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To evaluate the role of collateral and permeability imaging derived from dynamic contrast material-enhanced magnetic resonance angiography to predict PH 2 hemorrhagic transformation in acute ischemic stroke.
The secondary analysis of a published data from participants with acute ischemic stroke. The multiphase collateral map and permeability imaging were generated by using dynamic signals from dynamic contrast material-enhanced magnetic resonance angiography obtained at admission. https://www.selleckchem.com/products/opicapone.html To identify independent predictors of PH 2 hemorrhagic transformation, age, sex, risk factors, baseline National Institutes of Health Stoke Scale (NIHSS) score, baseline DWI lesion volume, collateral-perfusion status, mode of treatment, and successful early reperfusion were evaluated with multiple logistic regression analyses and the significance of permeability imaging in prediction of PH 2 hemorrhagic transformation was evaluated by subgroup analysis.
In 115 participants, including 70 males (mean (SD) age, 69 (12) years), PHic resonance angiography.
Pathogenesis of peritumoral brain edema (PTBE) in meningiomas remains unclear. Associations between PTBE volume and diffusion or perfusion properties of meningioma have not been studied. We aimed to investigate if diffusion and perfusion properties of meningioma correlate with its PTBE volume.
Seventy consecutive patients (mean age, 58.9 ± 13.7years; 37 women) with meningiomas who had preoperative DTI and DSC-PWI were retrospectively analyzed. PTBE volume, tumor volume, and mean T2 signal, ADC, FA, and CBV of the tumor were measured. Between meningiomas with and without PTBE, patient age and sex, as well as T2 signal intensity, volume, ADC, FA, and CBV of tumors, were compared. In meningiomas with PTBE, correlations of PTBE volume with patient age and sex, as well as T2 signal intensity, volume, ADC, FA, and CBV of tumors, were analyzed. Multivariable linear regression analysis was performed to identify factors associated with PTBE volume.
On univariable analysis, meningiomas without PTBE were more frequently found in women (P= 0.033) and demonstrated lower ADC (P= 0.020), higher FA (P<0.001), and lower CBV (P<0.001). PTBE volume of meningiomas correlated with tumor ADC (r= 0.444; P= 0.001), tumor FA (r= - 0.655; P<0.001), and tumor CBV (r= 0.402; P= 0.003). On multivariable analysis, tumor FA was the only factor associated with PTBE volume (P<0.001).
PTBE volume in meningioma correlates with tumor FA. DTI may help to understand the mechanism of PTBE in meningiomas.
PTBE volume in meningioma correlates with tumor FA. DTI may help to understand the mechanism of PTBE in meningiomas.
To evaluate the reliability and accuracy of thick maximum intensity projection (MIP) CTA images to detect large-vessel occlusion (LVO) in the anterior circulation in patients with acute stroke.
A total of 140 acute stroke patients (41 with and 99 without LVO) were evaluated by two neuroradiologists for LVO using axial 3-mm and 2-mm MIPs.
Interobserver agreement was substantial using 3-mm MIPs (ĸ = 0.67) and almost perfect using 2-mm MIPs (ĸ = 0.82). Using 3-mm MIPs, sensitivities were 80.5% and 68.3%, with specificities of 98.0% and 96.0%. Using 2-mm MIPs, sensitivities were 82.9% and 73.2%, with specificities of 98.0% and 99.0%. Sensitivity and specificity of 3 mm and 2 mm MIPs were not statistically significantly different (P ≥ 0.375). The majority of LVOs in the distal intracranial carotid artery, and/or M1-segment were correctly identified 96.0% (observer 1, 3-mm MIPs), 88.0% (observer 2, 3-mm MIPs), 96.0% (observer 1, 2-mm MIPs), and 96.0% (observer 2, 2 mm MIPs). Using 3-mm MIP images, observers 1 and 2 missed 7/15 (46.7%) and 9/15 (60.0%) of isolated M2-segment occlusions, respectively. Using 2-mm MIP images, observers 1 and 2 missed 5/15 (33.3%) and 6/15 (40.0%) of isolated M2-segment occlusions, respectively.
Thick (2-3 mm) axial MIPs are not useful to detect proximal LVO in the anterior circulation.
Thick (2-3 mm) axial MIPs are not useful to detect proximal LVO in the anterior circulation.Omburtamab is a B7H3-specific murine monoclonal antibody. B7H3 (CD 276) is a member of the B7 family of immune checkpoint co-inhibitory receptors overexpressed on many human malignancies. Radioimmunotherapy with 124I- or 131I-omburtamab administered in the cerebrospinal fluid (CSF), intraperitoneal or intratumoral cavity is currently under investigation for the treatment of CNS malignancies. The immunologic effects of anti-B7H3 therapy are not fully elucidated. A 6-year-old male was diagnosed with metastates of neuroblastoma to the received intraventricular 131I-omburtamab on an IRB-approved protocol. A treatment cycle consisted of a 2 mCi dosimetry dose and a 50 mCi treatment dose. Dosimetry by serial imaging, pharmacokinetics and safety were investigated. Clinical status, magnetic resonance imaging, CSF cell count and cytology were evaluated pre- and post-131I-omburtamab at 5 and 26 weeks. The patient did well with cycle 1. Three hours after the dosimetry dose of cycle 2, he developed a fever (39 °C), chills and headache. Blood and CSF samples were sent for culture. CSF was notable for nucleated cell pleocytosis with profound mast cell proliferation consistent with chemical meningitis. He was treated with supportive care; symptoms resolved over 48 h. Further therapy with 131I-omburtamab was electively discontinued. CSF cell count 5 weeks later demonstrated resolution of CSF pleocytosis. Local-regional administration of intraventricular 131I-omburtamab targeting B7H3 can result in a profound nucleated CSF pleocytosis with mastocytosis consistent with an acute allergic reaction.Tumor mutation burden (TMB) predicts response to immunotherapy in non-small cell lung cancer (NSCLC). The current TMB evaluation is expensive and not satisfactory. Here, novel tumor mutation score (TMS) was defined as the number of genes with mutations in candidate genes and compared with TMB and PD-L1 in 240 NSCLC patients and validated in 34 NSCLC patients. Eighteen genes were significantly associated with longer progression-free survival (PFS) or better response. The number of mutated genes within 18 favorable genes were defined as TMS18. TMS18 (HR = 0.307, P less then 0.001) had smaller hazard ratio and P value than TMB (HR = 0.455, P = 0.004) and PD-L1 expression (HR = 0.403, P = 0.005) in survival analysis. Moreover, TMS18 had significantly higher AUC than TMB and TMS18 combined with PD-L1 improved the accuracy. Universal cutoff of TMS18 enriched more patients with benefits. These findings were largely consistent in the validation cohort. Taken together, TMS18 was more powerful than TMB in predicting response of ICIs in NSCLC.
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