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1.
Proc Natl Acad Sci U S A ; 121(21): e2322923121, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38739798

RESUMEN

The ubiquitin-proteasome system is essential to all eukaryotes and has been shown to be critical to parasite survival as well, including Plasmodium falciparum, the causative agent of the deadliest form of malarial disease. Despite the central role of the ubiquitin-proteasome pathway to parasite viability across its entire life-cycle, specific inhibitors targeting the individual enzymes mediating ubiquitin attachment and removal do not currently exist. The ability to disrupt P. falciparum growth at multiple developmental stages is particularly attractive as this could potentially prevent both disease pathology, caused by asexually dividing parasites, as well as transmission which is mediated by sexually differentiated parasites. The deubiquitinating enzyme PfUCHL3 is an essential protein, transcribed across both human and mosquito developmental stages. PfUCHL3 is considered hard to drug by conventional methods given the high level of homology of its active site to human UCHL3 as well as to other UCH domain enzymes. Here, we apply the RaPID mRNA display technology and identify constrained peptides capable of binding to PfUCHL3 with nanomolar affinities. The two lead peptides were found to selectively inhibit the deubiquitinase activity of PfUCHL3 versus HsUCHL3. NMR spectroscopy revealed that the peptides do not act by binding to the active site but instead block binding of the ubiquitin substrate. We demonstrate that this approach can be used to target essential protein-protein interactions within the Plasmodium ubiquitin pathway, enabling the application of chemically constrained peptides as a novel class of antimalarial therapeutics.


Asunto(s)
Péptidos , Plasmodium falciparum , Proteínas Protozoarias , Ubiquitina Tiolesterasa , Plasmodium falciparum/enzimología , Plasmodium falciparum/metabolismo , Plasmodium falciparum/efectos de los fármacos , Ubiquitina Tiolesterasa/metabolismo , Ubiquitina Tiolesterasa/antagonistas & inhibidores , Ubiquitina Tiolesterasa/genética , Humanos , Péptidos/química , Péptidos/metabolismo , Péptidos/farmacología , Proteínas Protozoarias/metabolismo , Proteínas Protozoarias/química , Proteínas Protozoarias/genética , Proteínas Protozoarias/antagonistas & inhibidores , Antimaláricos/farmacología , Antimaláricos/química , Ubiquitina/metabolismo , Malaria Falciparum/parasitología , Malaria Falciparum/tratamiento farmacológico
2.
Am J Hum Genet ; 109(4): 601-617, 2022 04 07.
Artículo en Inglés | MEDLINE | ID: mdl-35395208

RESUMEN

Neurodevelopmental disorders are highly heterogenous conditions resulting from abnormalities of brain architecture and/or function. FBXW7 (F-box and WD-repeat-domain-containing 7), a recognized developmental regulator and tumor suppressor, has been shown to regulate cell-cycle progression and cell growth and survival by targeting substrates including CYCLIN E1/2 and NOTCH for degradation via the ubiquitin proteasome system. We used a genotype-first approach and global data-sharing platforms to identify 35 individuals harboring de novo and inherited FBXW7 germline monoallelic chromosomal deletions and nonsense, frameshift, splice-site, and missense variants associated with a neurodevelopmental syndrome. The FBXW7 neurodevelopmental syndrome is distinguished by global developmental delay, borderline to severe intellectual disability, hypotonia, and gastrointestinal issues. Brain imaging detailed variable underlying structural abnormalities affecting the cerebellum, corpus collosum, and white matter. A crystal-structure model of FBXW7 predicted that missense variants were clustered at the substrate-binding surface of the WD40 domain and that these might reduce FBXW7 substrate binding affinity. Expression of recombinant FBXW7 missense variants in cultured cells demonstrated impaired CYCLIN E1 and CYCLIN E2 turnover. Pan-neuronal knockdown of the Drosophila ortholog, archipelago, impaired learning and neuronal function. Collectively, the data presented herein provide compelling evidence of an F-Box protein-related, phenotypically variable neurodevelopmental disorder associated with monoallelic variants in FBXW7.


Asunto(s)
Proteína 7 que Contiene Repeticiones F-Box-WD , Trastornos del Neurodesarrollo , Ubiquitinación , Proteína 7 que Contiene Repeticiones F-Box-WD/química , Proteína 7 que Contiene Repeticiones F-Box-WD/genética , Proteína 7 que Contiene Repeticiones F-Box-WD/metabolismo , Células Germinativas , Mutación de Línea Germinal , Humanos , Trastornos del Neurodesarrollo/genética , Complejo de la Endopetidasa Proteasomal/metabolismo , Ubiquitina-Proteína Ligasas/genética , Ubiquitina-Proteína Ligasas/metabolismo
3.
Brief Bioinform ; 25(1)2023 11 22.
Artículo en Inglés | MEDLINE | ID: mdl-38018912

RESUMEN

Dysfunctions caused by missense mutations in the tumour suppressor p53 have been extensively shown to be a leading driver of many cancers. Unfortunately, it is time-consuming and labour-intensive to experimentally elucidate the effects of all possible missense variants. Recent works presented a comprehensive dataset and machine learning model to predict the functional outcome of mutations in p53. Despite the well-established dataset and precise predictions, this tool was trained on a complicated model with limited predictions on p53 mutations. In this work, we first used computational biophysical tools to investigate the functional consequences of missense mutations in p53, informing a bias of deleterious mutations with destabilizing effects. Combining these insights with experimental assays, we present two interpretable machine learning models leveraging both experimental assays and in silico biophysical measurements to accurately predict the functional consequences on p53 and validate their robustness on clinical data. Our final model based on nine features obtained comparable predictive performance with the state-of-the-art p53 specific method and outperformed other generalized, widely used predictors. Interpreting our models revealed that information on residue p53 activity, polar atom distances and changes in p53 stability were instrumental in the decisions, consistent with a bias of the properties of deleterious mutations. Our predictions have been computed for all possible missense mutations in p53, offering clinical diagnostic utility, which is crucial for patient monitoring and the development of personalized cancer treatment.


Asunto(s)
Mutación Missense , Neoplasias , Humanos , Proteína p53 Supresora de Tumor/genética , Mutación , Neoplasias/genética , Aprendizaje Automático
4.
Brief Bioinform ; 23(2)2022 03 10.
Artículo en Inglés | MEDLINE | ID: mdl-35189634

RESUMEN

Changes in protein sequence can have dramatic effects on how proteins fold, their stability and dynamics. Over the last 20 years, pioneering methods have been developed to try to estimate the effects of missense mutations on protein stability, leveraging growing availability of protein 3D structures. These, however, have been developed and validated using experimentally derived structures and biophysical measurements. A large proportion of protein structures remain to be experimentally elucidated and, while many studies have based their conclusions on predictions made using homology models, there has been no systematic evaluation of the reliability of these tools in the absence of experimental structural data. We have, therefore, systematically investigated the performance and robustness of ten widely used structural methods when presented with homology models built using templates at a range of sequence identity levels (from 15% to 95%) and contrasted performance with sequence-based tools, as a baseline. We found there is indeed performance deterioration on homology models built using templates with sequence identity below 40%, where sequence-based tools might become preferable. This was most marked for mutations in solvent exposed residues and stabilizing mutations. As structure prediction tools improve, the reliability of these predictors is expected to follow, however we strongly suggest that these factors should be taken into consideration when interpreting results from structure-based predictors of mutation effects on protein stability.


Asunto(s)
Biología Computacional , Proteínas , Biología Computacional/métodos , Bases de Datos de Proteínas , Mutación , Estabilidad Proteica , Proteínas/química , Proteínas/genética , Reproducibilidad de los Resultados
5.
Brief Bioinform ; 23(1)2022 01 17.
Artículo en Inglés | MEDLINE | ID: mdl-34882232

RESUMEN

Protein-carbohydrate interactions are crucial for many cellular processes but can be challenging to biologically characterise. To improve our understanding and ability to model these molecular interactions, we used a carefully curated set of 370 protein-carbohydrate complexes with experimental structural and biophysical data in order to train and validate a new tool, cutoff scanning matrix (CSM)-carbohydrate, using machine learning algorithms to accurately predict their binding affinity and rank docking poses as a scoring function. Information on both protein and carbohydrate complementarity, in terms of shape and chemistry, was captured using graph-based structural signatures. Across both training and independent test sets, we achieved comparable Pearson's correlations of 0.72 under cross-validation [root mean square error (RMSE) of 1.58 Kcal/mol] and 0.67 on the independent test (RMSE of 1.72 Kcal/mol), providing confidence in the generalisability and robustness of the final model. Similar performance was obtained across mono-, di- and oligosaccharides, further highlighting the applicability of this approach to the study of larger complexes. We show CSM-carbohydrate significantly outperformed previous approaches and have implemented our method and make all data freely available through both a user-friendly web interface and application programming interface, to facilitate programmatic access at http://biosig.unimelb.edu.au/csm_carbohydrate/. We believe CSM-carbohydrate will be an invaluable tool for helping assess docking poses and the effects of mutations on protein-carbohydrate affinity, unravelling important aspects that drive binding recognition.


Asunto(s)
Proteínas , Programas Informáticos , Carbohidratos , Ligandos , Aprendizaje Automático , Simulación del Acoplamiento Molecular , Unión Proteica , Proteínas/química
6.
Bioinformatics ; 39(7)2023 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-37382560

RESUMEN

MOTIVATION: With the development of sequencing techniques, the discovery of new proteins significantly exceeds the human capacity and resources for experimentally characterizing protein functions. Localization, EC numbers, and GO terms with the structure-based Cutoff Scanning Matrix (LEGO-CSM) is a comprehensive web-based resource that fills this gap by leveraging the well-established and robust graph-based signatures to supervised learning models using both protein sequence and structure information to accurately model protein function in terms of Subcellular Localization, Enzyme Commission (EC) numbers, and Gene Ontology (GO) terms. RESULTS: We show our models perform as well as or better than alternative approaches, achieving area under the receiver operating characteristic curve of up to 0.93 for subcellular localization, up to 0.93 for EC, and up to 0.81 for GO terms on independent blind tests. AVAILABILITY AND IMPLEMENTATION: LEGO-CSM's web server is freely available at https://biosig.lab.uq.edu.au/lego_csm. In addition, all datasets used to train and test LEGO-CSM's models can be downloaded at https://biosig.lab.uq.edu.au/lego_csm/data.


Asunto(s)
Proteínas , Programas Informáticos , Humanos , Proteínas/química
7.
Chemistry ; 30(7): e202303703, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-37953668

RESUMEN

Thiourea derivatives are in-demand motifs in organic synthesis, medicinal chemistry and material science, yet redox methods for the synthesis that start from safe, simple, inexpensive and readily available feedstocks are scarce. In this article, we disclose the synthesis of these motifs using elemental sulfur and nitromethane as the starting materials. The method harnesses the multi-electron auto-redox property of nitromethane in the presence of sulfur and amines, delivering thiourea products without any added oxidant or reductant. Extension of this reaction to cyclizable amines and/or higher homologues of nitromethane led to a wide range of nitrogen heterocycles and thioamides. Operationally simple, the reactions are scalable, tolerate a wide range of functional groups, and can be employed for the direct functionalization of natural products. Mechanistically, the nitro group was found to act as an oxidant leaving group, being reduced to ammonia whereas sulfur, along with the role of a sulfur building block for the thiocarbonyl group, behaved as a complementary reductant, being oxidized to sulfate.

8.
Org Biomol Chem ; 22(19): 3871-3875, 2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38651649

RESUMEN

A cost-effective, practical, straightforward and scalable synthesis of α-pyrones via base- and sulfur-promoted annulation of phenylacetates and chalcones is reported. Generated in situ from the starting components by using dbu as a base catalyst, the Michael adducts underwent a smooth oxidative cyclization into 3,4,6-triaryl-2-pyranones upon heating with DABCO and sulfur in DMSO. Extension to malonate in place of phenylacetates led to 4,6-diaryl-2-pyranone-2-carboxylates.

9.
Org Biomol Chem ; 22(6): 1167-1171, 2024 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-38226902

RESUMEN

Inexpensive sodium sulfide trihydrate was found to promote unprecedented 6e-regio-predefined redox condensation of o-nitroanilines with α-tetralones to benzo[a]phenazines. The method was also successfully extended to acetophenones and higher homologs as reducing partners to provide 2-phenylquinoxalines. Compared to traditional approaches toward benzo[a]phenazine and quinoxaline cores starting with o-phenylenediamines, the present strategy could afford these heterocycles with well-defined regiochemistry based on the structure of starting o-nitroanilines.

10.
Environ Res ; 247: 118227, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38253192

RESUMEN

The current study aimed to assess the effectiveness of biochar formed from algae in the removal of Cr(VI) through the process of impregnating brown algae Sargassum hemiphyllum with KHCO3. The synthesis of KHCO3-activated biochar (KBAB-3), demonstrating remarkable adsorption capabilities for Cr(VI), was accomplished utilizing a mixture of brown algae and KHCO3 in a mass ratio of 1:3, followed by calcination at a temperature of 700 °C. Based on the empirical evidence, it can be observed that KBAB-3 shown a significant ability to adsorb Cr(VI) within a range of 60-160 mg g-1 across different environmental conditions. In addition, the KBAB-3 material demonstrated the advantageous characteristic of easy separation, allowing for the continued maintenance of a high efficiency in removing Cr(VI) even after undergoing numerous cycles of reuse. In conclusion, the application of KBAB-3, a novel adsorbent, exhibits considerable prospects for effective removal of Cr(VI) from diverse water sources in the near future.


Asunto(s)
Carbón Orgánico , Phaeophyceae , Contaminantes Químicos del Agua , Adsorción , Contaminantes Químicos del Agua/análisis , Cromo/análisis , Agua , Cinética
11.
Environ Res ; 252(Pt 4): 119143, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38751000

RESUMEN

In this study, biochar derived from chestnut shells was synthesized through pyrolysis at varying temperatures from 300 °C to 900 °C. The study unveiled that the pyrolysis temperature is pivotal in defining the physical and chemical attributes of biochar, notably its adsorption capabilities and its role in activating peracetic acid (PAA) for the efficient removal of acetaminophen (APAP) from aquatic environments. Notably, the biochar processed at 900 °C, referred to as CN900, demonstrated an exceptional adsorption efficiency of 55.8 mg g-1, significantly outperforming its counterparts produced at lower temperatures (CN300, CN500, and CN700). This enhanced performance of CN900 is attributed to its increased surface area, improved micro-porosity, and a greater abundance of oxygen-containing functional groups, which are a consequence of the elevated pyrolysis temperature. These oxygen-rich functional groups, such as carbonyls, play a crucial role in facilitating the decomposition of the O-O bond in PAA, leading to the generation of reactive oxygen species (ROS) through electron transfer mechanisms. This investigation contributes to the development of sustainable and cost-effective materials for water purification, underscoring the potential of chestnut shell-derived biochar as an efficient adsorbent and catalyst for PAA activation, thereby offering a viable solution for environmental cleanup efforts.


Asunto(s)
Acetaminofén , Carbón Orgánico , Ácido Peracético , Pirólisis , Contaminantes Químicos del Agua , Carbón Orgánico/química , Acetaminofén/química , Contaminantes Químicos del Agua/química , Ácido Peracético/química , Adsorción , Purificación del Agua/métodos
12.
BMC Health Serv Res ; 24(1): 86, 2024 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-38233921

RESUMEN

BACKGROUND: Dementia is a global public health priority. The World Health Organization adopted a Global Action Plan on Dementia, with dementia awareness a priority. This study examined the knowledge, attitudes, and self-confidence with skills required for providing dementia care among primary health care providers in Vietnam. METHODS: A cross-sectional study was conducted with 405 primary health care providers who worked at commune health stations and district health centers in eight provinces across Vietnam. RESULTS: The results showed that primary health care providers had poor knowledge and little confidence but more positive attitudes toward dementia care and management. CONCLUSIONS: The results suggest the training needs for building capacity amongst primary health care providers, which will be critical as Vietnam's population ages.


Asunto(s)
Demencia , Médicos , Humanos , Conocimientos, Actitudes y Práctica en Salud , Vietnam , Estudios Transversales , Atención Primaria de Salud , Demencia/terapia
13.
Can Assoc Radiol J ; : 8465371241259951, 2024 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-38902978

RESUMEN

In the immunocompromised setting, there are distinct radiologic findings of primary central nervous system lymphoma (PCNSL), including necrotic ring-enhancing lesions, increased propensity for intralesional haemorrhage, and multiplicity. In this clinical context, advanced imaging with MR perfusion, spectroscopy, and diffusion-weighted imaging can be used to increase accuracy in the diagnosis of lymphoma over mimics such as high-grade glioma, metastases, or infection. This review summarizes the histology and pathophysiology of PCNSL in immunodeficient hosts, which provide a basis for its imaging appearances, prognosis, and treatment. This discussion is important for the general radiologist as the incidence of immunodeficiency-related PCNSL may be increasing.

14.
PLoS Pathog ; 17(7): e1009729, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34237115

RESUMEN

Rabies virus phosphoprotein (P protein) is a multifunctional protein that plays key roles in replication as the polymerase cofactor that binds to the complex of viral genomic RNA and the nucleoprotein (N protein), and in evading the innate immune response by binding to STAT transcription factors. These interactions are mediated by the C-terminal domain of P (PCTD). The colocation of these binding sites in the small globular PCTD raises the question of how these interactions underlying replication and immune evasion, central to viral infection, are coordinated and, potentially, coregulated. While direct data on the binding interface of the PCTD for STAT1 is available, the lack of direct structural data on the sites that bind N protein limits our understanding of this interaction hub. The PCTD was proposed to bind via two sites to a flexible loop of N protein (Npep) that is not visible in crystal structures, but no direct analysis of this interaction has been reported. Here we use Nuclear Magnetic Resonance, and molecular modelling to show N protein residues, Leu381, Asp383, Asp384 and phosphor-Ser389, are likely to bind to a 'positive patch' of the PCTD formed by Lys211, Lys214 and Arg260. Furthermore, in contrast to previous predictions we identify a single site of interaction on the PCTD by this Npep. Intriguingly, this site is proximal to the defined STAT1 binding site that includes Ile201 to Phe209. However, cell-based assays indicate that STAT1 and N protein do not compete for P protein. Thus, it appears that interactions critical to replication and immune evasion can occur simultaneously with the same molecules of P protein so that the binding of P protein to activated STAT1 can potentially occur without interrupting interactions involved in replication. These data suggest that replication complexes might be directly involved in STAT1 antagonism.


Asunto(s)
Evasión Inmune/fisiología , Chaperonas Moleculares/metabolismo , Virus de la Rabia/metabolismo , Rabia/virología , Proteínas Estructurales Virales/metabolismo , Replicación Viral/fisiología , Animales , Células COS , Chlorocebus aethiops , Células HEK293 , Humanos , Proteínas de la Nucleocápside/metabolismo , Rabia/metabolismo , Factor de Transcripción STAT1/metabolismo
15.
J Org Chem ; 88(15): 11197-11204, 2023 Aug 04.
Artículo en Inglés | MEDLINE | ID: mdl-37470501

RESUMEN

Elemental sulfur and DABCO were found to be an excellent combination to promote a one-pot cascade of condensation-oxidative cyclization of chalcones and unsubstituted cyanoacetamide in DMSO to provide 3-cyanopyrid-2-ones.

16.
Org Biomol Chem ; 21(3): 503-507, 2023 01 18.
Artículo en Inglés | MEDLINE | ID: mdl-36519810

RESUMEN

1-Anilinonaphtho[2,1-b]thiophenes could be conveniently synthesized from a three-component reaction of 1-acetonaphthones with anilines and elemental sulfur under catalyst-free simple heating conditions.


Asunto(s)
Compuestos de Anilina , Tiofenos , Azufre , Catálisis
17.
Environ Res ; 238(Pt 2): 117259, 2023 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-37775006

RESUMEN

Nano-heterojunction photocatalytic can operate removal of pollutants, which is basic for the sustainable development of a clean environment. Herein, we propose a novel MoS2/SnO2 (MS) S-scheme heterojunction by a facile hydrothermal process, which is cheap, easily available, highly visible-light response, and good stability. The MS nano-heterojunction suggested superior performance with the photocatalytic degradation of 97.6% within 100 min for ciprofloxacin (CIP) removal, which was 5.74 and 4.88 folds higher than that of pristine MoS2 and SnO2, respectively. The fabricated MS photocatalysts displayed outstanding photocatalytic efficiency toward Cr (VI) reduction. The removal capability of Cr (VI) reached up to 92.5% within 60 min. The photodegradation efficiency was 5.2 folds that of pristine MoS2. In addition, the antibacterial performance approximately approached 100% for E. coli within 10 min, which was more apparent than the others. A series of excellent results implied that MS nano-heterojunction had a high ultraviolet and visible light absorbance, larger specific surface area, outstanding electron-hole pairs migration and higher capability of photo-response electrons and holes separation rate. This system offers a novel window into the evolution of nano-heterojunction for wastewater treatment and solar energy harvesting applications.


Asunto(s)
Metales Pesados , Molibdeno , Antibacterianos , Escherichia coli , Luz
18.
Nucleic Acids Res ; 49(D1): D475-D479, 2021 01 08.
Artículo en Inglés | MEDLINE | ID: mdl-33095862

RESUMEN

Proteins are intricate, dynamic structures, and small changes in their amino acid sequences can lead to large effects on their folding, stability and dynamics. To facilitate the further development and evaluation of methods to predict these changes, we have developed ThermoMutDB, a manually curated database containing >14,669 experimental data of thermodynamic parameters for wild type and mutant proteins. This represents an increase of 83% in unique mutations over previous databases and includes thermodynamic information on 204 new proteins. During manual curation we have also corrected annotation errors in previously curated entries. Associated with each entry, we have included information on the unfolding Gibbs free energy and melting temperature change, and have associated entries with available experimental structural information. ThermoMutDB supports users to contribute to new data points and programmatic access to the database via a RESTful API. ThermoMutDB is freely available at: http://biosig.unimelb.edu.au/thermomutdb.


Asunto(s)
Bases de Datos de Proteínas , Mutación Missense/genética , Proteínas/genética , Termodinámica , Interfaz Usuario-Computador
19.
J Korean Med Sci ; 38(49): e410, 2023 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-38111281

RESUMEN

Geographical and racial factors constitute important distinctions between Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C), but no study has been conducted in Vietnam. Forty-one children with KD from January 2018 to July 2020 and 42 with KD/MIS-C from August 2020 to December 2022 were included in this study. Of the patients, 52.3% were aged between 12 and 35 months. Only two were aged over 5 years, and both were belong to the KD/MIS-C group. A 59.5% of the patients were male. Apart from fever, all symptoms tended to be more frequent in patients with KD/MIS-C. The prevalence of diffuse skin rash, hand and foot edema or erythema and gastrointestinal signs was significantly higher in patients hospitalized with KD/MIS-C. There was no significant difference in laboratory findings between the two groups. Coronary artery dilation was more frequently observed in patients with KD/MIS-C compared to those with KD (40.5% vs. 14.6%, P = 0.009).


Asunto(s)
COVID-19 , Exantema , Síndrome Mucocutáneo Linfonodular , Niño , Humanos , Masculino , Lactante , Preescolar , Femenino , Síndrome Mucocutáneo Linfonodular/complicaciones , Síndrome Mucocutáneo Linfonodular/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Vasos Coronarios , Exantema/etiología
20.
Can Assoc Radiol J ; 74(1): 100-109, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35848632

RESUMEN

Purpose: The centrally restricted diffusion sign of diffusion-weighted imaging (DWI) is associated with radiation necrosis (RN) in treated gliomas. Our goal was to evaluate its diagnostic accuracy to distinguish RN from tumor recurrence (TR) in treated brain metastases. Methods: Retrospective study of consecutive patients with brain metastases who developed a newly centrally necrotic lesion after radiotherapy (RT). One reader placed regions of interest (ROI) in the enhancing solid lesion and the non-enhancing central necrosis on the apparent diffusion coefficient (ADC) map. Two readers qualitatively assessed the presence of the centrally restricted diffusion sign. The final diagnosis was made by histopathology (n = 39) or imaging follow-up (n = 2). Differences between groups were assessed by Fisher's exact or Mann-Whitney U tests. Diagnostic accuracy and inter-reader agreement were evaluated using receiver operating characteristic (ROC) curve analysis and kappa scores. Results: Forty-one lesions (32 predominant RN; 9 predominant TR) were analyzed. An ADC value ≤ 1220 × 10-6 mm2/s (sensitivity 74%, specificity 89%, area under the curve [AUC] .85 [95% confidence interval {CI}, .70-.94] P < .0001) from the necrosis and an ADC necrosis/enhancement ratio ≤1.37 (sensitivity 74%, specificity 89%, AUC .82 [95% CI, .67-.93] P < .0001) provided the highest performance for RN diagnosis. The qualitative centrally restricted diffusion sign had a sensitivity of 69% (95% CI, .50-.83), specificity of 77% (95% CI, .40-.96), and a moderate (k = .49) inter-reader agreement for RN diagnosis. Conclusions: Radiation necrosis is associated with lower ADC values in the central necrosis than TR. A moderate interobserver agreement might limit the qualitative assessment of the centrally restricted diffusion sign.


Asunto(s)
Neoplasias Encefálicas , Recurrencia Local de Neoplasia , Humanos , Estudios Retrospectivos , Recurrencia Local de Neoplasia/diagnóstico por imagen , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/radioterapia , Imagen de Difusión por Resonancia Magnética/métodos , Necrosis/diagnóstico por imagen , Sensibilidad y Especificidad , Diagnóstico Diferencial
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