity and flow cytometry （FCM） for cell cycle analysis were performed.Then for in vivo study,xenotransplantation tumor model in nude mice was generated and treated with salidroside at the concentration of 50 mg/kg.d for totally 20 d.Body weight and tumor size were detected every 2 d after the treatment.The levels of 8-isoprostane,superoxide dismutase （SOD） and malondialdehyde （MDA）,special markers for oxidative stress,were detected while immunofluoresence staining was performed for astrocyte detection.Results：For in vitro study,salidroside could decrease the viability of human glioma cells U251 and the growth of U251 cells at G0/G1 checkpoint during the cell cycle.For in vivo study,salidroside could also inhibit the growth of human glioma tissue in nude mice.The body weight of these nude mice treated with salidroside did not decrease as quickly as control group.In the tumor xenotransplantation nude mice model,mice were found of inhibition of oxidative stress by detection of biomarkers.Furthermore,overgrowth of astrocytes due to the stimulation of oxidative stress in the cortex of brain was inhibited after the treatment of salidroside.Conclusions：Salidroside could inhibit the formation and growth of glioma both in vivo and in vitro and improve the tumor microenvironment via inhibition of oxidative stress and astrocytes.

Clinical and Pathological Studies of Meningioma-Glioma Mixed Tumor

Meningioma-glioma mixed tumor is rare central nervous system tumor. It is necessary to study its clinical and pathological characteristics as well as its possible genesis. This case was a 54-year-old man who was readmitted for recurrent glioma. Magnetic resonance imaging showed a big mass in right temporal lobe which was confirmed as meningioma-glioma by immunohistochemical analysis. Specific immunohistochemical staining is significant in tumor differential diagnosis, and helps to confirm tumor histic origin. By pathological studies, we found that glioma could stimulate adjacent normal meninges into neoplastic proliferation.

Experimental study on dendritic cells pulsed with brain tumor stem cells for immunotherapy of glioma

Objective To investigate the effect of dendritic cells pulsed with brain tumor stem cells which are used to treat on intracranial glioma. Methods We obtained murine brain tumor stem cells by grow ing C6 cells in epidermal grow th factor/basic fibroblast grow th factor w ithout serum.Dendritic cells isolated from rat bone marrow w ere pulsed w ith BTSCs. Rat brain

Giant Tuberculomas Suggesting a Malignant Brain Tumor: About Two Cases

Tuberculoma is a common condition in developing countries. In some cases, it may mimic a glial lesion, making differential diagnosis challenging. The authors report two cases of giant tuberculoma in young patients aged 14 and 16. A literature review was conducted on these cases. Both patients underwent partial excision. Histology concluded tuberculoma. Anti-tubercular treatment was implemented. The evolution one year later was marked by the persistence of neurological disorders, although they had improved.

Tumor necrosis factor-related apoptosis-inducing ligand-induced apoptosis in glioma U87 cells

Studies have shown that tumor necrosis factor-related apoptosis-inducing ligand（TRAIL）exhibits strong induction of apoptosis in human glioma cells.It remains unclear whether the mitochondrion pathway,an important apoptosis signaling pathway,is involved in TRAIL-induced glioma cell apoptosis.In the present study,in vitro cultured human glioma U87 cells were treated with human recombinant soluble TRAIL.Apoptosis of glioma U87 cells,mitochondrial transmembrane potential（Δψm）,cytoplasmic cytochrome c concentration and changes in caspase-3,-8 and-9 activity following human recombinant soluble TRAIL treatment were investigated to determine the mechanism of glioma U87 cell apoptosis induced by TRAIL.Additionally,blocking caspase-8resulted in TRAIL-induced mitochondrion pathway activation,suggesting that TRAIL,through activating caspase-8,initiated a series of mitochondrial events and resulted in apoptosis of glioma U87 cells.

Health-related quality of life in high-grade glioma patients

Gliomas are malignant primary brain tumors and yet incurable. Palliation and the maintenance or improvement of the patient's quality of life is therefore of main importance. For that reason, health-related quality of life(HRQoL) has become an important outcome measure in clinical trials, next to traditional outcome measures such as overall and progression-free survivals, and radiological response to treatment. HRQoL is a multidimensional concept covering physical, psychological, and social domains, as well as symptoms induced by the disease and its treatment. HRQoL is assessed by using self-reported, validated questionnaires. Various generic HRQoL questionnaires, which can be supplemented with a brain tumor- specific module, are available. Both the tumor and its treatment can have a negative effect on HRQoL. However, treatment with surgery, radiotherapy, chemotherapy, and supportive treatment may also improve patients' HRQoL, in addition to extending survival. It is expected that the impact of HRQoL measurements in both clinical trials and clinical practice will increase. Hence, it is important that HRQoL data are collected, analyzed, and interpreted correctly. Methodological issues such as selection bias and missing data may hamper the interpretation of HRQoL data and should therefore be accounted. In clinical trials, HRQoL can be used to assess the benefits of a new treatment strategy, which should be weighed carefully against the adverse effects of that treatment. In daily clinical practice, HRQoL assessments of an individual patient can be used to inform physicians about the impact of a specific treatment strategy, and it may facilitate the communication between the physicians and the patients.

Effects of Photodynamic Therapy on the Ultrastructure of Glioma Cells

To study the change in ultrastructure of C6 glioma cells after photodynamic therapy （PDT）, to compare morphological differences in necrosis and apoptosis before and after PDT treatment, and to evaluate the effect of photodynamic therapy on the blood brain tumor barrier （BTB） of C6 glioma. Methods The model was produced by transplanting C6 glioma cells cultured in vitro using Peterson method into the caudate nuclei of Wister rats. The experiment group received PDT for two weeks after the operation. The sub-cellular structure, blood-brain-barrier （BBB） and BTB in both groups were observed under electron microscope. Results Apoptosis in different phases and necrosis could be observed in some C6 glioma cells. Swelling occurred on the ultrastructure of cellular organs such as mitochondria and endoplasmic reticulum in most of the cells. Damage to the BTB, reduction of the number of cellular organs in endothelial cells of the capillary blood vessels, stretch of the tight junction, and enlargement of the gaps between endothelial cells were also seen in the experiment group. Meanwhile, limited impact on the normal sub-ceUular structures and BBB was observed. Conclusion PDT could induce apoptosis and necrosis of C6 glioma cells due to the damage to the ultrastructure of mitochondria and endoplasmic reticulum. The weakened function of C6 glioma BTB initiated by PDT makes it possible to perform a combined therapy of PDT and chemotherapy for glioma.

Telomerase reverse transcriptase promoter-driven expression of iodine pump genes for targeted radioiodine therapy of malignant glioma cells

Radioiodine i s a routine therapy for differentiated thyroid cancers.Non-thyroid cancers can intake radioiodine after transfection of the human sodium iodide symporter (hNIS) gene.The human telomerase reverse transcriptase (hTERT) promoter,an excellent tumor-specific promoter,has potential value for targeted gene therapy of glioma.We used the hTERT promoter to drive the expression of the hNIS and human thyroid peroxidase (hTPO) gene as a primary step for testing the effects of radioiodine therapy on malignant glioma.The U87 and U251 cells were co-transfected with two adenoviral vectors,in which the hNIS gene had been coupled to the hTERT promoter and the hTPO gene had been coupled to the CMV promoter,respectively.Then,we performed Western blot,125I intake and efflux assays,and clonogenic assay with cancer cells.We also did 99mTc tumor imaging of nude mice models.After co-transfection with Ad-hTERT-hNIS and Ad-CMV-hTPO,glioma cells showed the 125I intake almost 1.5 times higher than cells transfected with Ad-hTERT-hNIS alone.Western blots revealed bands of approximately 70 kDa and 110 kDa,consistent with the hNIS and hTPO proteins.In clonogenic assay,approximately 90% of cotransfected cells were killed,compared to 50% of control cells after incubated with 37 MBq of 131I.These results demonstrated that radioiodine therapy was effective in treating malignant glioma cell lines following induction of tumor-specific iodide intake by the hTERT promoter-directed hNIS expression in vitro.Cotransfected hNIS and hTPO genes can result in increased intake and longer retention of radioiodine.Nude mice harboring xenografts transfected with Ad-hTERT-NIS can take 99mTc scans.

EXPRESSION OF IL-13Ra2 GENE IN HUMAN BRAIN TUMORS

Objective： To investigate the expression of IL-13Ra2 gene in brain tumors. Methods： Seventy-nine human brain tumors were obtained from the department of Neurosurgery of China Medical University. Human IL-13Ra2 expression was evaluated by reverse transcriptase polymerase chain reaction and immunohistochemical analysis. Results： IL-13Ra2 gene was highly expressed in glioblastoma, medulloblastoma, malignant meningioma and benign meningioma. Conclusion： Human IL-13Ra2 gene is expressed in brain tumors in addition to gliomas, and our result indicates that the IL-13Ra2 gene promoter based gene therapy method can be used to treat brain tumors in addition to gliomas. Further studies involving larger numbers of samples are necessary to fully understand the expression profile of IL-13Ra2 gene in the brain tumors.

CXCR4-Expressing Glial Precursor Cells Demonstrate Enhanced Migratory Tropism for Glioma

Malignant glioma remains one of the most intractable of human cancers principally due to the highly infiltrative nature of these neoplasms. The use of neural precursor cells (NPC) has received considerable attention based on their ability to selectively migrate towards disseminated areas of tumor in vivo and their described ability to deliver tumor-directed therapies specifically to infiltrating tumor cells. Fundamental to optimizing the use of these cells for potential clinical translation is the development of an understanding regarding the biologic cues that govern their ability to migrate towards infiltrative glioma foci. To this end, in this paper we detail that NPC selected for double-expression of the glial-precursor marker A2B5 and the cell-surface chemokine receptor, CXCR4, demonstrate enhanced in vitro gliomadirected tropism. These findings demonstrate the relevance of these markers for the phenotypic segregation of an optimally tumor-tropic NPC sub-population as a means of enhancing NPC-based therapeutic strategies for the treatment of glioma.

Diffusive modelling of glioma evolution: a review

Gliomas, the most aggressive form of brain cancer, are known for their widespread invasion into the tissue near the tumor lesion. Exponential models, which have been widely used in other types of cancers, cannot be used for the simulation of tumor growth, due to the diffusive behavior of glioma. Diffusive models that have been proposed in the last two decades seem to better approximate the expansion of gliomas. This paper covers the history of glioma diffusive modelling, starting from the simplified initial model in 90s and describing how this have been enriched to take into account heterogenous brain tissue, anisotropic migration of glioma cells and adjustable proliferation rates. Especially, adjustable proliferation rates are very important for modelling therapy plans and personalising therapy to different patients.

The diagnostic value of neuron specific enolase in patients with gliomas

Objective: In order ic look into the alterations and effects of neuron specific enolase (NSE) in cerebralspinal fluid (CSF ) and serum of foe paticnts with glioma and meningiomas. Methods: We studied CSF and serumlevels of NSE in 40 patients with gliomas and 10 with meningiomas;3 days before and after operation byradioimmunoassay. Results: Compared with the value of NSE: in CSF and serum from 10 control patients. samplesfrom patients with malignant gliomas contained abnormally high level of NSE before operation (P < 0. 05 ) butnormal level after operation (P >0. 05 ). However. samples from patients with low grade gliomas andmeningiomas were within normal range before and after operation (P >0. 05). Gliomas with totall refectionshowed normal NSE values but with sub lotal removal presented high levels of NSE after surgery (P < 0. 05).Conclusion: The increased value of NSE in patients with malignant gliomas may be associated with elevated rate of glucolysis. As one of the new tumor markers NSE Is postulated to play an important role in the diagnosi followup and monitoring of gliomas.

Diagnosis and treatment of mixed glioma

The authors present 83 patients with mixed glioma with experiences in clinical diagnosis and treatment.In all these cases.there were 44 tumors as grade 1 or 2,and 39 as grade 3 or 4.In 39 tumors.two glial components(oligodendrocytes and astrocytes) occurr

Exogenous p16 gene therapy combined with X-ray irradiation suppresses the growth of human glioma cells

In this study, we infected human glioma U251 cells with a replication-defective recombinant adenovirus carrying the p16 gene. This adenovirus constructed was able to transfect exogenous p16 into the human glioma cells efficiently, and direct a high level of p16 protein expression. Tumor-inhibition experiments demonstrated that treatment with the adenovirus-p16 significantly inhibited the growth of glioma cells in vitro as well as the in vivo development of tumors in nude mice bearing a brain glioma. The combination of adenovirus-p16 gene treatment and X-ray irradiation resulted in a greater inhibition of tumor growth. Adenovirus-mediated p16 gene therapy conferred a significant antitumor effect against human glioma cells both in vitro and in vivo, and that there was a synergistic effect when X-ray irradiation was also used.

Treatment of malignant glioma using hyperthermia

Thirty pathologically diagnosed patients with grade Ⅲ-Ⅳ primary or recurrent malignant glioma （tumor diameter 3-7 cm） were randomly divided into two groups. The control group underwent conventional radiotherapy and chemotherapy. In the hyperthermia group, primary cases received hyperthermia treatment, and patients with recurrent tumors were treated with hyperthermia in com- bination with radiotherapy and chemotherapy. Hyperthermia treatment was administered using a 13.56-MHz radio frequency hyperthermia device. Electrodes were inserted into the tumor with the aid of a CT-guided stereotactic apparatus and heat was applied for 1 hour. Dudng 3 months a^er hyperthermia, patients were evaluated with head CT or MRI every month. Gliomas in the hyper- thermia group exhibited growth retardation or growth termination. Necrosis was evident in 80% of the heated tumor tissue and there was a decrease in tumor diameter. Our findings indicate that ra- dio frequency hyperthermia has a beneficial effect in the treatment of malignant glioma.

The exciting potential of nanotherapy in brain-tumor targeted drug delivery approaches

Delivering therapeutics to the central nervous system（CNS） and brain-tumor has been a major challenge. The current standard treatment approaches for the brain-tumor comprise of surgical resection followed by immunotherapy, radiotherapy, and chemotherapy. However, the current treatments are limited in providing significant benefits to the patients and despite recent technological advancements; brain-tumor is still challenging to treat. Brain-tumor therapy is limited by the lack of effective and targeted strategies to deliver chemotherapeutic agents across the blood-brain barrier（BBB）. The BBB is the main obstacle that must be overcome to allow compounds to reach their targets in the brain. Recent advances have boosted the nanotherapeutic approaches in providing an attractive strategy in improving the drug delivery across the BBB and into the CNS. Compared to conventional formulations, nanoformulations offer significant ad vantages in CNS drug delivery approaches. Considering the above facts, in this review, the physiological/anatomical features of the brain-tumor and the BBB are briefly discussed. The drug transport mechanisms at the BBB are outlined. The approaches to deliver chemotherapeutic drugs across the CNS into the brain-tumor using nanocarriers are summarized. In addition, the challenges that need to be addressed in nanotherapeutic approaches for their enhanced clinical application in brain-tumor therapy are discussed.

多参数磁共振成像影像组学鉴别高级别胶质瘤及单发脑转移瘤的价值

目的:利用多参数磁共振成像(magnetic resonance imaging,MRI)影像组学鉴别高级别胶质瘤及单发脑转移瘤。方法:回顾性收集经病理活检证实为高级别胶质瘤或单发脑转移瘤患者的MRI结构序列及功能序列表观扩散系数(apparent diffusion coefficient,ADC)影像,共103例。手动勾画感兴趣区域容积(volumes of interest,VOI),包括肿瘤核心区域、周围水肿区域以及肿瘤全域。使用Python中的开源Pyradiomics包进行影像组学特征提取。然后选择t检验和最小绝对收缩和选择算子(least absolute shrinkage and selection operator,LASSO)方法进行特征筛选及降维。最后使用逻辑回归(Logistic regression,LR)、随机森林(random forest,RF)、支持向量机(support vector machines,SVM)及K-邻近(K-nearest neighbors,KNN)四种分类器建模,对比鉴别高级别胶质瘤及单发脑转移瘤的效能。结果:高级别胶质瘤及单发脑转移瘤患者的性别及年龄之间不存在统计学差异,肿瘤位置之间存在统计学差异。基于肿瘤核心区域鉴别两者取得最高的诊断效能,曲线下面积(area under curve,AUC)最高为0.924。在多序列组合模型中,ALL_TCR_LR模型的AUC值最高,为0.924,被选为最优分类器模型。结论:基于肿瘤核心区域的多序列影像组学使用LR机器学习分类器可实现高级别胶质瘤及单发脑转移瘤的鉴别,为临床决策和实践提供了较大的帮助。

Apoptosis in glioma-bearing rats after neural stem cell transplantation

Abnormal activation of the Ras/Raf/Mek/Erk signaling cascade plays an important role in glioma. Inhibition of this aberrant activity could effectively hinder glioma cell proliferation and promote cell apoptosis. To investigate the mechanism of gJioblastoma treatment by neural stem ceiJ trans- plantation with respect to the Ras/Raf/Mek/Erk pathway, C6 glioma cells were prepared in sus- pension and then infused into the rat brain to establish a glioblastoma model. Neural stem cells isolated from fetal rats were then injected into the brain of this glioblastoma model. Results showed that Raf-1, Erk and Bcl-2 protein expression significantly increased, while Caspase-3 protein expression decreased. After transplantation of neural stem cells, Raf-1, Erk and Bcl-2 protein expression significantly decreased, while Caspase-3 protein expression significantly in-creased. Our findings indicate that transplantation of neural stem cells may promote apoptosis of glioma cells by inhibiting Ras/Raf/Mek/Erk signaling, and thus may represent a novel treatment approach for glioblastoma.

芒柄花素通过miR-1229/ZDHHC9分子轴对胶质瘤细胞增殖、活力及凋亡的影响

目的:探讨芒柄花素对胶质瘤细胞增殖和凋亡的影响及其分子作用机制。方法:构建皮下移植瘤小鼠模型,灌胃给予5.72、14.31、22.9、31.49 mg/kg剂量的芒柄花素,观察肿瘤重量、体积变化;免疫组织化学法检测肿瘤组织增殖细胞核抗原(PCNA)表达。用不同浓度(20、50、80、110μmol/L)的芒柄花素处理TJ905细胞,并将TJ905细胞分为空白对照组、110μmol/L芒柄花素组、110μmol/L芒柄花素+miR-1229组、110μmol/L芒柄花素+miR-1229+ZDHHC9组、miR-NC组、miR-1229 mimic组。用Edu实验、CCK-8实验检测细胞增殖能力,TUNEL实验检测细胞凋亡,实时荧光定量聚合酶链反应(RT-qPCR)实验检测miR-1229、ZDHHC9 mRNA表达水平,在线网站及双荧光素酶报告基因法验证miR-1229与ZDHHC9靶向结合。结果:与空白对照组比较,不同剂量的芒柄花素处理组肿瘤体积、重量及PCNA蛋白表达均显著降低(均P<0.05)。与对照组比较,不同浓度(20、50、80、110μmol/L)的芒柄花素处理后,细胞增殖率显著降低,凋亡率显著升高(均P<0.05);与110μmol/L芒柄花素组比较,110μmol/L芒柄花素+miR-1229组细胞增殖率、细胞活力均显著降低,凋亡率显著增加(均P<0.05);与110μmol/L芒柄花素+miR-1229组比较,110μmol/L芒柄花素+miR-1229+ZDHHC9组细胞增殖率、细胞活力均显著增加,凋亡率显著下降(均P<0.05);双荧光素酶报告基因实验验证miR-1229与ZDHHC9靶向结合。结论:芒柄花素可能通过miR-1229/ZDHHC9分子轴抑制胶质瘤细胞增殖,并诱导其凋亡。