Deep learning and radiomics-based approach to meningioma grading: exploring the potential value of peritumoral edema regions.

Objective.To address the challenge of meningioma grading, this study aims to investigate the potential value of peritumoral edema (PTE) regions and proposes a unique approach that integrates radiomics and deep learning techniques.Approach.The primary focus is on developing a transfer learning-based meningioma feature extraction model (MFEM) that leverages both vision transformer (ViT) and convolutional neural network (CNN) architectures. Additionally, the study explores the significance of the PTE region in enhancing the grading process.Main results.The proposed method demonstrates excellent grading accuracy and robustness on a dataset of 98 meningioma patients. It achieves an accuracy of 92.86%, precision of 93.44%, sensitivity of 95%, and specificity of 89.47%.Significance.This study provides valuable insights into preoperative meningioma grading by introducing an innovative method that combines radiomics and deep learning techniques. The approach not only enhances accuracy but also reduces observer subjectivity, thereby contributing to improved clinical decision-making processes.

CI-UNet: melding convnext and cross-dimensional attention for robust medical image segmentation.

Deep learning-based methods have recently shown great promise in medical image segmentation task. However, CNN-based frameworks struggle with inadequate long-range spatial dependency capture, whereas Transformers suffer from computational inefficiency and necessitate substantial volumes of labeled data for effective training. To tackle these issues, this paper introduces CI-UNet, a novel architecture that utilizes ConvNeXt as its encoder, amalgamating the computational efficiency and feature extraction capabilities. Moreover, an advanced attention mechanism is proposed to captures intricate cross-dimensional interactions and global context. Extensive experiments on two segmentation datasets, namely BCSD, and CT2USforKidneySeg, confirm the excellent performance of the proposed CI-UNet as compared to other segmentation methods.

Accurate segmentation algorithm of acoustic neuroma in the cerebellopontine angle based on ACP-TransUNet.

Acoustic neuroma is one of the most common tumors in the cerebellopontine angle area. Patients with acoustic neuroma have clinical manifestations of the cerebellopontine angle occupying syndrome, such as tinnitus, hearing impairment and even hearing loss. Acoustic neuromas often grow in the internal auditory canal. Neurosurgeons need to observe the lesion contour with the help of MRI images, which not only takes a lot of time, but also is easily affected by subjective factors. Therefore, the automatic and accurate segmentation of acoustic neuroma in cerebellopontine angle on MRI is of great significance for surgical treatment and expected rehabilitation. In this paper, an automatic segmentation method based on Transformer is proposed, using TransUNet as the core model. As some acoustic neuromas are irregular in shape and grow into the internal auditory canal, larger receptive fields are thus needed to synthesize the features. Therefore, we added Atrous Spatial Pyramid Pooling to CNN, which can obtain a larger receptive field without losing too much resolution. Since acoustic neuromas often occur in the cerebellopontine angle area with relatively fixed position, we combined channel attention with pixel attention in the up-sampling stage so as to make our model automatically learn different weights by adding the attention mechanism. In addition, we collected 300 MRI sequence nuclear resonance images of patients with acoustic neuromas in Tianjin Huanhu hospital for training and verification. The ablation experimental results show that the proposed method is reasonable and effective. The comparative experimental results show that the Dice and Hausdorff 95 metrics of the proposed method reach 95.74% and 1.9476 mm respectively, indicating that it is not only superior to the classical models such as UNet, PANet, PSPNet, UNet++, and DeepLabv3, but also show better performance than the newly-proposed SOTA (state-of-the-art) models such as CCNet, MANet, BiseNetv2, Swin-Unet, MedT, TransUNet, and UCTransNet.

E2F transcription factor 1/small nucleolar RNA host gene 18/microRNA-338-5p/forkhead box D1: an important regulatory axis in glioma progression.

This study aims to probe the biological functions of long non-coding RNA small nucleolar RNA host gene 18 (SNHG18) on glioma cells and its underlying mechanism. In this study, SNHG18 expression in glioma tissues was quantified employing GEPIA database; quantitative real-time PCR was adopted to examine the expressions of SNHG18, microRNA-338-5p (miR-338-5p) and forkhead box D1 (FOXD1) mRNA in glioma tissues and cell lines; cell proliferation, migration and invasion were detected utilizing cell counting kit-8, EdU and Transwell assays; Western blot was utilized to quantify the protein expressions of E-cadherin, N-cadherin, Vimentin and FOXD1; dual-luciferase reporter gene and RNA immunoprecipitation experiments were utilized to validate the targeting relationships between SNHG18 and miR-338-5p, as well as miR-338-5p and FOXD1 mRNA 3'UTR; dual-luciferase reporter gene and chromatin immunoprecipitation assays were utilized to verify the binding of E2F transcription factor 1 (E2F1) to the SNHG18 promoter region. It was revealed that, SNHG18 expression in glioma was up-regulated and associated with unfavorable prognosis of the patients; knockdown of SNHG18 repressed the malignant biological behaviors of glioma cells, enhanced E-cadherin expression and repressed N-cadherin and Vimentin expressions. MiR-338-5p was a target of SNHG18, and SNHG18 promoted the expression of FOXD1 by decoying miR-338-5p. Additionally, E2F1 could bind to the promoter of SNHG18 to elevate its expression. In conclusion, SNHG18 accelerates glioma progression via regulating the miR-338-5p/FOXD1 axis.

Bioinformatics analysis of microarray data reveals epithelial-mesenchymal-transition in pediatric ependymoma.

The objectives of this study were to explore the possible mechanisms of pediatric ependymoma using bioinformatics methods and provide potential genes and signaling pathways for pediatric ependymoma study. The data of GES74195 from Gene Expression Ominibus was analyzed by R language for pediatric ependymoma study. The differentially expressed genes were explored using gene set enrichment analysis, search tool for the retrieval of interacting genes, Cytoscape as well as other mainstream bioinformatics methods. Extracellular matrix-receptors interaction pathways and focal adhesion pathway were demonstrated as the key signaling pathway for pediatric ependymoma. The potential hub genes enriched in the two signaling pathways were regarded as final hub genes for this microarray analysis. The development and progression of pediatric ependymoma were associated with epithelial-mesenchymal-transition. Various potential hub genes and potential key signaling pathways in order to further explore their values in the diagnosis and treatment of this disease in the future.

Spinal hemangioblastoma: surgical procedures, outcomes and review of the literature.

PURPOSE: total removal of spinal hemangioblastomas with satisfactory clinical outcomes remains a challenge. We aimed to evaluate the surgical outcomes of our spinal hemangioblastomas patients, summarize our experiences with this condition and review-related literature. METHODS: records of 18 spinal hemangioblastoma patients who underwent microsurgical resection were analyzed retrospectively. Clinical features, surgical procedures and outcomes were reviewed to assess the prognosis of their spinal hemangioblastomas. The McCormick classification method was used to evaluate spinal function and MR scans used to assess location and features of the tumor pre-surgically, tumor recurrence and syringomyelia status post-surgically. RESULTS: total resection of 37 tumors was achieved in all 18 cases. Of those patients, two (11%) were accompanied with von Hippel-Lindau (VHL). Of the 37 tumors, 3 (8.1%) were completely intramedullary, 16 (43.2%) intramedullary-extramedullary and 18 (48.6%) primarily extramedullary. Tumors accompanied with syringomyelia were present in 17 (94.4%) patients. Clinical symptoms such as pain were reduced within 48 h after surgery in 16 patients. Post-operative neurological functions improved in all cases at 3 months post-surgery. Over the subsequent 3-18 month follow-up period, pre-operative symptoms improved in all 18 patients and no tumor recurrence was present. Syringomyelia was reduced or absent within 3-6 months. CONCLUSIONS: our results indicated that a complete microscopic resection was effective in eliminating symptoms in these spinal hemangioblastoma patients, who showed a good prognosis after surgery. These improvements in clinical symptoms may be associated with the blood flow changes, but not with reductions and/or eliminations of syrinx after surgery.

MicroRNA­301a/ZNRF3/wnt/ß­catenin signal regulatory crosstalk mediates glioma progression.

MicroRNA (miR)­mediated mRNA and multiple signaling pathway dysregulations have been extensively implicated in several cancer types, including gliomas. Although previous studies have reported that miR­301a acts as an oncogene, the underlying mechanisms of miR­301a in the initiation and progression of glioma remain unknown. The present study aimed to investigate the involvement of miR­301a­mediated signaling pathway dysregulation in glioma. The results identified that miR­301a was significantly upregulated in gliomas and was associated with a poor prognosis based on The Cancer Genome Atlas and Chinese Glioma Genome Atlas databases. Moreover, zinc and ring finger 3 (ZNRF3) exerted a critical role in the miR­301a­mediated effects on the malignant phenotype, such as by affecting proliferation and apoptosis. Mechanistically, the TOP/FOP luciferase assay, western blotting and immunofluorescence results demonstrated that miR­301a knockdown inhibited the wnt/ß­catenin signaling pathway, at least partially via ZNRF3, while ZNRF3 was a direct functional target of miR­301a, as indicated by luciferase reporter assay and western blot analysis. Furthermore, ZNRF3 could in turn repress miR­301a expression, which was dependent on the wnt pathway. Collectively, the present study identified a novel miR­301a/ZNRF3/wnt/ß­catenin signaling feedback loop that serves critical roles in glioma tumorigenesis, and that may represent a potential therapeutic target.

RPN2 is targeted by miR-181c and mediates glioma progression and temozolomide sensitivity via the wnt/ß-catenin signaling pathway.

Accumulating evidence indicates that the dysregulation of the miRNAs/mRNA-mediated carcinogenic signaling pathway network is intimately involved in glioma initiation and progression. In the present study, by performing experiments and bioinformatics analysis, we found that RPN2 was markedly elevated in glioma specimens compared with normal controls, and its upregulation was significantly linked to WHO grade and poor prognosis. Knockdown of RPN2 inhibited tumor proliferation and invasion, promoted apoptosis, and enhanced temozolomide (TMZ) sensitivity in vitro and in vivo. Mechanistic investigation revealed that RPN2 deletion repressed ß-catenin/Tcf-4 transcription activity partly through functional activation of glycogen synthase kinase-3ß (GSK-3ß). Furthermore, we showed that RPN2 is a direct functional target of miR-181c. Ectopic miR-181c expression suppressed ß-catenin/Tcf-4 activity, while restoration of RPN2 partly reversed this inhibitory effect mediated by miR-181c, implying a molecular mechanism in which TMZ sensitivity is mediated by miR-181c. Taken together, our data revealed a new miR-181c/RPN2/wnt/ß-catenin signaling axis that plays significant roles in glioma tumorigenesis and TMZ resistance, and it represents a potential therapeutic target, especially in GBM.

HMGN5 Silencing Suppresses Cell Biological Progression via AKT/MAPK Pathway in Human Glioblastoma Cells.

HMGN5 regulates biological function and molecular transcription via combining with a nucleosome. There has been growing evidence that aberrant expression of HMGN5 is associated with malignant neoplasm development and progression. In the present study, we found that the expression of HMGN5 is significantly higher in high-grade glioblastoma tissues than in low-grade samples. To clarify the function of HMGN5 in glioblastoma, we knocked down HMGN5 in U87 and U251 glioblastoma cells via siRNA. The results demonstrated that HMGN5 was involved in the regulation of proliferation and apoptosis, migration, and invasion of glioblastoma cells. These outcomes also indicated that silencing HMGN5 possibly suppressed the expression of p-AKT and p-ERK1/2. Taken together, our research reveals that HMGN5 might be an efficient target for glioblastoma-targeted therapy.

Functions and clinical significance of circular RNAs in glioma.

CircRNAs are a class of single-stranded RNA molecules with a covalently closed loop structure and have been characterized by high stability, abundance, conservation, and display tissue/developmental stage-specific expression, furthermore, based on the abundance in distinct body fluids or exosomes, circRNAs present novel biomarkers and targets for the diagnosis and prognosis of cancers. Recently, the regulatory mechanisms of biogenesis and molecular functions, including miRNAs and RBPs sponge, translation as well as transcriptional and splicing regulation, have been gradually uncovered, although various aspects remained to be elucidated in combination with deep-sequence and bioinformatics. Accumulating studies have indicated that circRNAs are more enriched in neuronal tissues partly due to the abundance of specific genes promoting circularization, suggesting dysregulation of circRNAs is closely related to diseases of the nervous system, including glioma. In this review, we elaborate on the biogenesis, functions, databases as well as novel advances especially involved in the molecular pathways, highlight its great value as diagnostic or therapeutic targets in glioma.

Overexpression of human MX2 gene suppresses cell proliferation, migration, and invasion via ERK/P38/NF-κB pathway in glioblastoma cells.

In human, there are two myxovirus resistance genes-MX1 and MX2, which respectively encode MXA and MXB protein. For MXB, it was traditionally deemed to work in the progression of cell cycle and adjustment of nuclear import. Thus, we speculated that it might play important roles in tumor progression. The purpose of this study was to preliminarily explore the underlying functions and mechanism of the MX2 gene on glioblastoma multiforme. Quantitative reverse transcription polymerase chain reaction, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide (MTT), and transwell experiments were to detect the relative MX2 mRNA level and its biological functions on glioma cells, respectively. The data displayed that MX2 was obviously downregulated both in glioblastoma (GBM) and GBM cell lines, meanwhile, its overexpression could markedly reduce cell proliferation, migration, and invasion of glioma cells, implying that it was related with glioblastoma progression. In addition, the overall survival of patient with glioblastoma had a negative correlation with the MX2 expression. Then, Western blot indicated the potential mechanism of MX2 in glioblastoma. We found that MX2 overexpression could decrease the relative levels of phosphorylated-ERK1/2 (p-ERK1/2), p-p38, and nuclear factor-κB (NF-κB), while have no effects on extracellular signal-regulated kinase (ERK), p38, and lamin B1. Moreover, the influences of MX2 overexpression on cell proliferation, migration, and invasion could be weakened by the three inhibitors (PD98059, SB203580, and (pyridin-2-ylmethyl) dithiocarbamate [PDTC]). These results implied that MX2 might suppress the proliferation and metastasis of glioma cells by manipulating the ERK/P38/NF-κB signaling pathway. In conclusion, MX2 is potential to be a new marker used for glioblastoma prognosis or a new target for glioblastoma treatments.

MiRNA-154-5p inhibits cell proliferation and metastasis by targeting PIWIL1 in glioblastoma.

MicroRNAs (miRNAs) play a critical role in glioblastoma initiation and progression. PIWIL1, a human homolog of the PIWI family, has a critical effect on glioblastoma progression. In present study, we found that the expression of miR-154-5p was significantly lower in glioblastoma. Our results suggested that the overexpression of miR-154-5p suppressed proliferation and metastasis, induced apoptosis, whereas inhibiting the expression of miR-154-5p significantly promoted proliferation and metastasis of glioblastoma. We further proved that miR-154-5p directly integrated with the 3'-UTR of PIWIL1 and reintroduction of PIWIL1 can rescue the phenotype changes induced by miR-154-5p. Taken together, our study reveals that miR-154-5p can counteract the malignant phenotypes of glioblastoma by targeting PIWIL1, which might be beneficial to reveal new therapeutic targets for glioblastoma.

Protocatechuic Acid Inhibits Inflammatory Responses in LPS-Stimulated BV2 Microglia via NF-κB and MAPKs Signaling Pathways.

Protocatechuic acid (PA), a major metabolite of anthocyanins, has been reported to possess antioxidant and anti-inflammatory activities. However, the effects of PA on LPS-induced inflammatory responses in microglia have not been reported. The aim of this study was to investigate the anti-inflammatory effects and molecular mechanisms of PA on LPS-stimulated BV2 microglia. The production of inflammatory mediators TNF-α, IL-6, IL-1ß, and PGE2 were detected by ELISA. TLR4, NF-κB and MAPKs activation were detected by western blotting. Our results demonstrated that PA dose-dependently inhibited LPS-induced TNF-α, IL-6, IL-1ß, and PGE2 production. In addition, PA suppressed LPS-induced TLR4 expression, NF-κB and MAPKs activation, which resulted in the inhibition of inflammatory mediators. In conclusion, these results suggested that PA exhibited anti-inflammatory effects on LPS-stimulated BV2 microglia and the mechanisms were involved in the inhibition of TLR4-mediated NF-κB and MAPKs signaling pathways.

Intracranial granulocytic sarcoma: two cases and literature review.

Intracranial granulocytic sarcoma was a relatively rare tumor composed of myeloid blasts and/or immature myeloid cells in an extramedullary site which is associated with acute/chronic myeloid leukemia. In this paper, two cases of intracranial granulocytic sarcoma, one male aged 36 and one 28-year-old female, were reported to improve the diagnosis and treatment of such diseases. Diagnostic and treatment procedures for them were retrospectively summarized and relevant literature reviews were combined. Pathological biopsy was conducted to validate the diagnosis. Surgical resections in combination with chemotherapy were performed. The differential diagnosis of intracranial granulocytic sarcoma from malignant lymphomas and alternative small round cell malignancy was confirmed by biopsy and immunohistochemistry.

Clinical functional anatomy of the pterygopalatine ganglion, cephalgia and related dysautonomias: A review.

The purpose of this article is to explain the anatomy of the pterygopalatine ganglion (PPG), its location in the pterygopalatine fossa (PPF) in the skull, and the relationship it has to the Vidian nerve terminal branches and the fifth cranial nerve. An overview of the neuro-anatomical/clinical correlations, a spectrum of pathologies affecting the seventh cranial nerve and some therapies both medical and surgical are noted. The focus is the pterygopalatine region with discussion of the proximal courses of the seventh and fifth cranial nerves and their pathological processes. The ganglion is used as an example of neuro-anatomical model for explaining cluster headaches (CH). Radiological correlation is included to clarify the location of the PPF and its clinical importance.

The extended subtemporal transtentorial approach: the impact of trochlear nerve dissection and tentorial incision.

The subtemporal transtentorial approach provides excellent exposure of the incisural space. Incision of the tentorium improves access to the interpeduncular cistern, basilar artery, and rostral ventral pons. Description of the starting and termination points of the tentorial incision has varied greatly. We assessed the impact on surgical exposure of freeing the trochlear nerve (TN) from its dural canal (DC) in addition to dividing and retracting the tentorium. A subtemporal approach was performed on 10 hemispheres of cadaveric specimens. Following exposure of the middle tentorial incisura, the TN is dissected from its DC over a few millimeters. Two retraction sutures are placed along the tentorial edge, posterior to the TN entrance in its DC. The tentorial incision is started between the sutures. Dissection of TN from its DC continues for a short distance. The tentorial incision is extended straight up towards the superior petrosal sinus. Dissection of the TN DC continues anteriorly, up to its entry into the cavernous sinus. The tentorial incision can then be extended, just over the entrance to Meckel's cave, and the flap reflected far anterolateraly. Using this technique, the exposure of the interpeduncular cistern and its content increased by a mean of 8.2 mm (standard deviation [SD] 3.9 mm) in the anteroposterior axis and by 5.5mm (SD 1.9 mm) in the rostrocaudal axis. Tentorial incision following dissection of the TN from its DC optimizes reflection of the tentorium flap anterolateraly, maximizes the exposure, and improves lighting and visibility as well as maneuverability within the interpeduncular and rostral pre-pontine cisterns.