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Article ; Online: The ESMO-EANO clinical practice guidelines for neurological and vascular complications of primary and secondary brain tumours: a valuable tool for clinicians.

Sepúlveda-Sánchez, J M / Pérez-Núñez, A

Annals of oncology : official journal of the European Society for Medical Oncology

2020 Volume 32, Issue 2, Page(s) 139–141

MeSH term(s)	Brain Neoplasms/complications ; Brain Neoplasms/epidemiology ; Brain Neoplasms/therapy ; Follow-Up Studies ; Humans ; Medical Oncology
Language	English
Publishing date	2020-12-11
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	1025984-3
ISSN	1569-8041 ; 0923-7534
ISSN (online)	1569-8041
ISSN	0923-7534
DOI	10.1016/j.annonc.2020.12.005
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Zs.A 2862: Show issues

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Article ; Online: Low rCBV values in glioblastoma tumor progression under chemoradiotherapy.

Hilario, A / Salvador, E / Cardenas, A / Romero, J / Lechuga, C / Chen, Z / Martinez de Aragon, A / Perez-Nuñez, A / Hernandez-Lain, A / Sepulveda, J / Lagares, A / Toldos, O / Rodriguez-Gonzalez, V / Ramos, A

Neuroradiology

2024 Volume 66, Issue 3, Page(s) 317–323

Abstract: Purpose: After standard treatment for glioblastoma, perfusion MRI remains challenging for differentiating tumor progression from post-treatment changes. Our objectives were (1) to correlate rCBV values at diagnosis and at first tumor progression and (2) ...

Abstract	Purpose: After standard treatment for glioblastoma, perfusion MRI remains challenging for differentiating tumor progression from post-treatment changes. Our objectives were (1) to correlate rCBV values at diagnosis and at first tumor progression and (2) to analyze the relationship of rCBV values at tumor recurrence with enhancing volume, localization of tumor progression, and time elapsed since the end of radiotherapy in tumor recurrence. Methods: Inclusion criteria were (1) age > 18 years, (2) histologically confirmed glioblastoma treated with STUPP regimen, and (3) tumor progression according to RANO criteria > 12 weeks after radiotherapy. Co-registration of segmented enhancing tumor VOIs with dynamic susceptibility contrast perfusion MRI was performed using Olea Sphere software. For tumor recurrence, we correlated rCBV values with enhancing tumor volume, with recurrence localization, and with time elapsed from the end of radiotherapy to progression. Analyses were performed with SPSS software. Results: Sixty-four patients with glioblastoma were included in the study. Changes in rCBV values between diagnosis and first tumor progression were significant (p < 0.001), with a mean and median decreases of 32% and 46%, respectively. Mean rCBV values were also different (p < 0.01) when tumors progressed distally (radiation field rCBV values of 1.679 versus 3.409 distally). However, changes and, therefore, low rCBV values after radiotherapy in tumor recurrence were independent of time. Conclusion: Chemoradiation alters tumor perfusion and rCBV values may be decreased in the setting of tumor progression. Changes in rCBV values with respect to diagnosis, with low rCBV in tumor progression, are independent of time but related to the site of recurrence.
MeSH term(s)	Humans ; Adult ; Middle Aged ; Glioblastoma/diagnostic imaging ; Glioblastoma/radiotherapy ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/radiotherapy ; Neoplasm Recurrence, Local/diagnostic imaging ; Contrast Media ; Chemoradiotherapy ; Magnetic Resonance Imaging/methods
Chemical Substances	Contrast Media
Language	English
Publishing date	2024-01-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	123305-1
ISSN	1432-1920 ; 0028-3940
ISSN (online)	1432-1920
ISSN	0028-3940
DOI	10.1007/s00234-023-03279-7
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Zs.A 658: Show issues

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Article ; Online: Development of a Low-Cost Smart Sensor GNSS System for Real-Time Positioning and Orientation for Floating Offshore Wind Platform.

Revert Calabuig, Neus / Laarossi, Ismail / Álvarez González, Antonio / Pérez Nuñez, Alejandro / González Pérez, Laura / García-Minguillán, Abraham Casas

Sensors (Basel, Switzerland)

2023 Volume 23, Issue 2

Abstract: A low-cost smart sensor GNSS system has been developed to provide accurate real-time position and orientation measurements on a floating offshore wind platform. The approach chosen to offer a viable and reliable solution for this application is based on ... ...

Abstract	A low-cost smart sensor GNSS system has been developed to provide accurate real-time position and orientation measurements on a floating offshore wind platform. The approach chosen to offer a viable and reliable solution for this application is based on the use of the well-known advantages of the GNSS system as the main driver for enhancing the accuracy of positioning. For this purpose, the data reported in this work are captured through a GNSS receiver operating over multiple frequency bands (L1, L2, L5) and combining signals from different constellations of navigation satellites (GPS, Galileo, and GLONASS), and they are processed through the precise point positioning (PPP) and real-time kinematic (RTK) techniques. Furthermore, aiming to improve global positioning, the processing unit fuses the results obtained with the data acquired through an inertial measurement unit (IMU), reaching final accuracy of a few centimeters. To validate the system designed and developed in this proposal, three different sets of tests were carried out in a (i) rotary table at the laboratory, (ii) GNSS simulator, and (iii) real conditions in an oceanic buoy at sea. The real-time positioning solution was compared to solutions obtained by post-processing techniques in these three scenarios and similar results were satisfactorily achieved.
MeSH term(s)	Wind ; Interior Design and Furnishings ; Laboratories
Language	English
Publishing date	2023-01-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s23020925
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Article ; Online: Sexual-biased necroinflammation is revealed as a predictor of bevacizumab benefit in Glioblastoma.

Hiller-Vallina, Sara / Mondejar-Ruescas, Lucia / Caamaño-Moreno, Marta / Cómitre-Mariano, Blanca / Alcivar-López, Denisse / Sepulveda, Juan M / Hernández-Laín, Aurelio / Pérez-Núñez, Ángel / Segura-Collar, Berta / Gargini, Ricardo

Neuro-oncology

2024

Abstract: Background: Glioblastoma (GBM) is a highly malignant brain tumor that affects men more often than women. In addition, the former shows a poorer survival prognosis. To date the reason for this sex-specific aggressiveness remains unclear. Therefore, the ... ...

Abstract	Background: Glioblastoma (GBM) is a highly malignant brain tumor that affects men more often than women. In addition, the former shows a poorer survival prognosis. To date the reason for this sex-specific aggressiveness remains unclear. Therefore, the aim of this study is to investigate tumor processes that explain these sex differences. Methods: This was a retrospective study of GBM patients which was stratified according to sex. Cohort with 73 tumors were analyzed with immunohistochemistry, RNA-seq and RT-qPCR to characterize differences in vascular and immunological profiles. Transcriptomic profiling, GSEA and pathway enrichment analysis were used for discovery molecular pathways predominant in each group. We further investigated the therapeutic effect of Bevacizumab (VEGFA blocking antibody) in retrospective GBM cohort (36 tumors) based on sex differences. Results: We found that under hypoxic tumor conditions, two distinct tumor immuno-angiogenic ecosystems develop linked to sex differences and ESR1 expression are generated. One of these subgroups, which includes male patients with low ESR1 expression, is characterized by vascular fragility associated with the appearance of regions of necrosis and high inflammation (called necroinflamed tumors). This male-specific tumor subtype shows high inflammation related to MDSC infiltration. Using this stratification, we identified a possible group of patients who could respond to bevacizumab (BVZ) and revealed a genetic signature that may find clinical applications as a predictor of those who may benefit most from this treatment. Conclusions: This study provides a stratification based on the sexual differences in GBM, which associates the poor prognosis with the presence of immunosuppressive myeloid cells in the necrotic areas. This new stratification could change the current prognosis of GBM and identifies those who respond to BVZ treatment.
Language	English
Publishing date	2024-02-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2028601-6
ISSN	1523-5866 ; 1522-8517
ISSN (online)	1523-5866
ISSN	1522-8517
DOI	10.1093/neuonc/noae033
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Zs.A 5307: Show issues

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Article ; Online: GoRG: Towards a GPU-Accelerated Multiview Hyperspectral Depth Estimation Tool for Medical Applications.

Sancho, Jaime / Sutradhar, Pallab / Rosa, Gonzalo / Chavarrías, Miguel / Perez-Nuñez, Angel / Salvador, Rubén / Lagares, Alfonso / Juárez, Eduardo / Sanz, César

Sensors (Basel, Switzerland)

2021 Volume 21, Issue 12

Abstract: HyperSpectral (HS) images have been successfully used for brain tumor boundary detection during resection operations. Nowadays, these classification maps coexist with other technologies such as MRI or IOUS that improve a neurosurgeon's action, with their ...

Abstract	HyperSpectral (HS) images have been successfully used for brain tumor boundary detection during resection operations. Nowadays, these classification maps coexist with other technologies such as MRI or IOUS that improve a neurosurgeon's action, with their incorporation being a neurosurgeon's task. The project in which this work is framed generates an unified and more accurate 3D immersive model using HS, MRI, and IOUS information. To do so, the HS images need to include 3D information and it needs to be generated in real-time operating room conditions, around a few seconds. This work presents Graph cuts Reference depth estimation in GPU (GoRG), a GPU-accelerated multiview depth estimation tool for HS images also able to process YUV images in less than 5.5 s on average. Compared to a high-quality SoA algorithm, MPEG DERS, GoRG YUV obtain quality losses of -0.93 dB, -0.6 dB, and -1.96% for WS-PSNR, IV-PSNR, and VMAF, respectively, using a video synthesis processing chain. For HS test images, GoRG obtains an average RMSE of 7.5 cm, with most of its errors in the background, needing around 850 ms to process one frame and view. These results demonstrate the feasibility of using GoRG during a tumor resection operation.
MeSH term(s)	Algorithms ; Brain ; Brain Neoplasms ; Humans ; Magnetic Resonance Imaging
Language	English
Publishing date	2021-06-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s21124091
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Article: Predicting Regions of Local Recurrence in Glioblastomas Using Voxel-Based Radiomic Features of Multiparametric Postoperative MRI.

Cepeda, Santiago / Luppino, Luigi Tommaso / Pérez-Núñez, Angel / Solheim, Ole / García-García, Sergio / Velasco-Casares, María / Karlberg, Anna / Eikenes, Live / Sarabia, Rosario / Arrese, Ignacio / Zamora, Tomás / Gonzalez, Pedro / Jiménez-Roldán, Luis / Kuttner, Samuel

Cancers

2023 Volume 15, Issue 6

Abstract: The globally accepted surgical strategy in glioblastomas is removing the enhancing tumor. However, the peritumoral region harbors infiltration areas responsible for future tumor recurrence. This study aimed to evaluate a predictive model that identifies ... ...

Abstract	The globally accepted surgical strategy in glioblastomas is removing the enhancing tumor. However, the peritumoral region harbors infiltration areas responsible for future tumor recurrence. This study aimed to evaluate a predictive model that identifies areas of future recurrence using a voxel-based radiomics analysis of magnetic resonance imaging (MRI) data. This multi-institutional study included a retrospective analysis of patients diagnosed with glioblastoma who underwent surgery with complete resection of the enhancing tumor. Fifty-five patients met the selection criteria. The study sample was split into training (N = 40) and testing (N = 15) datasets. Follow-up MRI was used for ground truth definition, and postoperative structural multiparametric MRI was used to extract voxel-based radiomic features. Deformable coregistration was used to register the MRI sequences for each patient, followed by segmentation of the peritumoral region in the postoperative scan and the enhancing tumor in the follow-up scan. Peritumoral voxels overlapping with enhancing tumor voxels were labeled as recurrence, while non-overlapping voxels were labeled as nonrecurrence. Voxel-based radiomic features were extracted from the peritumoral region. Four machine learning-based classifiers were trained for recurrence prediction. A region-based evaluation approach was used for model evaluation. The Categorical Boosting (CatBoost) classifier obtained the best performance on the testing dataset with an average area under the curve (AUC) of 0.81 ± 0.09 and an accuracy of 0.84 ± 0.06, using region-based evaluation. There was a clear visual correspondence between predicted and actual recurrence regions. We have developed a method that accurately predicts the region of future tumor recurrence in MRI scans of glioblastoma patients. This could enable the adaptation of surgical and radiotherapy treatment to these areas to potentially prolong the survival of these patients.
Language	English
Publishing date	2023-03-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15061894
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Article ; Online: Synthetic MRI improves radiomics-based glioblastoma survival prediction.

Moya-Sáez, Elisa / Navarro-González, Rafael / Cepeda, Santiago / Pérez-Núñez, Ángel / de Luis-García, Rodrigo / Aja-Fernández, Santiago / Alberola-López, Carlos

NMR in biomedicine

2022 Volume 35, Issue 9, Page(s) e4754

Abstract: Glioblastoma is an aggressive and fast-growing brain tumor with poor prognosis. Predicting the expected survival of patients with glioblastoma is a key task for efficient treatment and surgery planning. Survival predictions could be enhanced by means of ... ...

Abstract	Glioblastoma is an aggressive and fast-growing brain tumor with poor prognosis. Predicting the expected survival of patients with glioblastoma is a key task for efficient treatment and surgery planning. Survival predictions could be enhanced by means of a radiomic system. However, these systems demand high numbers of multicontrast images, the acquisitions of which are time consuming, giving rise to patient discomfort and low healthcare system efficiency. Synthetic MRI could favor deployment of radiomic systems in the clinic by allowing practitioners not only to reduce acquisition time, but also to retrospectively complete databases or to replace artifacted images. In this work we analyze the replacement of an actually acquired MR weighted image by a synthesized version to predict survival of glioblastoma patients with a radiomic system. Each synthesized version was realistically generated from two acquired images with a deep learning synthetic MRI approach based on a convolutional neural network. Specifically, two weighted images were considered for the replacement one at a time, a T2w and a FLAIR, which were synthesized from the pairs T1w and FLAIR, and T1w and T2w, respectively. Furthermore, a radiomic system for survival prediction, which can classify patients into two groups (survival >480 days and
MeSH term(s)	Brain Neoplasms/pathology ; Glioblastoma/pathology ; Humans ; Magnetic Resonance Imaging/methods ; Retrospective Studies
Language	English
Publishing date	2022-05-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1000976-0
ISSN	1099-1492 ; 0952-3480
ISSN (online)	1099-1492
ISSN	0952-3480
DOI	10.1002/nbm.4754
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Zs.A 2869: Show issues

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Article ; Online: Correlation of radiological and immunochemical parameters with clinical outcome in patients with recurrent glioblastoma treated with Bevacizumab.

Manneh Kopp, R A / Sepúlveda-Sánchez, J M / Ruano, Y / Toldos, O / Pérez Núñez, A / Cantero, D / Hilario, A / Ramos, A / de Velasco, G / Sánchez-Gómez, P / Hernández-Laín, A

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico

2019 Volume 21, Issue 10, Page(s) 1413–1423

Abstract: Background: Some phase 2 trials had reported encouraging progression-free survival with Bevacizumab in monotherapy or combined with chemotherapy in glioblastoma. However, phase 3 trials showed a significant improvement in progression free survival ... ...

Abstract	Background: Some phase 2 trials had reported encouraging progression-free survival with Bevacizumab in monotherapy or combined with chemotherapy in glioblastoma. However, phase 3 trials showed a significant improvement in progression free survival without a benefit in overall survival. To date, there are no predictive biomarker of response for Bevacizumab in glioblastoma. Methods: We used Immunochemical analysis on tumor samples and pretreatment and post-treatment perfusion-MRI to try to identify possible predictive angiogenesis-related biomarkers of response and survival in patients with glioblastoma treated with bevacizumab in the first recurrence. We analyzed histological parameters: vascular proliferation, mitotic number and Ki-67 index; molecular factors: MGMT promoter methylation, EGFR amplification and EGFR variant III; immunohistochemical: MET, Midkine, HIF1, VEGFA, VEGF-R2, CD44, Olig2, microvascular area and microvascular density; and radiological: rCBV. Results: In the statistical analysis, no significant correlation of any histological, molecular, microvascular or radiological parameters could be demonstrated with the response rate, PFS or OS with bevacizumab treatment. Conclusion: Unfortunately, in this histopathological, molecular, immunohistochemical and neuroradiological study we did not find any predictive biomarker of response or survival benefit for Bevacizumab in glioblastoma.
MeSH term(s)	Adult ; Aged ; Angiogenesis Inhibitors/therapeutic use ; Antineoplastic Agents, Immunological/therapeutic use ; Bevacizumab/therapeutic use ; Biomarkers, Tumor/analysis ; Brain Neoplasms/blood supply ; Brain Neoplasms/chemistry ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/drug therapy ; Cerebrovascular Circulation ; DNA Modification Methylases/metabolism ; DNA Repair Enzymes/metabolism ; Female ; Gene Amplification ; Genes, erbB-1 ; Glioblastoma/blood supply ; Glioblastoma/chemistry ; Glioblastoma/diagnostic imaging ; Glioblastoma/drug therapy ; Humans ; Immunohistochemistry ; Ki-67 Antigen/analysis ; Male ; Methylation ; Microvessels/pathology ; Middle Aged ; Mitotic Index ; Neoplasm Recurrence, Local/blood supply ; Neoplasm Recurrence, Local/chemistry ; Neoplasm Recurrence, Local/diagnostic imaging ; Neoplasm Recurrence, Local/drug therapy ; Retrospective Studies ; Tissue Array Analysis ; Tumor Suppressor Proteins/metabolism
Chemical Substances	Angiogenesis Inhibitors ; Antineoplastic Agents, Immunological ; Biomarkers, Tumor ; Ki-67 Antigen ; Tumor Suppressor Proteins ; Bevacizumab (2S9ZZM9Q9V) ; DNA Modification Methylases (EC 2.1.1.-) ; MGMT protein, human (EC 2.1.1.63) ; DNA Repair Enzymes (EC 6.5.1.-)
Language	English
Publishing date	2019-03-15
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2397359-6
ISSN	1699-3055 ; 1699-048X
ISSN (online)	1699-3055
ISSN	1699-048X
DOI	10.1007/s12094-019-02070-6
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Zs.A 6644: Show issues

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Article ; Online: Neuropsychological management of the awake patient surgery: A protocol based on 3-year experience with glial tumors.

Navarro-Main, Blanca / Jiménez-Roldán, Luis / González Leon, Pedro / Castaño-León, Ana M / Lagares, Alfonso / Pérez-Nuñez, Ángel

Neurocirugia (English Edition)

2020 Volume 31, Issue 6, Page(s) 279–288

Abstract: Introduction: Glial brain tumours usually require neurosurgical treatment and they are associated with cognitive, emotional and behavioural impairments. Awake intraoperative brain mapping is the gold standard technique used to optimize the onco- ... ...

Title translation	Protocolo de intervención neuropsicológica en la cirugía del paciente despierto: experiencia de 3 años con tumores gliales.
Abstract	Introduction: Glial brain tumours usually require neurosurgical treatment and they are associated with cognitive, emotional and behavioural impairments. Awake intraoperative brain mapping is the gold standard technique used to optimize the onco-functional balance. Neuropsychological assessment and intervention have relevance in this type of procedures. Currently, there is a lack of protocolled structure for the neuropsychological intervention being able to satisfy patient needs. Method: A retrospective descriptive study of 52 patients was performed, all of them with a diagnosis of glial tumour. The structure of the protocol developed in our centre is reported, also data of neuropsychological evaluation, comparing baseline performance with both immediate posterior performance, and long term performance. Results: We describe our experience in each step of the intervention, highlighting the development of eight neurocognitive protocols for intraoperative brain mapping. The results of the neuropsychological examination objectify deficits in the immediate after surgery assessment which are reduced in the long-term assessment. Conclusions: We emphasize the need of providing and structuring the cognitive and emotional aspects of patients suffering from any pathology that entails acquired brain damage in hospital environment. This type of approach is aimed at increasing the quality of life of cancer patients by structuring and optimizing tasks during their surgical intervention and attending to the neuropsychological difficulties they suffer.
MeSH term(s)	Brain Mapping ; Brain Neoplasms/surgery ; Glioma/complications ; Glioma/surgery ; Humans ; Neurosurgical Procedures ; Quality of Life ; Retrospective Studies ; Wakefulness
Language	Spanish
Publishing date	2020-04-18
Document type	Journal Article
ISSN	2529-8496
ISSN (online)	2529-8496
DOI	10.1016/j.neucir.2020.02.005
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Article: Prognostic value of circulating endothelial cells in glioblastoma patients: a pilot study.

Vaz Salgado, María Angeles / Earl, Julie / Berrocal, Victor Rodriguez / Arrieta, Freddy Salge / Gomez, Ana / Sepulveda-Sanchez, Juan Manuel / Perez-Nuñez, Ángel / de la Fuente, Elena Corral / Lourido, Daniel / Villamayor, María / Pian, Hector / Muriel, Alfonso / Rossi, Elisabetta / Zamarchi, Rita / Carrato, Alfredo / Ley, Luis

Future science OA

2022 Volume 8, Issue 5, Page(s) FSO796

Abstract: Aim: Glioblastoma (GB) is an aggressive tumor type and the detection of circulating endothelial cells (CECs) in peripheral blood has been related to angiogenesis.: Materials & methods: A prospective single-center pilot study of CEC detection at ... ...

Abstract	Aim: Glioblastoma (GB) is an aggressive tumor type and the detection of circulating endothelial cells (CECs) in peripheral blood has been related to angiogenesis. Materials & methods: A prospective single-center pilot study of CEC detection at diagnosis in 22 patients with GB was performed, using the US FDA-approved CellSearch system. Results: A CEC cutoff value was estimated using a receiver operating curve (ROC) and patients were classified into two groups: <40 CEC/4 ml and >40 CEC/4 ml blood. Median overall survival was 25.33 months for group 1 and 8.23 months for group 2 cases (p = 0.02). There was no correlation between CEC and PWI (perfusion-weighted imaging) RM. Conclusion: CEC detection has a prognostic value in GB cases at diagnosis.
Language	English
Publishing date	2022-05-24
Publishing country	England
Document type	Journal Article
ISSN	2056-5623
ISSN	2056-5623
DOI	10.2144/fsoa-2022-0008
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