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Background: Glioma tumor is the most common primary brain tumor and extent of resection of this tumor plays a significant role in the survival rate of the patients. Intraoperative ultrasound (IOUS) has become a convenient technique in brain tumor surgery due to its non-invasiveness, affordability, and real-time imaging capabilities, making it appealing to neurosurgeons, and assists neurosurgeons in identifying the tumor's location and adjacent structures during surgery. Materials & Method: This study was done prospectively, in Rasul Akram and Shahada-ye-Haftam Tir hospitals, Tehran, Iran, and evaluated IOUS's use in 20 patients with brain glioma between 2019 and 2022. Simple random sampling was used to select patients. The resection was performed using IOUS, and the extent of resection was assessed through imaging. We used SonoSite convex ultrasound probe with bandwidth of 10-3 MHz and scan depth of 3 to 18 cm. Results: The study found that with ultrasound guidance, the average mass resection rate was 89.3%. The use of ultrasound during surgery improved the resection rate compared to previous studies. Motor complications observed in 15% of patients after surgery included paralysis and verbal deficits, while the rate of meningitis was low. The average length of hospitalization for patients was 10 days, and the average intraoperative bleeding was 344 cubic centimeters. Conclusion: Ultrasound can be a valuable tool in resection of brain glioma as it provides real-time imaging and assists in tumor resection, and detect adjacent structures. However, it should be used in conjunction with other monitoring modalities. Further studies are necessary to explore the full potential and limitations of IOUS in neurosurgery. [ABSTRACT FROM AUTHOR]

Glioblastoma is the most common form of brain cancer in adults that produces severe damage to the brain leading to a very poor survival prognosis. The standard of care for glioblastoma is usually surgery, as well as radiotherapy followed by systemic temozolomide chemotherapy, resulting in a median survival time of about 12 to 15 months. Despite these therapeutic efforts, the tumor returns in the vast majority of patients. When relapsing, statistics suggest an imminent death dependent on the size of the tumor, the Karnofsky Performance Status, and the tumor localization. Following the standard of care, the administration of Bevacizumab, inhibiting the growth of the tumor vasculature, is an approved medicinal treatment option approved in the United States, but not in the European Union, as well as the recently approved alternating electric fields (AEFs) generator NovoTTF/Optune. However, it is clear that regardless of the current treatment regimens, glioma patients continue to have dismal prognosis and novel treatments are urgently needed. Here, we describe different approaches of recently developed therapeutic glioma brain cancer vaccines, which stimulate the patient's immune system to recognize tumor-associated antigens (TAA) on cancer cells, aiming to instruct the immune system to eventually attack and destroy the brain tumor cells, with minimal bystander damage to normal brain cells. These distinct immunotherapies may target particular glioma TAAs which are molecularly defined, but they may also target broad patient-derived tumor antigen preparations intentionally evoking a very broad polyclonal antitumor immune stimulation.

IntroductionCancer bioenergetics is an essential hallmark of neoplastic transformation. Warburg postulated that mitochondrial OXPHOS is impaired in cancer cells, leading to aerobic glycolysis as the primary metabolic pathway. However, mitochondrial function is altered but not entirely compromised in most malignancies, and that mitochondrial uncoupling is known to increase the carcinogenic potential and modifies treatment response by altering metabolic reprogramming. Our earlier study showed that transient DNP exposure increases glycolysis in human glioma cells (BMG-1). The current study investigated the persistent effect of DNP on the energy metabolism of BMG-1 cells and its influence on tumor progression in glioma xenografts.MethodsBMG-1 cells were treated with 2,4-dinitrophenol (DNP) in-vitro, to establish the OXPHOS-modified (OPM-BMG) cells. Further cellular metabolic characterization was carried out in both in-vitro cellular model and in-vivo tumor xenografts to dissect the role of metabolic adaptation in these cells and compared them with their parental phenotype. Results and DiscussionChronic exposure to DNP in BMG-1 cells resulted in dual-state hyper-energy metabolism with elevated glycolysis++ and OXPHOS++ compared to parental BMG-1 cells with low glycolysis+ and OXPHOS+. Tumor xenograft of OPM-BMG cells showed relatively increased tumor-forming potential and accelerated tumor growth in nude mice. Moreover, compared to BMG-1, OPM-BMG tumor-derived cells also showed enhanced migration and invasion potential. Although mitochondrial uncouplers are proposed as a valuable anti-cancer strategy; however, our findings reveal that prolonged exposure to uncouplers provides tumor growth advantage over the existing glioma phenotype that may lead to poor clinical outcomes.

Diffusion MRI is widely used for the clinical examination of a variety of diseases of the nervous system. However, clinical MRI scanners are mostly capable of magnetic field gradients in the range of 20–80 mT/m and are thus limited in the detection of small tissue structures such as determining axon diameters. The availability of high gradient systems such as the Connectome MRI scanner with gradient strengths up to 300 mT/m enables quantification of the reduction of the apparent diffusion coefficient and thus resolution of a wider range of diffusion coefficients. In addition, biological tissues are heterogenous on many scales and the complexity of tissue microstructure may not be accurately captured by models based on pre-existing assumptions. Thus, it is important to analyze the diffusion distribution without prior assumptions of the underlying diffusion components and their symmetries. In this paper, we outline a framework for analyzing diffusion MRI data with b-values up to 17,800 s/mm2 to obtain a Full Diffusion Tensor Distribution (FDTD) with a wide variety of diffusion tensor structures and without prior assumption of the form of the distribution, and test it on a healthy subject. We then apply this method and use a machine learning method based on K-means classification to identify features in FDTD to visualize and characterize tissue heterogeneity in two subjects with diffuse gliomas.

Classification of brain tumor is one of the most vital tasks within medical image processing. Classification of images greatly depends on the features extracted from the image, and thus, feature extraction plays a great role in the correct classification of images. In this paper, an enhanced method is presented for glioma MR images classification using hybrid statistical and wavelet features. In the proposed method, 52 features are extracted using the first-order and second-order statistical features (based on the four MRI modalities: Flair, T1, T1c, and T2) in addition to the discrete wavelet transform producing a total of 152 features. The extracted features are applied to the multilayer perceptron (MLP) classifier. The results using the MLP were compared with various known classifiers. The method was tested on the dataset MICCAI BraTS 2015 which is a standard dataset used for research purposes. The proposed hybrid statistical and wavelet features produced 96.72% accuracy for high-grade glioma and 96.04% accuracy for low-grade glioma, which are relatively better compared to the existing studies.

Background: The most common primary tumors of the brain are gliomas. Despite improvements in treatment strategy, the prognosis for patients with high-grade gliomas has stayed poor, while it is relatively good for low-grade gliomas. The main and gold standard way for grading glial tumor is biopsy. Accurate assessment of tumor grade is vital for the determination of best treatment plan. The purpose of this study was to evaluate the role of diffusion tensor imaging (as a noninvasive method) using relative anisotropy (RA) in glial tumor grading. Methods: A total of 20 histologically confirmed gliomas patients were scanned using a 1.5-Tesla magnetic resonance scanner. We described two regions of interest (ROIs), white matter adjacent to the tumor and the homologous fiber tracts to first ROI in the contralateral hemisphere. Findings: The relative anisotropy values and ratio of the low-grade gliomas tended to be higher than those of the high-grade gliomas in the peritumoral fibers (P = 0.008, for RAt and P = 0.039 for RAt/n). Conclusion: Our findings prove that the relative anisotropy was different between low- and high-grade gliomas, which may be helpful in grading.

Objective: Despite advances in surgical and adjuvant radiation therapy and chemotherapy strategies, malignant gliomas continue to be associated with poor prognosis in patients. To address suitable strategies, scientists pay close attention to factors that cause angiogenesis. Angiogenesis is a possible target in the treatment of human gliomas. Genistein has been previously introduced as an anti-angiogenic agent for different cancers. To evaluate the effect of Genistein on the angiogenic cascade, we investigated the expression of hepatocyte growth factor (HGF) transcripts in mesenchymal stem cell like cells from high grade and low grade brain tumors before and after treatment with Genistein. Materials and Methods: Brain tumor obtained from patient diagnoses with GBM and low grade glioma in sterile condition, wash with PBS, cut in to small pieces, digested with collagenase type I and culture in tissue culture flask contain MDEM 10% FBS. As cells arise to passage 3, they were treated with Genistein and then the HGF gene expression was determined by QRT-PCR in treated and untreated cells. Results: Genistein has a significant effect on both types of tumors after cells expose to compound compared to untreated cells. According to the results, Genistein has a remarkable effect on downregulating HGF transcripts where it showed 13×106- and 2-fold lower expression than untreated cells in high grade and low grade glioma cells, respectively. Conclusion: Our research showed that Genistein has a significant effect on downregulation of HGF. Consequently, Genistein have some important advantages for treatment of invasive brain tumors, however more investment cannot be ignore to make a suitable decision about effect of this compound on brain tumors [ABSTRACT FROM AUTHOR]