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Open Access 01-08-2020 | Lymphoma | Clinical Study

Distinct topographic-anatomical patterns in primary and secondary brain tumors and their therapeutic potential

Authors: Kevin Akeret, Victor E. Staartjes, Flavio Vasella, Carlo Serra, Jorn Fierstra, Marian Christoph Neidert, Luca Regli, Niklaus Krayenbühl

Published in: Journal of Neuro-Oncology | Issue 1/2020

Abstract

Purpose

Understanding the topographic-anatomical patterns of brain tumors has the potential to improve our pathophysiological understanding and may allow for anatomical tailoring of surgery and radiotherapy. This study analyzed topographic-anatomical patterns underlying neuroepithelial tumors, primary CNS lymphoma and metastases.

Methods

Any histologically confirmed supra- or infratentorial parenchymal neoplasia of one institution over a 4-year period was included. Using high-resolution magnetic resonance imaging data, a detailed analysis of the topographic-anatomical tumor features was performed. Differences between neuroepithelial tumors, primary central nervous system lymphoma (PCNSL) and metastases were assessed using pairwise comparisons adjusted for multiple testing, upon significance of the omnibus test.

Results

Based on image analysis of 648 patients—419 (65%) neuroepithelial tumors, 28 (5%) PCNSL and 201 (31%) metastases—entity-specific topographic-anatomical patterns were identified. Neuroepithelial tumors showed a radial ventriculo-cortical orientation, inconsistent with the current belief of a growth along white matter tracts, whereas the pattern in PCNSL corresponded to a growth along such. Metastases preferentially affected the cortex and subcortical white matter of large arteries’ terminal supply areas. This study provides a comprehensive anatomical description of the topography of NT, PCNSL and metastases intended to serve as a topographic reference for clinicians and neuroscientists.

Conclusions

The identified distinct anatomical patterns provide evidence for a specific interaction between tumor and anatomical structures, following a pathoclitic concept. Understanding differences in their anatomical behavior has the potential to improve our pathophysiological understanding and to tailor therapy of brain tumors.

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Title: Distinct topographic-anatomical patterns in primary and secondary brain tumors and their therapeutic potential
Authors: Kevin Akeret
Victor E. Staartjes
Flavio Vasella
Carlo Serra
Jorn Fierstra
Marian Christoph Neidert
Luca Regli
Niklaus Krayenbühl
Publication date: 01-08-2020
Publisher: Springer US
Keywords: Lymphoma
Metastasis
Brain Tumor
Published in: Journal of Neuro-Oncology / Issue 1/2020
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-020-03574-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Distinct topographic-anatomical patterns in primary and secondary brain tumors and their therapeutic potential

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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