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      Pre-operative MRI Radiomics for the Prediction of Progression and Recurrence in Meningiomas

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          Abstract

          Objectives: A subset of meningiomas may show progression/recurrence (P/R) after surgical resection. This study applied pre-operative MR radiomics based on support vector machine (SVM) to predict P/R in meningiomas.

          Methods: From January 2007 to January 2018, 128 patients with pathologically confirmed WHO grade I meningiomas were included. Only patients who had undergone pre-operative MRIs and post-operative follow-up MRIs for more than 1 year were studied. Pre-operative T2WI and contrast-enhanced T1WI were analyzed. On each set of images, 32 first-order features and 75 textural features were extracted. The SVM classifier was utilized to evaluate the significance of extracted features, and the most significant four features were selected to calculate SVM score for each patient.

          Results: Gross total resection (Simpson grades I–III) was performed in 93 (93/128, 72.7%) patients, and 19 (19/128, 14.8%) patients had P/R after surgery. Subtotal tumor resection, bone invasion, low apparent diffusion coefficient (ADC) value, and high SVM score were more frequently encountered in the P/R group ( p < 0.05). In multivariate Cox hazards analysis, bone invasion, ADC value, and SVM score were high-risk factors for P/R ( p < 0.05) with hazard ratios of 7.31, 4.67, and 8.13, respectively. Using the SVM score, an AUC of 0.80 with optimal cutoff value of 0.224 was obtained for predicting P/R. Patients with higher SVM scores were associated with shorter progression-free survival ( p = 0.003).

          Conclusions: Our preliminary results showed that pre-operative MR radiomic features may have the potential to offer valuable information in treatment planning for meningiomas.

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          Most cited references50

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          The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary.

          The 2016 World Health Organization Classification of Tumors of the Central Nervous System is both a conceptual and practical advance over its 2007 predecessor. For the first time, the WHO classification of CNS tumors uses molecular parameters in addition to histology to define many tumor entities, thus formulating a concept for how CNS tumor diagnoses should be structured in the molecular era. As such, the 2016 CNS WHO presents major restructuring of the diffuse gliomas, medulloblastomas and other embryonal tumors, and incorporates new entities that are defined by both histology and molecular features, including glioblastoma, IDH-wildtype and glioblastoma, IDH-mutant; diffuse midline glioma, H3 K27M-mutant; RELA fusion-positive ependymoma; medulloblastoma, WNT-activated and medulloblastoma, SHH-activated; and embryonal tumour with multilayered rosettes, C19MC-altered. The 2016 edition has added newly recognized neoplasms, and has deleted some entities, variants and patterns that no longer have diagnostic and/or biological relevance. Other notable changes include the addition of brain invasion as a criterion for atypical meningioma and the introduction of a soft tissue-type grading system for the now combined entity of solitary fibrous tumor / hemangiopericytoma-a departure from the manner by which other CNS tumors are graded. Overall, it is hoped that the 2016 CNS WHO will facilitate clinical, experimental and epidemiological studies that will lead to improvements in the lives of patients with brain tumors.
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            Improved Optimization for the Robust and Accurate Linear Registration and Motion Correction of Brain Images

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              Epidemiology and etiology of meningioma

              Although most meningiomas are encapsulated and benign tumors with limited numbers of genetic aberrations, their intracranial location often leads to serious and potentially lethal consequences. They are the most frequently diagnosed primary brain tumor accounting for 33.8% of all primary brain and central nervous system tumors reported in the United States between 2002 and 2006. Inherited susceptibility to meningioma is suggested both by family history and candidate gene studies in DNA repair genes. People with certain mutations in the neurofibromatosis gene (NF2) have a very substantial increased risk for meningioma. High dose ionizing radiation exposure is an established risk factor for meningioma, and lower doses may also increase risk, but which types and doses are controversial or understudied. Because women are twice as likely as men to develop meningiomas and these tumors harbor hormone receptors, an etiologic role for hormones (both endogenous and exogenous) has been hypothesized. The extent to which immunologic factors influence meningioma etiology has been largely unexplored. Growing emphasis on brain tumor research coupled with the advent of new genetic and molecular epidemiologic tools in genetic and molecular epidemiology promise hope for advancing knowledge about the causes of intra-cranial meningioma. In this review, we highlight current knowledge about meningioma epidemiology and etiology and suggest future research directions.
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                Author and article information

                Contributors
                Journal
                Front Neurol
                Front Neurol
                Front. Neurol.
                Frontiers in Neurology
                Frontiers Media S.A.
                1664-2295
                14 May 2021
                2021
                : 12
                : 636235
                Affiliations
                [1] 1Department of Medical Imaging, Chi-Mei Medical Center , Tainan, Taiwan
                [2] 2Department of Health and Nutrition, Chia Nan University of Pharmacy and Science , Tainan, Taiwan
                [3] 3Department of Radiological Sciences, University of California, Irvine , Irvine, CA, United States
                [4] 4Department of Radiology, E-DA Hospital, I-Shou University , Kaohsiung, Taiwan
                [5] 5Graduate Institute of Medical Sciences, Chang Jung Christian University , Tainan, Taiwan
                [6] 6Department of Neurosurgery, Chi-Mei Medical Center, Chiali , Tainan, Taiwan
                [7] 7Department of Nursing, Min-Hwei College of Health Care Management , Tainan, Taiwan
                [8] 8Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University , Taipei, Taiwan
                Author notes

                Edited by: Xuejun Li, Central South University, China

                Reviewed by: Alissa A. Thomas, University of Vermont, United States; Maria Caffo, University of Messina, Italy

                *Correspondence: Ching-Chung Ko kocc0729@ 123456gmail.com

                This article was submitted to Neuro-Oncology and Neurosurgical Oncology, a section of the journal Frontiers in Neurology

                †These authors have contributed equally to this work

                Article
                10.3389/fneur.2021.636235
                8160291
                34054688
                e4c8716f-4541-4a18-919b-e8d02ae9394c
                Copyright © 2021 Ko, Zhang, Chen, Chang, Chen, Lim, Wu and Su.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 01 December 2020
                : 29 March 2021
                Page count
                Figures: 5, Tables: 2, Equations: 2, References: 50, Pages: 9, Words: 6299
                Funding
                Funded by: Chi Mei Medical Center 10.13039/501100006578
                Categories
                Neurology
                Original Research

                Neurology
                magnetic resonance imaging,radiomics,support vector machine,meningioma,progression,recurrence

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