Brain Tumor Location Research Articles

Automatic Detection of Brain Tumor on Computed Tomography Images for Patients in the Intensive Care Unit.

Patients in the intensive care unit require fast and efficient handling, including in-diagnosis service. The objectives of this study are to produce a computer-aided system so that it can help radiologists to classify the types of brain tumors suffered by patients quickly and accurately; to build applications that can determine the location of brain tumors from CT scan images; and to get the results of the analysis of the system design. The combination of the zoning algorithm with Learning Vector Quantization can increase the speed of computing and can classify normal and abnormal brains with an average accuracy of 85%.

Brain Tumor Detection from MRI using Adaptive Thresholding and Histogram based Techniques

This paper depicts a computerized framework that can distinguish brain tumor and investigate the diverse highlights of the tumor. Brain tumor segmentation means to isolated the unique tumor tissues, for example, active cells, edema and necrotic center from ordinary mind tissues of WM, GM, and CSF. However, manual segmentation in magnetic resonance data is a timeconsuming task. We present a method of automatic tumor segmentation in magnetic resonance images which consists of several steps. The recommended framework is helped by image processing based technique that gives improved precision rate of the cerebrum tumor location along with the computation of tumor measure. In this paper, the location of brain tumor from MRI isrecognized utilizing adaptive thresholding with a level set and a morphological procedure with histogram. Automatic brain tumor stage is performed by using ensemble classification. Such phase classifies brain images into tumor and non-tumors using Feed Forwarded Artificial neural network based classifier. For test investigation, continuous MRI images gathered from 200 people are utilized. The rate of fruitful discovery through the proposed procedure is 97.32 percentage accurate.

Evaluation of comorbid psychiatric disorders in patients with primary brain tumors before and after surgery

BackgroundA range of psychiatric disorders are associated with brain tumors. The aim of this study was to assess the frequency of psychiatric disorders in adults with primary brain tumors before and after surgery. MethodsThe study was conducted on 120 adult patients diagnosed with primary brain tumors (age ≥18 years). Patients with recent diagnosis (less than 6 months) who were hospitalized in Imam Reza Hospital of Tabriz between December 2016 and November 2017 were included. The diagnostic interview was performed based on DSM-IV criteria using a semi-structured interview with SCID-I before and one month after surgery. The frequency of psychiatric disorders in patients was then compared pre- and post-operation. ResultsPre-surgical studies revealed that 26.66 % of patients with primary brain tumors had symptoms of psychiatric disorders. The most prevalent disorders found in patients were depressive disorders (13.07 %), adjustment disorder (9/15 %) and anxiety disorders (5.88 %).Post-surgical evaluations indicated that the frequency of psychiatric disorders was reduced to 22.5 %. However, there was no significant difference between pre- and post-surgical outcomes. Among patients with psychiatric disorders, the most common location of brain tumors was frontal lobe and the most common pathology was meningioma. Further analysis also revealed that tumor location and pathology was not associated with the incidence and type of psychiatric disorders. ConclusionIn adults with primary brain tumors, the most common psychiatric disorder was depressive disorder.

Towards Real-Time Computing of Intraoperative Hyperspectral Imaging for Brain Cancer Detection Using Multi-GPU Platforms

Several causes make brain cancer identification a challenging task for neurosurgeons during the surgical procedure. The surgeons’ naked eye sometimes is not enough to accurately delineate the brain tumor location and extension due to its diffuse nature that infiltrates in the surrounding healthy tissue. For this reason, a support system that provides accurate cancer delimitation is essential in order to improve the surgery outcomes and hence the patient’s quality of life. The brain cancer detection system developed as part of the “HypErspectraL Imaging Cancer Detection” (HELICoiD) European project meets this requirement exploiting a non-invasive technique suitable for medical diagnosis: the hyperspectral imaging (HSI). A crucial constraint that this system has to satisfy is providing a real-time response in order to not prolong the surgery. The large amount of data that characterizes the hyperspectral images, and the complex elaborations performed by the classification system make the High Performance Computing (HPC) systems essential to provide real-time processing. The most efficient implementation developed in this work, which exploits the Graphic Processing Unit (GPU) technology, is able to classify the biggest image of the database (worst case) in less than three seconds, largely satisfying the real-time constraint set to 1 minute for surgical procedures, becoming a potential solution to implement hyperspectral video processing in the near future.

Automated Brain Tumor Detection and Segmentation from MRI Images using Adaptive Connected Component Pixel Segmentation

Magnetic resource imaging (MRI) imagesare used in examining the soft tissues which include brain tumors, ligament and tendon injury, spinal cord injury. Gray scale image processing is good for basic segmentation application.The exact location of brain tumor and its length is hard to find.This paper proposes an efficient method to segment the brain tumor. The result shows good segmentation accuracy.

Detection of BRAF V600E mutation by immunohistochemistry and PCR-RFLP in Moroccan patients with Pediatric Low-Grade Gliomas

BackgroundPediatric Low-Grade Gliomas (pLGGs) are among the most common tumors in children worldwide. Some Low-Grade Gliomas are caused by activation of V600E Protein and by mutations in BRAF gene specially V600E BRAF mutation regulating proliferation and differentiation of cells. The BRAF proto-oncogene is recognized for its important role in the MAPK pathway and the BRAF V600E mutation is recognized as common in patients with pLGGs. AimWe identified the frequency of BRAF V600E mutation in Moroccan patients with pLGGs, according to their sex, age, brain tumor location and subtype, by two methods of exploration: Immunohistochemistry and PCR-RFLP. MethodologyWe studied the BRAF V600E mutation in 89 pLGG tissues, using PCR-RFLP and immunohistochemistry. Data was analyzed by using IBM SPSS software v24. Results19 patients had a BRAF V600E mutation positive collectively, compared to 70 with a negative BRAF V600E mutation by using Immunohistochemistry. 9 cases of 89 were heterozygous for the mutation, 2 homozygous mutant genotype was found while the 78 cases remaining had normal homozygous genotype by using PCR-RFLP. Based on our findings, the prevalence of BRAF V600E mutation is 21.3% in the pLGGs and there is significant relationship between the BRAF V600E mutation, brain tumors location and subtype. ConclusionOur study investigated the involvement of the BRAF V600E mutation in Pediatric Low-Grade Gliomas in Morocco. Future studies should be conducted to identify the role of this mutation in pLGGs progression.

Hemispheric tumor location and the impact on health-related quality of life, symptomatology, and functional performance outcomes in patients with glioma: an exploratory cross-sectional study

Purpose To inform high-quality rehabilitation services, this study investigates if patients with glioma located in the right- or left-hemisphere present with different health-related quality of life, symptomatology, and functional performance in the early disease state. Material and methods Between 2013 and 2017, 81 adult patients were assessed during the first week of chemo-radiation, following resection. Patients were stratified into two groups depending on a right- or left-hemispheric lesion. Independent t-tests analyzed potential differences regarding health-related quality of life, symptomatology, and functional performance. Results Forty-five patients (56%) had a tumor located in the right hemisphere, whereas 36 patients (44%) had a tumor in the left hemisphere. Except for more patients with tumors in the left hemisphere having their tumor located in eloquent brain areas, the groups were well matched. No group differences were found in health-related quality of life. Group differences were found in communication deficits (Δ-10.9, 95%CI −19.1; −2.3, p = 0.01), which were more frequent in patients with left-sided lesions, and of headaches (Δ13.9, 95%CI 1.8; 25.9, p = 0.02), which were more frequent in patients with right-hemispheric lesions, who also had significantly greater difficulties with process-skills when performing everyday life tasks (Δ-0.3, 95%CI −0.5; −0.1, p < 0.01). Also, weak evidence suggests that patients with Glioblastoma Multiforme located in the right hemisphere are more affected by fatigue compared to their left-hemispheric comparisons (Δ14.6, 95%CI 0.19; 29.0, p < 0.05). Conclusions The hemispheric location of a glial-cell brain tumor has no consequence for health-related quality of life at the beginning of chemo-radiation treatments. However, findings of tumor-location dependent conditions of communication, headache, patients’ ability to perform executive functions, and fatigue should be considered in rehabilitation situations when designing an intervention to potentially improve executive functions and relieve the symptoms. Implications for rehabilitation It is unclear if laterality impact glioma patients health-related quality of life and functional performance, which might implicate differentiated rehabilitation interventions. The hemispheric location of a glial-cell brain tumor has no consequence for the health-related quality of life at the beginning of chemo-radiation, following surgery. Tumor-location dependent conditions of communication, headache, fatigue, and patients’ ability to perform executive functions should be considered when designing an intervention to improve executive functions and symptom-relieve. In rehabilitation interventions, tumor laterality is not a factor that needs to be considered before recommending aerobic training to improve the functional capacity of patients with glioma.

P14.33 Adult brainstem gliomas in neurofibromatosis type 1 (NF1)

Abstract BACKGROUND The brainstem is the second location of brain tumors after optic pathways in NF1. In NF1 children, brainstem gliomas are usually indolent and have a better prognosis than their counterparts in non NF1 children. In contrast, the natural history and prognosis of adult brainstem gliomas in NF1 are nearly unknown. MATERIAL AND METHODS We conducted a retrospective analysis of medical records and MRI of adult NF1 patients followed for a brainstem glioma in 8 centers over a 17 years period (2000–2017). Clinical and imaging characteristics, management and outcome were analyzed. RESULTS Twenty five patients were included in the study (13 males and 12 females) with a median age of 32 (range 17–58). The epicenter of the tumor was located into the pons n=13 (52%), the mesencephalon n=7 (28%), the medulla oblongata n=5 (20%). On MRI, contrast enhancement was seen in 19 tumors (76%). Pathological examination was available in 13 tumors (52%) and showed a high grade astrocytoma (III or IV) in 9 tumors. Five patients were asymptomatic, 3 remained asymptomatic during the follow-up (median follow-up: 86 months, range 22–124). Twenty patients were symptomatic with a median duration of symptom of 2.5 months (range 1–10) before diagnosis. Among these symptomatic patients, 15 died from tumor progression despite treatment with radiation therapy and or chemotherapy. The median overall survival of symptomatic patients was 36 months. CONCLUSION Brainstem gliomas are rare tumors in adults with NF1. Unlike children, adult brainstem gliomas seem to have an unexpected poor prognosis, suggesting the disease may be different in adulthood.

Pediatric posterior fossa incidentalomas.

Pediatric brain incidentalomas are increasingly being diagnosed. As the posterior fossa (PF) is the location of most brain tumors in children, lesions of this region are of special interest. Currently, the natural history of incidental lesions in the PF is unknown. We present our experience treating such lesions. A retrospective study was carried out in two large tertiary pediatric centers. Patients were included if they had an incidental PF lesion suspected of being a tumor, and diagnosed before the age of 20years. We analyzed treatment strategy, pathology, and outcome of operated and non-operated cases. Seventy children (31 females) with a mean age of 8.4 ± 6.1years were included. The three most common indications for imaging were headaches (16, assumed to be unrelated to the lesions), workup of unrelated conditions (14), and unspecified reasons (14). Twenty-seven patients (39%) were operated immediately, and 43 followed, of which 12 were eventually operated due to radiological changes, 28.9 ± 16.2months after diagnosis. The most commonly found pathology was pilocytic astrocytomas (21 of 39 operated cases). Almost 10% were found to be malignant tumors including medulloblastomas (5) and ATRT (1). Incidental PF lesions in children include both benign and malignant tumors. While certain lesions may be followed, others may require surgical treatment. Specific treatment decisions are based on initial radiological appearance, change in radiological characteristics over time, location, and evolving symptoms. The surgical risks must be balanced vis-à-vis the risk of missing a high-grade tumor and the very rare risk of malignant transformation.

Incidence and clinical significance of postoperative delirium after brain tumor surgery

Delirium is an acute and reversible deterioration of mental state. Postoperative delirium (POD) can develop after surgical procedures and is associated with impaired health status and worse recovery. So far, there is little data about postoperative delirium after brain surgery. The aim of this study was to evaluate frequency, risk factors, and prognostic value of POD in predicting short-term postoperative outcomes after brain tumor surgery. Five-hundred and twenty-two patients who underwent elective brain tumor surgery in 2010-2017 were included in this prospective study. Patients were monitored for POD using the Confusion Assessment Method for the ICU (CAM-ICU) for 2 to 7days after the surgery. At hospital discharge, outcomes were evaluated using the Glasgow Outcome Scale (GOS). POD was diagnosed in 22 (4.2%) patients. Risk factors of POD were low level of hemoglobin, poor functional status at time of admission, low education level and older age (65years and older). POD incidence was not associated with brain tumor laterality, location, extent of resection, histological diagnosis, or affected brain lobe. POD was associated with greater risk for unfavorable outcomes at hospital discharge (OR = 5.3; 95% CI [2.1-13.4], p = 0.001). POD is not a common complication after elective brain tumor surgery. Older age, poor functional status, low education level and anemia are associated with greater POD risk. Extent of surgical intervention and brain tumor location are not associated with POD risk. POD is associated with worse outcome at hospital discharge.

Multiple Brain Developmental Venous Anomalies as a Marker for Constitutional Mismatch Repair Deficiency Syndrome.

Biallelic constitutional mutations in DNA mismatch repair genes cause a distinct syndrome, constitutional mismatch repair deficiency syndrome (CMMRD), characterized by cancers from multiple organs, most commonly brain tumors, during childhood. Surveillance protocols include total and brain MR imaging among other modalities to enable early detection of tumors. Brain surveillance scans revealed prominent brain developmental venous anomalies (DVAs) in some patients. DVAs are benign vascular anomalies, and their incidence in the general population is 2.6%-6.4%. Most developmental venous anomalies are asymptomatic and are found incidentally. Our purpose was to assess the prevalence of DVAs in CMMRD patients and describe their phenotype. A retrospective descriptive analysis of brain MR imaging studies from 10 patients from 3 families with CMMRD was performed. Analysis included the number of developmental venous anomalies, location, draining vessels, and associated vascular anomalies (ie, cavernomas), with clinical correlation of symptoms and tumors. All 10 patients had ≥2 developmental venous anomalies, and 2 had, in addition, non-therapy-induced cavernomas. There was no clinically symptomatic intracranial bleeding from developmental venous anomalies. Six patients had malignant brain tumors. The location of brain tumors was not adjacent to the developmental venous anomalies. No new developmental venous anomalies developed during follow-up. The occurrence of multiple developmental venous anomalies in all our patients with CMMRD suggests that developmental venous anomalies may be a characteristic of this syndrome that has not been previously described. If confirmed, this quantifiable feature can be added to the current scoring system and could result in early implementation of genetic testing and surveillance protocols, which can be life-saving for these patients.

T132. Connectivity analysis of glioma patients with language disturbances

Language production involves a complex brain network that should be taken into account in pre-surgical planning of patients with brain tumors. Connectivity analysis (functional and structural) of magnetic resonance imaging data (cMRI) enables the study of the functional interaction and structural relationship between brain regions. Our goal was to correlate cMRI data with clinical manifestations of language disturbances We recruited sixteen patients (mean age of 47 years old; 8 female) diagnosed with low and high grade brain gliomas (47%) located in frontal (57%), temporal (17%), parietal (13%) lobes and in the insular region (13%). They performed pre-operative clinical language tests, structural (diffusion tensor imaging – DTI), and functional MRI (fMRI) using a battery of language paradigms. We extracted connectivity metrics (i.e. node degree, betweeness centrality, partition coefficient, and clustering coefficient) from thirteen brain regions and normalized the data (i.e. using mean and standard deviation) within each region and across patients. For a set of brain regions involved in language processing (i.e. opercular, supramarginal and superior temporal gyrus), we evaluated the correlation between local connectivity metrics and brain tumor location, language clinical tests and the outcome of cortical stimulation during awake craniotomy (i.e. whether it produced language disturbances). We analyzed seventeen MRI datasets (i.e. one patient received treatment twice and three others had previously performed craniotomies) including DTI data in only twelve patients. Clinically, three presented conduction aphasia (two with temporal and one with a frontal lobe tumor), four had anomic aphasia (two with frontal, one with insular and another with temporal lobe tumor) and two with expressive aphasia with frontal lobe tumors. The extracted metrics failed to correlate with tumor location. Language tests correlated with higher partition (r = 0.75) coefficient of opercular or supramarginal gyrus. Cortical stimulation at opercular or supramarginal gyrus correlated either with a higher clustering (r = 0.68) or lower partition (r = −0.64) coefficient in supramarginal or opercular gyri, respectively. cMRI from DTI and task-based language paradigms correlates with clinical evaluation language tests as expected. Also, connectivity measures suggest a homo-lateral compensation in the language network when opercular or supramarginal gyri are affected besides contralateral as reported in literature.

Surgery in elderly patients with intracranial meningioma: neuropsychological functioning during a long term follow-up.

Surgical treatment of elderly patients with meningioma is has proved to be safe, especially when patients are selected using dedicated surgical scores. These scores take into account tumor size, edema, location and patient's co-morbidities. Neuropsychological functioning (NPF) of this kind of patients has been poorly studied in literature and it is not taken into account by these scores. Aim of our study was to describe the long-term outcome in terms of NPF of elderly patients undergoing surgery. Patients older than 70years of age affected by intracranial meningioma and selected with the Clinical-Radiological Grading Score were included in our study. Neuropsychological testing was performed using a dedicated battery of tests before surgery, 3 and 12months after surgery. Clinical, neurological and radiological outcomes were studied as well. Forty-one patients with a median age of 74years were included in this study. Preoperatively only 1/41 patients showed a normal NPF with all tests scoring normally. Four out of 39 patients showed a complete neuropsychological recovery after 3 months; while 10/37 patients had a complete recovery after 12months. NPF showed a trend of progressive improvement after surgery. Our study is the first experience reported in literature describing a long term follow-up in elderly patients after surgery for intracranial meningioma. In our series, surgery determined an improvement of NPF over time; especially with a low complication rate related to the selection of patients obtained through the CRGS. Further studies need to be performed in order to understand how brain edema, tumor size, volume and tumor location affect NPF in both short and long term.

Segmentation Method for Pathological Brain Tumor and Accurate Detection using MRI

Image segmentation is challenging task in field of medical image processing. Magnetic resonance imaging is helpful to doctor for detection of human brain tumor within three sources of images (axil, corneal, sagittal). MR images are nosier and detection of brain tumor location as feature is more complicated. Level set methods have been applied but due to human interaction they are affected so appropriate contour has been generated in discontinuous regions and pathological human brain tumor portion highlighted after applying binarization, removing unessential objects; therefore contour has been generated. Then to classify tumor for segmentation hybrid Fuzzy K Mean-Self Organization Mapping (FKM-SOM) for variation of intensities is used. For improved segmented accuracy, classification has been performed, mainly features are extracted using Discrete Wavelet Transformation (DWT) then reduced using Principal Component Analysis (PCA). Thirteen features from every image of dataset have been classified for accuracy using Support Vector Machine (SVM) kernel classification (RBF, linear, polygon) so results have been achieved using evaluation parameters like Fscore, Precision, accuracy, specificity and recall.

Association between psychological distress, subjective cognitive complaints and objective neuropsychological functioning in brain tumor patients

ObjectivesPsychological distress and cognitive impairment are common complications in patients with brain tumors that are associated with poor quality of life and worse prognosis. This pilot study aimed to evaluate the associations between psychological distress, subjective cognitive complaints and baseline neuropsychological performance of brain tumor patients before neurosurgery. Patients and methodsSixty-two patients with various brain tumors referred for routine neuropsychological assessment 2–3days before neurosurgery participated in the study. Short neuropsychological assessment battery was used to evaluate attention and executive functions, memory and verbal fluency. Presence of cognitive complaints was evaluated during neuropsychological interview using standardized symptoms checklist. Level of psychological distress was assessed using the Hospital Anxiety and Depression Scale. ResultsVarious attention and executive function problems were reported by 13–58% patients; memory problems by 8–63%; language problems by 10–58% of patients. 36–57% of patients scored below 5th percentile on objective memory measures; 32–45% on attention measures and 11–27% on verbal fluency. However, correlation between objective neuropsychological findings and subjective cognitive complaints was weak, ranging from 0.0 to 0.3. 45% of patients met criteria for increased psychological distress. Psychological distress was associated with subjective cognitive complaints but failed to predict objective neuropsychological findings. Brain tumor histological diagnosis, side and location were not related to neuropsychological functioning. ConclusionCognitive impairment and psychological distress are highly prevalent in BT patients before neurosurgery. Although depression and distress may adversely impact quality of life and prognosis of BT patients, our current findings do not confirm that distress has strong negative impact on objective preoperative cognitive functioning. However, it is related to worse subjective evaluation of one’s cognitive abilities. Therefore, objective neuropsychological assessment of cognitive functions is highly recommended despite concern.

Impact of the Brain Tumor Location on Functional Capacity of the of Patient

Introduction. The vast majority of lesions of the nervous system are located intra cranially. Their location in each brain structure results in the appearance of different deficits affecting the functional capacity of patients, and ultimately their quality of life.Aim. The aim of the study is to investigate the effect of tumor location on the functional capacity of patients with such tumors in the preoperative and postoperative periods.Material and Methods. Material includes 236 patients hospitalized in the Department of Neurosurgery 10th Military Hospital with Policlinic IP HCC Bydgoszcz. The research was approved by the Bioethics Committee at Collegium Medicum in Bydgoszcz (KB 222/2011). The analysis included 5 subgroups of patients taking into account the location of intracranial lesions in these patients. There were defined: a group of patients with tumors located in the temporal lobe (1), frontal lobe (2), parietal lobe (3), cerebral chamber (4), and cerebral lesions (5). The functional capacity was assessed by the KPS Scale (Karnofsky’s Performance Scale) (three times: on the day of admission to the Clinic, on the 5th and 30th day after the surgery) and by the GOS Scale (Glasgow’s Outcome Scale) (twice: on the 5th and 30th day following the surgery).Results. On the fifth day of the postoperative period, a statistically significant decrease in the functional capacity was observed in patients with tumors located in the cerebral, the extra cranial tumors, in the frontal and temporal lobes (p&lt;0.05). In the postoperative period, significant increase in functioning was observed in patients with ventricular tumors cerebral and extra cranial (p&lt;0.05). The final outcome of the treatment was improved on the 30th day in patients with extra cranial tumors (p&lt;0.05).Conclusions. In the early postoperative period the functional capacity of most patients decreases, and the lowest functional capacity decline is observed in patients with parietal lobe tumors. 30 days after the surgery, the functionality of the patients increases, particularly with tumors located in the cerebral cortex as well as with extra cranial tumors. (JNNN 2017;6(2):66–72)

Brain tumor location influences the onset of acute psychiatric adverse events of levetiracetam therapy: an observational study.

To explore possible correlations among brain lesion location, development of psychiatric symptoms and the use of antiepileptic drugs (AEDs) in a population of patients with brain tumor and epilepsy. The medical records of 283 patients with various types of brain tumor (161 M/122 F, mean age 64.9years) were analysed retrospectively. Patients with grade III and IV glioma, previous history of epileptic seizures and/or psychiatric disorders were excluded. Psychiatric symptoms occurring after initiation of AED therapy were considered as treatment emergent psychiatric adverse events (TE-PAEs) if they fulfilled the following conditions: (1) onset within 4weeks after the beginning of AED therapy; (2) disappearance on drug discontinuation; (3) absence of any other identified possible concurrent cause. The possible influence of the following variables were analysed: (a) AED drug and dose; (b) location and neuroradiologic features of the tumor, (c) location and type of EEG epileptic abnormalities, (d) tumor excision already or not yet performed; (e) initiation or not of radiotherapy. TE-PAEs occurred in 27 of the 175 AED-treated patients (15.4%). Multivariate analysis showed a significant association of TE-PAEs occurrence with location of the tumor in the frontal lobe (Odds ratio: 5.56; 95% confidence interval 1.95-15.82; p value: 0.005) and treatment with levetiracetam (Odds ratio: 3.61; 95% confidence interval 1.48-8.2; p value: 0.001). Drug-unrelated acute psychiatric symptoms were observed in 4 of the 108 AED-untreated patients (3.7%) and in 7 of the 175 AED-treated patients (4%). The results of the present study suggest that an AED alternative to levetiracetam should be chosen to treat epileptic seizures in patients with a brain tumor located in the frontal lobe to minimize the possible onset of TE-PAEs.

Clinical Profile of Brain Tumour in Children

Background: This study was designed to evaluate the clinical profile and location of brain tumours in children so that brain tumour cases could be diagnosed and managed earlier.Materials and Methods: This cross sectional study was carried out from April 2011 to April 2012. A total 50 clinically suspected cases of brain tumour and supported by MRI were enrolled in this study.Results: Brain tumour of children was predominant in male where male to female ratio was almost 1.9:1. Supratentorial and Infratentorial brain tumour were found in 36% and 64% cases respectively in children. According to MRI findings in the supratentorial location, craniopharyngioma were commonest (50%) followed by cerebral astrocytoma (22.2%). In the infratentorial region, medulloblastoma was observed in (40.6%), followed by cerebellar astrocytoma (31.3%). Vertigo, weakness of limbs were found in 46.9% and 87.5% cases respectively in infratentorial group which were significantly (p&lt;0.05) higher than supratentorial group. Growth failure and behavioral change were found in 16.7% and 22.2% cases respectively in supratentorial which were significantly (p&lt;0.05) higher than infratentorial group. Papilloedema, reduced muscle power, increased muscle tone, exaggerated deep reflexes, clonus, gait disturbance and cerebellar signs were significantly (p&lt;0.05) higher in infratentorial group.Conclusion: Craniopharyngioma and medulloblastoma were more common findings in MRI evaluation in the supratentorial and infratentorial location respectively. Growth failure and behavioral change were found higher in supratentorial than infratentorial group. Vertigo, weakness of limbs, papilloedema, reduced muscle power, increased muscle tone, exaggerated deep reflexes, clonus, gait disturbance and cerebellar signs were higher in infratentorial group.J Shaheed Suhrawardy Med Coll, June 2016, Vol.8(1); 8-12

An efficient approach for brain image (tissue) compression based on the position of the brain tumor

Medical image processing plays an important role in brain tissue detection and segmentation. In this paper, a computer aided detection of brain tissue compression based on the estimation of the location of the brain tumor. The proposed system detects and segments the brain tissues and brain tumor using mathematical morphological operations. Further, the brain tissue with tumor is compressed using lossless compression technique and the brain tissue without tumor is compressed using lossy compression technique. The proposed method achieves 96.46% sensitivity, 99.20% specificity and 98.73% accuracy for the segmentation of white matter regions from the brain. The proposed method achieves 98.16% sensitivity, 99.36% specificity and 98.78% accuracy for the segmentation of cerebrospinal fluid CSF regions from the brain and also achieves 93.07% sensitivity, 98.79% specificity and 97.63% accuracy for the segmentation of grey matter regions from the brain. This paper focus the brain tissue compression based on the location of brain tumor. The grey matter of the brain is applied to lossless compression due to the presence of the tumor in grey matter of the brain. The proposed system achieves 29.23% of compression ratio for compressing the grey matter of the brain region. The white matter and CSF regions of the brain are applied to lossy compression due to the non-presence of the tumor. The proposed system achieves 39.13% of compression ratio for compressing the white matter and also achieves 37.5% of compression ratio for compressing the CSF tissue. © 2016 Wiley Periodicals, Inc. Int J Imaging Syst Technol, 26, 237-242, 2016

5-ALA Photodynamic Therapy in Neurosurgery, Towards the Design of a Treatment Planning System: A Proof of Concept

Purpose. Glioblastoma (GBM) treatment still remains a complex challenge. Among alternatives or adjuvant therapies, photodynamic therapy (5-ALA PDT) appears to be a promising approach. 5-ALA PDT can be delivered intraoperatively, early after tumor resection, or interstitially according to brain tumor location. A treatment planning system was designed to manage dosimetry issues before PDT delivery.Methods. The TPS was developed according to a specific workflow from stereotactic image registration to light fluence rate modeling. Here, we describe a proof of concept of a treatment planning system (TPS) dedicated to interstitial 5-ALA PDT. This tool enables the planning of a whole treatment in surgical stereotactic conditions. Stereotactic registration and dosimetry components are detailed and evaluated. The registration process is compared to a commercial solution (Leksell Gamma Plan®, Elekta®, Sweden) defined as the ground truth and dosimetry model implemented in our TPS and is compared to numerical simulations.Results. Registration achieved a sub-millimetric mean relative error that matched the standard MRI resolution. Dosimetry comparison showed a negligible error between analytical and numerical models and enabled a validation of the dosimetry algorithm implemented.Conclusions. A treatment planning system was designed to achieve 5-ALA PDT simulations before the patients underwent surgery. Similarly, for radiation therapy, we proposed a system to plan and evaluate the 5-ALA PDT dosimetry for optimizing treatment delivery. Although this system remains to be perfected, this preliminary work aimed to demonstrate the feasibility of planning 5-ALA PDT treatments in stereotactic conditions. Future improvements will mainly focus on the optimization of the treatment delivery, automatic segmentation and GPU-accelerated Monte-Carlo management to take into account GBM tissue heterogeneity.