Neuro-oncology Imaging Research Articles

Hybrid Somatostatin Receptor PET/MRI of the Head and Neck.

Hybrid PET/MRI has the potential to transform neuro-oncologic imaging, particularly in diagnosis and treatment planning of somatostatin receptor-expressing tumors of the head and neck. Hybrid PET/MRI combines high-resolution MRI with functional information from PET, providing precise anatomic information and overcoming difficulties in localization inherent to PET alone. There is a range of tumors in the head and neck that overexpress somatostatin receptors and are therefore amenable to evaluation with somatostatin receptor PET/MRI. These include meningiomas, paragangliomas, olfactory neuroblastomas, pituitary neuroendocrine tumors, middle ear neuroendocrine tumors, and medullary thyroid carcinomas. The combination of PET and MRI is superior to either modality alone and can address several unique diagnostic challenges associated with these lesions. The authors discuss the superior capabilities of somatostatin receptor PET/MRI, including improved lesion localization, more sensitive demonstration of disease extent, enhanced surveillance, optimized radiation therapy planning, and accurate prediction of response to somatostatin analog therapy. Although there are only a few dedicated PET/MRI units available in clinical practice, commercial software is now available that can automatically fuse PET/CT data with recently acquired MRI data, increasing the availability of this approach. Radiologists should be aware of the advantages of somatostatin receptor PET/MRI in evaluation of head and neck tumors as well as the potential pitfalls of this approach so that they can accurately advise clinicians and better interpret these studies. ©RSNA, 2024 See the invited commentary by Shatzkes and Strauss in this issue.

PET imaging of gliomas: Status quo and quo vadis?

PET imaging, particularly using amino acid tracers, has become a valuable adjunct to anatomical MRI in the clinical management of patients with glioma. Collaborative international efforts have led to the development of clinical and technical guidelines for PET imaging in gliomas. The increasing readiness of statutory health insurance agencies, especially in European countries, to reimburse amino acid PET underscores its growing importance in clinical practice. Integrating artificial intelligence and radiomics in PET imaging of patients with glioma may significantly improve tumor detection, segmentation, and response assessment. Efforts are ongoing to facilitate the clinical translation of these techniques. Considerable progress in computer technology developments (eg quantum computers) may be helpful to accelerate these efforts. Next-generation PET scanners, such as long-axial field-of-view PET/CT scanners, have improved image quality and body coverage and therefore expanded the spectrum of indications for PET imaging in Neuro-Oncology (eg PET imaging of the whole spine). Encouraging results of clinical trials in patients with glioma have prompted the development of PET tracers directing therapeutically relevant targets (eg the mutant isocitrate dehydrogenase) for novel anticancer agents in gliomas to improve response assessment. In addition, the success of theranostics for the treatment of extracranial neoplasms such as neuroendocrine tumors and prostate cancer has currently prompted efforts to translate this approach to patients with glioma. These advancements highlight the evolving role of PET imaging in Neuro-Oncology, offering insights into tumor biology and treatment response, thereby informing personalized patient care. Nevertheless, these innovations warrant further validation in the near future.

Abstract 5501: Novel whole slide imaging modes for imaging mass cytometry unveil extensive cellular heterogeneity in human glioma

Abstract Gliomas present a complex form of cancer that is challenging to diagnose and treat, with a median survival of just over one year after diagnosis for primary glioblastoma (GBM). GBM can occur as multi-lesion, remote, or diffuse tumors, and often contains a tumor microenvironment (TME) that is devoid of peripheral immune cells. Additional hallmark features of GBM include necrosis, hemorrhage, and pseudo palisades, making it a highly heterogeneous disease requiring further investigation. Identification of the cellular and spatial level composition of the TME is vital for interpretation of GBM disease origin, progression, prediction, and treatment. A 40-plus-marker neuro-oncology Imaging Mass Cytometry™ (IMC™) antibody panel was used to determine the cellular and structural landscape of the brain TME. We applied the panel on a tissue microarray (TMA) containing dozens of human glioma cores and uncovered the spatial distribution of over 40 distinct molecular markers. We performed imaging using two new features of the Hyperion XTi™ Imaging System that provide whole slide scanning capabilities. Ultrafast preview mode was applied to rapidly screen tumor cores for expression signatures associated with tumor immuno-oncology processes. This enabled biomarker-guided selection of areas in tumor tissue that were imaged at higher resolution and analyzed using single-cell analysis. In parallel, a high-throughput tissue mode was applied to perform a detailed scan of the brain tumor TMA followed by pixel-based analysis to unravel the spatial composition of the TME. Using tissue mode imaging, we successfully mapped the spatial location of cell populations making up human gliomas, such as neurons, astrocytes, microglia, and oligodendrocytes, across the entire TMA. Various tumor cell phenotypes, resident and infiltrating cells, and resting and activated microglia were detected across all TMA cores. Subsequent single-cell analysis of select regions of interest provided a quantitative assessment of the cellular composition of the brain TME. We classified the distinct states of neurons and quantified myeloid and lymphoid immune cell infiltration across normal, astrocytoma, and GBM tissues. Striking cellular and protein heterogeneity was observed between acquired cores, indicating the complexity of each case that is impossible to capture with low-plex visualization techniques. Therefore, IMC is a highly relevant tool capable of quantitative spatial evaluation of the high-plex protein composition in the brain TME without the complications of autofluorescence, tissue degradation, and spectral overlap. Empowered by the neuro-oncology panel and new whole slide imaging modes, IMC accelerates neurological research and provides insights into the spatial complexity of gliomas and other tumors. For research purpose only. Not for use in diagnostic procedures. Citation Format: Nick Zabinyakov, Qanber Raza, Thomas D. Pfister, Nikesh Parsotam, David Howell, Liang Lim, Christina Loh. Novel whole slide imaging modes for imaging mass cytometry unveil extensive cellular heterogeneity in human glioma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5501.

Amide proton transfer weighted imaging in pediatric neuro-oncology: initial experience.

Amide proton transfer weighted (APTw) imaging enables in vivo assessment of tissue-bound mobile proteins and peptides through the detection of chemical exchange saturation transfer. Promising applications of APTw imaging have been shown in adult brain tumors. As pediatric brain tumors differ from their adult counterparts, we investigate the radiological appearance of pediatric brain tumors on APTw imaging. APTw imaging was conducted at 3 T. APTw maps were calculated using magnetization transfer ratio asymmetry at 3.5 ppm. First, the repeatability of APTw imaging was assessed in a phantom and in five healthy volunteers by calculating the within-subject coefficient of variation (wCV). APTw images of pediatric brain tumor patients were analyzed retrospectively. APTw levels were compared between solid tumor tissue and normal-appearing white matter (NAWM) and between pediatric high-grade glioma (pHGG) and pediatric low-grade glioma (pLGG) using t-tests. APTw maps were repeatable in supratentorial and infratentorial brain regions (wCV ranged from 11% to 39%), except those from the pontine region (wCV between 39% and 50%). APTw images of 23 children with brain tumor were analyzed (mean age 12 years ± 5, 12 male). Significantly higher APTw values are present in tumor compared with NAWM for both pHGG and pLGG (p< 0.05). APTw values were higher in pLGG subtype pilocytic astrocytoma compared with other pLGG subtypes (p< 0.05). Non-invasive characterization of pediatric brain tumor biology with APTw imaging could aid the radiologist in clinical decision-making.

Advances in Neuro-Oncological Imaging: An Update on Diagnostic Approach to Brain Tumors

This study delineates the pivotal role of imaging within the field of neurology, emphasizing its significance in the diagnosis, prognostication, and evaluation of treatment responses for central nervous system (CNS) tumors. A comprehensive understanding of both the capabilities and limitations inherent in emerging imaging technologies is imperative for delivering a heightened level of personalized care to individuals with neuro-oncological conditions. Ongoing research in neuro-oncological imaging endeavors to rectify some limitations of radiological modalities, aiming to augment accuracy and efficacy in the management of brain tumors. This review is dedicated to the comparison and critical examination of the latest advancements in diverse imaging modalities employed in neuro-oncology. The objective is to investigate their respective impacts on diagnosis, cancer staging, prognosis, and post-treatment monitoring. By providing a comprehensive analysis of these modalities, this review aims to contribute to the collective knowledge in the field, fostering an informed approach to neuro-oncological care. In conclusion, the outlook for neuro-oncological imaging appears promising, and sustained exploration in this domain is anticipated to yield further breakthroughs, ultimately enhancing outcomes for individuals grappling with CNS tumors.

Computational Fractal-Based Analysis of MR Susceptibility-Weighted Imaging (SWI) in Neuro-Oncology and Neurotraumatology.

Susceptibility-weighted imaging (SWI) is a magnetic resonance imaging (MRI) technique able to depict the magnetic susceptibility produced by different substances, such as deoxyhemoglobin, calcium, and iron. The main application of SWI in clinical neuroimaging is detecting microbleedings and venous vasculature. Quantitative analyses of SWI have been developed over the last few years, aimed to offer new parameters, which could be used as neuroimaging biomarkers. Each technique has shown pros and cons, but no gold standard exists yet. The fractal dimension (FD) has been investigated as a novel potential objective parameter for monitoring intratumoral space-filling properties of SWI patterns. We showed that SWI patterns found in different tumors or different glioma grades can be represented by a gradient in the fractal dimension, thereby enabling each tumor to be assigned a specific SWI fingerprint. Such results were especially relevant in the differentiation of low-grade versus high-grade gliomas, as well as from high-grade gliomas versus lymphomas.Therefore, FD has been suggested as a potential image biomarker to analyze intrinsic neoplastic architecture in order to improve the differential diagnosis within clinical neuroimaging, determine appropriate therapy, and improve outcome in patients.These promising preliminary findings could be extended into the field of neurotraumatology, by means of the application of computational fractal-based analysis for the qualitative and quantitative imaging of microbleedings in traumatic brain injury patients. In consideration of some evidences showing that SWI signals are correlated with trauma clinical severity, FD might offer some objective prognostic biomarkers.In conclusion, fractal-based morphometrics of SWI could be further investigated to be used in a complementary way with other techniques, in order to form a holistic understanding of the temporal evolution of brain tumors and follow-up response to treatment, with several further applications in other fields, such as neurotraumatology and cerebrovascular neurosurgery as well.

APT weighted imaging in diffuse gliomas.

Amide proton transfer-weighted (APTw) imaging is a non-invasive molecular MRI technique with a wide range of applications in neuroradiology and particularly neuro-oncology imaging. More than 15 years of pre-clinical experiments and clinical studies have demonstrated that APTw metrics are reproducible and reliable, leading to large-scale clinical acceptance. At present, major vendors of MRI scanners provide APTw sequences upon request. However, most neuroradiologists are unfamiliar with this advanced MRI contrast, its related metrics, and its established added value to patient care. In this manuscript, we present the APTw contrast and illustrate its clinical potential for glioma patients, before and after tumor therapy. We also show common artifacts of APTw imaging and discuss potential limitations and future refinements. Our goal is to suggest how this emerging technique can aid in diffuse gliomas work-up.

Molecular Imaging of Glial Tumors: Established and Emerging Tracers

AbstractVarious positron emission tomography (PET) tracers have been developed and extensively studied in the field of neuro-oncology imaging. In the management of brain tumors, accurate delineation of tumor extent, assessment of treatment response, and detection of early recurrence are the most important factors. At present, conventional anatomical imaging paired with amino acid tracer PET imaging is the recommended imaging modality for glial tumor evaluation. Newer PET tracers targeting various structures in the tumor microenvironment have been extensively studied. This review summarizes the established and emerging PET tracers having potential impact on neuro-oncology practice.

Tumor Response Metrics in Neuro-Oncology: A Review

Despite the efforts spent in clinical trials in neuro-oncology during the last few decades, many challenges remain in the radiologic evaluation of brain tumors and metastases. This article aims to explain the current use of tumor metrics, especially in phase II clinical trials, to evaluate response to systemic therapy in neuro-oncology. We will discuss the imaging findings associated with progression and with partial, minor, or complete response to treatment, as well as the method of measurement, the distinction between disease-related and treatment-related changes, and inclusion of clinical symptoms to define treatment response and progression. The evaluation of response in brain tumors requires metrics that account for differences in response between high- and low-grade gliomas and specific tumor behaviors associated with radiation and immunotherapy, among other pitfalls. Advanced brain imaging techniques, such as perfusion and permeability imaging, should be incorporated into clinical trials to measure response to novel therapeutic agents more accurately.Learning Objectives: To understand the role of tumor metrics analysis and the main challenges and pitfalls of applying neuro-oncology imaging criteria

Next-generation PET/CT imaging in meningioma—first clinical experiences using the novel SSTR-targeting peptide [18F]SiTATE

BackgroundSomatostatin-receptor (SSTR)-targeted PET/CT provides important clinical information in addition to standard imaging in meningioma patients. [18F]SiTATE is a novel, 18F-labeled SSTR-targeting peptide with superior imaging properties according to preliminary data. We provide the first [18F]SiTATE PET/CT data of a large cohort of meningioma patients.MethodsPatients with known or suspected meningioma undergoing [18F]SiTATE PET/CT were included. Uptake intensity (SUV) of meningiomas, non-meningioma lesions, and healthy organs were assessed using a 50% isocontour volume of interest (VOI) or a spherical VOI, respectively. Also, trans-osseous extension on PET/CT was assessed.ResultsA total of 107 patients with 117 [18F]SiTATE PET/CT scans were included. Overall, 231 meningioma lesions and 61 non-meningioma lesions (e.g., post-therapeutic changes) were analyzed. Physiological uptake was lowest in healthy brain tissue, followed by bone marrow, parotid, and pituitary (SUVmean 0.06 ± 0.04 vs. 1.4 ± 0.9 vs. 1.6 ± 1.0 vs. 9.8 ± 4.6; p < 0.001). Meningiomas showed significantly higher uptake than non-meningioma lesions (SUVmax 11.6 ± 10.6 vs. 4.0 ± 3.3, p < 0.001). Meningiomas showed significantly higher uptake than non-meningioma lesions (SUVmax 11.6±10.6 vs. 4.0±3.3, p<0.001). 93/231 (40.3%) meningiomas showed partial trans-osseous extension and 34/231 (14.7%) predominant intra-osseous extension. 59/231 (25.6%) meningioma lesions found on PET/CT had not been reported on previous standard imaging.ConclusionThis is the first PET/CT study using an 18F-labeled SSTR-ligand in meningioma patients: [18F]SiTATE provides extraordinary contrast in meningioma compared to healthy tissue and non-meningioma lesions, which leads to a high detection rate of so far unknown meningioma sites and osseous involvement. Having in mind the advantageous logistic features of 18F-labeled compared to 68Ga-labeled compounds (e.g., longer half-life and large-badge production), [18F]SiTATE has the potential to foster a widespread use of SSTR-targeted imaging in neuro-oncology.

Modern preoperative imaging and functional mapping in patients with intracranial glioma.

Magnetic resonance imaging (MRI) in therapy-naïve intracranial glioma is paramount for neuro-oncological diagnostics, and it provides images that are helpful for surgery planning and intraoperative guidance during tumor resection, including assessment of the involvement of functionally eloquent brain structures. This study reviews emerging MRI techniques to depict structural information, diffusion characteristics, perfusion alterations, and metabolism changes for advanced neuro-oncological imaging. In addition, it reflects current methods to map brain function close to a tumor, including functional MRI and navigated transcranial magnetic stimulation with derived function-based tractography of subcortical white matter pathways. We conclude that modern preoperative MRI in neuro-oncology offers a multitude of possibilities tailored to clinical needs, and advancements in scanner technology (e. g., parallel imaging for acceleration of acquisitions) make multi-sequence protocols increasingly feasible. Specifically, advanced MRI using a multi-sequence protocol enables noninvasive, image-based tumor grading and phenotyping in patients with glioma. Furthermore, the add-on use of preoperatively acquired MRI data in combination with functional mapping and tractography facilitates risk stratification and helps to avoid perioperative functional decline by providing individual information about the spatial location of functionally eloquent tissue in relation to the tumor mass. KEY POINTS:: · Advanced preoperative MRI allows for image-based tumor grading and phenotyping in glioma.. · Multi-sequence MRI protocols nowadays make it possible to assess various tumor characteristics (incl. perfusion, diffusion, and metabolism).. · Presurgical MRI in glioma is increasingly combined with functional mapping to identify and enclose individual functional areas.. · Advancements in scanner technology (e. g., parallel imaging) facilitate increasing application of dedicated multi-sequence imaging protocols.. CITATION FORMAT: · Sollmann N, Zhang H, Kloth C et al. Modern preoperative imaging and functional mapping in patients with intracranial glioma. Fortschr Röntgenstr 2023; 195: 989 - 1000.

Abstract 676: Neuro-oncology imaging mass cytometry panels enable spatial investigation of brain tumor microenvironment

Abstract Brain neoplasms represent a complex form of cancer that is one of the most challenging to classify and treat. Over 120 different tumor subtypes originate from various parts of the central nervous system, which makes identifying the composition of the tumor microenvironment (TME) vital for early assessment of progression, treatment, and prevention. We developed high-plex proteomic analysis tools to thoroughly characterize the TME of both human and mouse brain tissues using Imaging Mass Cytometry™ (IMC™). IMC offers unprecedented insight into the TME by uncovering the spatial distribution of 40-plus distinct molecular markers without autofluorescence, facilitating the research of brain neoplasms. Here, we demonstrate the application of high-plex human and mouse neuro-oncology IMC panels on normal and tumor formalin-fixed paraffin-embedded brain tissues. A basic neurophenotyping panel was developed and used to customize the Maxpar® Human and Maxpar OnDemand™ Mouse Immuno-Oncology IMC Panel Kits. Human and mouse neuro-oncology panels provide deep phenotyping and characterization of brain TME composition. These neuro panels consist of cross-reactive clones and enable flexible panel design for brain-specific research goals, such as brain tumor classification, and assessment of neuronal inflammation, degeneration, and development. We applied the neuro-oncology panels on tissue microarrays (TMAs) containing a variety of human brain tumors and mouse glioblastoma and neuroblastoma tissues. Normal brain tissues were used for comparative analysis as controls. The Hyperion™ Imaging System was utilized to digitize images from the tissues followed by quantitative analysis to assess the cellular composition of normal and cancerous brain TME. We successfully identified major cell populations that make up human and mouse brain matter, such as neurons, astrocytes, microglia, and oligodendrocytes. Various tumor cell phenotypes, resident and infiltrating cells, and resting and activated microglia were detected in multiple tumor subtypes. Subsequent single-cell analysis provided a comprehensive and quantitative assessment of the brain TME in our samples. We classified the distinct states of neurons and quantified myeloid and lymphoid immune cell infiltration across normal, astrocytoma, and glioblastoma tissues. Empowered by high-plex neuro-oncology panels, IMC can accelerate brain tumor research and provide insights into the spatial complexity of neuronal neoplasms. Citation Format: Nick Zabinyakov, Qanber Raza, Christina Loh. Neuro-oncology imaging mass cytometry panels enable spatial investigation of brain tumor microenvironment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 676.

Imaging Cancer in Neuroradiology

Neuroimaging plays a pivotal role in the diagnosis, management, and prognostication of brain tumors. Recently, the World Health Organization published the fifth edition of the WHO Classification of Tumors of the Central Nervous System (CNS5), which places greater emphasis on tumor genetics and molecular markers to complement the existing histological and immunohistochemical approaches. Recent advances in computational power allowed modern neuro-oncological imaging to move from a strictly morphology-based discipline to advanced neuroimaging techniques with quantifiable tissue characteristics such as tumor cellularity, microstructural organization, hemodynamic, functional, and metabolic features, providing more precise tumor diagnosis and management. The aim of this review is to highlight the key imaging features of the recently published CNS5, outlining the current imaging standards and summarizing the latest advances in neuro-oncological imaging techniques and their role in complementing traditional brain tumor imaging and management.

Current state of pediatric neuro-oncology imaging, challenges and future directions

Imaging plays a central role in neuro-oncology including primary diagnosis, treatment planning, and surveillance of tumors. The emergence of quantitative imaging and radiomics provided an uprecedented opportunity to compile mineable databases that can be utilized in a variety of applications. In this review, we aim to summarize the current state of conventional and advanced imaging techniques, standardization efforts, fast protocols, contrast and sedation in pediatric neuro-oncologic imaging, radiomics-radiogenomics, multi-omics and molecular imaging approaches. We will also address the existing challenges and discuss future directions.

Diffusion Weighted Imaging in Neuro-Oncology: Diagnosis, Post-Treatment Changes, and Advanced Sequences-An Updated Review.

DWI is an imaging technique commonly used for the assessment of acute ischemia, inflammatory disorders, and CNS neoplasia. It has several benefits since it is a quick, easily replicable sequence that is widely used on many standard scanners. In addition to its normal clinical purpose, DWI offers crucial functional and physiological information regarding brain neoplasia and the surrounding milieu. A narrative review of the literature was conducted based on the PubMed database with the purpose of investigating the potential role of DWI in the neuro-oncology field. A total of 179 articles were included in the study.

A New Frontier in Fighting Brain Cancer: Cutting Edge Magnetic Resonance Imaging Techniques

Of the currently available brain imaging techniques for diagnosing tumors, diffusion-weighted MRI and perfusion MRI are cutting-edge techniques and may provide improved diagnostic capacity compared to traditional techniques such as positron emission tomography. Moreover, they are fully non-invasive and avoid the exposure to radiation. While MRI in general has been used in research and medicine for decades, the more recent development of multi-modal and multiparametric imaging in neuro oncology holds much promise for the enhancement of diagnosis, prognosis, and patient-tailored treatments in this field. This review will evaluate how these various imaging techniques provide clinical value above and beyond previous techniques.

The Use of 18F-FET-PET-MRI in Neuro-Oncology: The Best of Both Worlds-A Narrative Review.

Gliomas are the most frequent primary tumors of the brain. They can be divided into grade II-IV astrocytomas and grade II-III oligodendrogliomas, based on their histomolecular profile. The prognosis and treatment is highly dependent on grade and well-identified prognostic and/or predictive molecular markers. Multi-parametric MRI, including diffusion weighted imaging, perfusion, and MR spectroscopy, showed increasing value in the non-invasive characterization of specific molecular subsets of gliomas. Radiolabeled amino-acid analogues, such as 18F-FET, have also been proven valuable in glioma imaging. These tracers not only contribute in the diagnostic process by detecting areas of dedifferentiation in diffuse gliomas, but this technique is also valuable in the follow-up of gliomas, as it can differentiate pseudo-progression from real tumor progression. Since multi-parametric MRI and 18F-FET PET are complementary imaging techniques, there may be a synergistic role for PET-MRI imaging in the neuro-oncological imaging of primary brain tumors. This could be of value for both primary staging, as well as during treatment and follow-up.

Reply: 18F-FDOPA PET for the Noninvasive Prediction of Glioma Molecular Parameters: A Radiomics Study.

REPLY: We read with interest the letter to the editor by Langen and colleagues in response to our recent study published in The Journal of Nuclear Medicine ([1][1]). We agree with them that radiomics analysis is a promising approach for PET imaging in neurooncology, although its application in

PET Imaging in Neuro-Oncology: An Update and Overview of a Rapidly Growing Area.

Simple SummaryPositron emission tomography (PET) is a functional imaging technique which plays an increasingly important role in the management of brain tumors. Owing different radiotracers, PET allows to image different metabolic aspects of the brain tumors. This review outlines currently available PET radiotracers and their respective indications in neuro-oncology. It specifically focuses on the investigation of gliomas, meningiomas, primary central nervous system lymphomas as well as brain metastases. Recent advances in the production of PET radiotracers, image analyses and translational applications to peptide radionuclide receptor therapy, which allow to treat brain tumors with radiotracers, are also discussed. The objective of this review is to provide a comprehensive overview of PET imaging’s potential in neuro-oncology as an adjunct to brain magnetic resonance imaging (MRI).PET plays an increasingly important role in the management of brain tumors. This review outlines currently available PET radiotracers and their respective indications. It specifically focuses on 18F-FDG, amino acid and somatostatin receptor radiotracers, for imaging gliomas, meningiomas, primary central nervous system lymphomas as well as brain metastases. Recent advances in radiopharmaceuticals, image analyses and translational applications to therapy are also discussed. The objective of this review is to provide a comprehensive overview of PET imaging’s potential in neuro-oncology as an adjunct to brain MRI for all medical professionals implicated in brain tumor diagnosis and care.

Artificial Intelligence in Neuro-Oncologic Imaging: A Brief Review for Clinical Use Cases and Future Perspectives.

The artificial intelligence (AI) techniques, both deep learning end-to-end approaches and radiomics with machine learning, have been developed for various imaging-based tasks in neuro-oncology. In this brief review, use cases of AI in neuro-oncologic imaging are summarized: image quality improvement, metastasis detection, radiogenomics, and treatment response monitoring. We then give a brief overview of generative adversarial network and potential utility of synthetic images for various deep learning algorithms of imaging-based tasks and image translation tasks as becoming new data input. Lastly, we highlight the importance of cohorts and clinical trial as a true validation for clinical utility of AI in neuro-oncologic imaging.