Faculty Profiles - SAITO Ryuta

Papers - SAITO Ryuta

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Favorable seizure and developmental outcomes without preoperative intracranial electroencephalography in pediatric patients following epilepsy surgery: A single epilepsy center retrospective study. International journal Open Access

Taro Okumura, Naotaka Usui, Akihiko Kondo, Hiroshi Ogawa, Mitsuru Hashiguchi, Yosuke Kuromi, Tokito Yamaguchi, Hideyuki Otani, Katsumi Imai, Tomotaka Ishizaki, Takafumi Tanei, Satoshi Maesawa, Ryuta Saito

Epilepsia Vol. 66 ( 4 ) page： 1084 - 1096 2025.4

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: At our institute, most pediatric patients undergo epilepsy surgery following a thorough presurgical evaluation without intracranial electroencephalography (EEG). We conducted an initial validation of our noninvasive presurgical strategy by assessing the seizure and developmental outcomes of 135 children. METHODS: All 135 pediatric patients were <15 years old, had undergone curative surgery, and were followed for at least 2 years postoperatively. Presurgical evaluations and postoperative seizure and developmental outcomes were investigated. Thorough noninvasive evaluation included 3-T magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) in all patients. Intracranial EEG was mainly indicated for patients whose MRIs were negative or subtle. We defined Engel class I as favorable and Engel classes II-IV as unfavorable seizure outcomes. Intelligence quotient (IQ) and developmental quotient (DQ) before and 2 years after surgery were used to assess developmental/neuropsychological outcomes. RESULTS: MRI was positive in 130 of 135 patients (96.3%), including 39 of 40 with focal cortical dysplasia (FCD) type II and 30 of 33 with FCD type I. FDG-PET revealed concordant localizing findings in 119 of 132 patients (90.2%). Ictal single photon emission computed tomography provided concordant localizing information in 85 of 91 patients (93.4%). Intracranial EEG was performed in only 10 of 135 patients (7.4%). Ninety-seven of 135 patients (71.9%) were seizure-free 2 years after surgery. The final seizure-free rate was 99 of 135 (73.3%). Temporal lobe surgery predicted a favorable seizure outcome by multivariate analysis, whereas FCD type I and preoperative IQ/DQ < 70 predicted an unfavorable outcome. The mean IQ change was +1.3 points, and the mean DQ change was +1.0 points. Mean DQ significantly improved following extratemporal surgery (multivariate regression, p < .05), and mean DQ significantly decreased in patients with epileptic spasms (multivariate regression, p < .01). SIGNIFICANCE: Thorough noninvasive presurgical evaluation enables detection of subtle MRI lesions and curative epilepsy surgery without intracranial EEG in most patients, including those with FCD type II and type I, and leads to favorable seizure and developmental/neuropsychological outcomes.

DOI： 10.1111/epi.18249

Spontaneous Shrinkage of isocitrate dehydrogenase (IDH)-mutant astrocytoma caused by intra-tumoural cyst rupture: a case report. Reviewed International journal

Ryutaro Suzuki, Masayuki Kanamori, Ryuta Saito, Yoshiteru Shimoda, Mika Watanabe, Teiji Tominaga

British journal of neurosurgery Vol. 39 ( 2 ) page： 246 - 250 2025.3

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: T2-fluid-attenuated inversion recovery (FLAIR) mismatch sign is a specific imaging finding of isocitrate dehydrogenase (IDH)-mutant astrocytomas. Histologically, a hypointense area on FLAIR images indicates the presence of microcysts. Here we report a case of IDH-mutant astrocytoma that shrunk spontaneously. CASE DESCRIPTION: A 26-year-old woman presented with a complaint of headache. Her magnetic resonance (MR) images revealed a lesion mass with a T2-FLAIR mismatch sign in the left frontal lobe. Subsequently, after 1 month, she was referred to our department, and we found that the lesion had unexpectedly shrunk; however, no further shrinkage was observed in the next 3 months. Furthermore, a biopsy was performed, and the results indicated a diagnosis of astrocytoma, IDH-mutant CNS WHO grade 3. Thus, she underwent subtotal resection. We found no neurological deficits in the patient, and she received 60 Gy of radiotherapy at the local site and chemotherapy with nimustine hydrochloride (ACNU), followed by the administration of ACNU every 8 weeks for 2 years. Overall, after 36 months of tumour resection, she was in good health and exhibited no recurrence. Notably, her histological and MR image findings suggested that the macroscopic cyst was formed by the fusion of microcysts, which is a characteristic feature of IDH-mutant astrocytoma with a T2-FLAIR mismatch sign, and that the tumour shrunk because of the rupture of the cyst in the Sylvian cistern. CONCLUSION: The present case report suggests that IDH-mutant astrocytoma cannot be ruled out even when the lesion shrinks spontaneously.

DOI： 10.1080/02688697.2023.2170328

Superselective Angiography of Vasa Vasorum Within Partially Thrombosed Vertebral Aneurysm: A Case Report. Reviewed International journal

Kawasaki Y, Izumi T, Nishihori M, Goto S, Araki Y, Yokoyama K, Saito R

Neurosurgery Vol. 96 ( 3 ) page： e52 - e57 2025.3

Evaluation of mild cognitive impairment in older patients with essential tremor. International journal

Miki Hashida, Satoshi Maesawa, Satomi Mizuno, Sachiko Kato, Yoshiki Ito, Manabu Mutoh, Takahiro Suzuki, Tomotaka Ishizaki, Takafumi Tanei, Takashi Tsuboi, Masashi Suzuki, Daisuke Nakatsubo, Takahiko Tsugawa, Epifanio Bagarinao, Toshihiko Wakabayashi, Masahisa Katsuno, Ryuta Saito

Parkinsonism & related disorders Vol. 131 page： 107228 - 107228 2025.2

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: Recent studies have reported that essential tremor (ET) presents with not only motor symptoms but also cognitive dysfunction. However, detailed pathological mechanisms remain unclear. Here, we evaluate the characteristics of cognitive changes in older patients. METHODS: Eighty-five patients aged 65 years or older with ET but without dementia were evaluated for cognitive function using the Addenbrooke Cognitive Examination Revised (ACE-R). The patients were compared with healthy controls (HCs), and the characteristics of cognitive dysfunction were examined. Age at onset and correlations with tremor severity were also investigated. Moreover, we performed resting-state network (RSNs) analysis in a subset of these patients, and the functional connectivity (FC) within the networks was compared with age-matched controls. RESULTS: Compared to HCs, older patients with ET showed a clear reduction in the total (p = 0.001), attention (p = 0.005), verbal fluency (p = 0.001), and memory (p = 0.001) ACE-R scores. Older-onset patients showed significant cognitive dysfunction compared with younger-onset patients. Verbal fluency correlated with tremor severity in the multiple regression analysis (p < 0.001). RSNs showed an increase in FC in the frontal lobes within the language network in patients with ET compared to HCs (p < 0.05, FWE-corrected). CONCLUSION: Older patients with ET showed obvious cognitive dysfunction compared to HCs, indicating that cognitive dysfunction varies by age of onset and correlates with tremor severity. The results of the RSNs analysis suggest that the pathological mechanism of cognitive dysfunction in ET patients involves network changes similar to those in the early stages of Alzheimer's disease.

DOI： 10.1016/j.parkreldis.2024.107228

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Comparison of Early-onset Efficacy of Anti-calcitonin Gene-related Peptide Monoclonal Antibodies for Patients with Migraine in Real-world Clinical Practice: Study Protocol for an Exploratory Clinical Trial. Open Access

Takafumi Tanei, Satoshi Maesawa, Yusuke Nishimura, Tomotaka Ishizaki, Yoshitaka Nagashima, Miki Hashida, Shun Yamamoto, Masahiko Ando, Yachiyo Kuwatsuka, Atsushi Hashizume, Toshihiko Wakabayashi, Ryuta Saito

Neurologia medico-chirurgica Vol. 65 ( 2 ) page： 71 - 80 2025.2

Language：English Publishing type：Research paper (scientific journal)

Three anti-calcitonin gene-related peptide monoclonal antibodies (CGRP-mAbs) are available in Japan: galcanezumab, fremanezumab, and erenumab. Early-onset efficacy has been demonstrated for each CGRP-mAb in comparison with placebo, but differences among the drugs are unclear. Only galcanezumab requires 2 doses at the initial injection. This study is a multicenter, open-label, randomized, two-group comparison trial, consisting of the random selection of a CGRP-mAb and 6 consecutive injections, and then discontinuation of the CGRP-mAb after 6 injections. The primary outcome is a comparison of early-onset efficacy between galcanezumab and both fremanezumab and erenumab after the initial injection. The secondary outcomes are comparisons between galcanezumab and both fremanezumab and erenumab, and between fremanezumab and erenumab as follows: weekly number of headache days, migraine days, and acute medication use are compared to baseline during one month after initial injection; time of subjectively perceiving onset of effect after initial injection; monthly changes in headache status from baseline to after third (3rd) injections; effective rates after initial and 3rd injections; improvement rates of depression scores between baseline and after 3rd injections; changes in number of absenteeism and presenteeism days in each month from baseline to after 3rd injections; proportion of ineffective cases after 3rd injections; recurrence rates and time to recurrence after CGRP-mAb discontinuation; effective rates of CGRP-mAb re-injections; detection of clinical factors associated with effectiveness after the initial and 3rd injections. The aim of this study is to investigate differences in early-onset efficacy among the CGRP-mAbs, and when and to what extent headache symptoms recur after discontinuation.

DOI： 10.2176/jns-nmc.2024-0201

Hemorrhagic complication due to vascular side branch injury from a distant site in stereoelectroencephalography: A case report and proposed rules for safer electrode implantation.

Suzuki T, Ishizaki T, Maesawa S, Hashida M, Ito Y, Tanei T, Saito R

Seizure Vol. 125 page： 50 - 53 2025.2

Postoperative fragmentation and distal migration of Carotid Stent in vascular Eagle Syndrome☆

Nishihori, M; Izumi, T; Goto, S; Muraoka, S; Kogame, H; Saito, R

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES Vol. 34 ( 2 ) page： 108202 2025.2

Residual Pattern of the Hyperintense Area on T2-Weighted Magnetic Resonance Imaging After Initial Treatment Predicts the Pattern and Location of Recurrence in Patients with Newly Diagnosed Glioblastoma. Reviewed International journal

Yoshiteru Shimoda, Masayuki Kanamori, Shota Yamashita, Ichiyo Shibahara, Rei Umezawa, Shunji Mugikura, Keiichi Jingu, Ryuta Saito, Yukihiko Sonoda, Toshihiro Kumabe, Hidenori Endo

World neurosurgery Vol. 193 page： 517 - 532 2025.1

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: This study examined the clinical significance of residual hyperintense area on T2-weighted magnetic resonance imaging (T2R) without gadolinium-enhanced lesions at the end of initial treatment (debulking surgery, concomitant radiotherapy, and temozolomide) in patients with glioblastoma. METHODS: Among 150 glioblastoma cases, 77 cases without enhanced lesions at the end of initial treatment and without factors modifying the distribution of residual hyperintense area or pattern of recurrence were included. We retrospectively reviewed the relationship of residual hyperintense area after initial treatment with progression-free survival (PFS), overall survival (OS), and pattern of recurrence. RESULTS: In these 77 cases, the median PFS and OS were 12.4 and 27.4 months, respectively. At the end of initial treatment, 55 (71.4%) cases had residual hyperintense area (T2 residual group, T2R), whereas 22 (28.6%) showed no hyperintense area (T2 disappeared group, disappeared hyperintense area on T2-weighted magnetic resonance imaging [T2D]). Based on univariate and multivariate analyses, the residual hyperintense area after initial treatment was not a prognostic factor for PFS or OS. Distant recurrences occurred more frequently in the T2D group than in the T2R group 50.0% versus 9.5%. In the T2R group, the recurrence site coincided with the residual hyperintense area in 36 (85.7%) of 42 recurrences. CONCLUSIONS: The T2R at the end of initial treatment can predict local recurrence. However, the distant recurrence occurred frequently in T2D group. Thus, attention should be paid to local recurrences in T2R group and distant recurrences in T2D group.

DOI： 10.1016/j.wneu.2024.10.012

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Endoscopic Cystoventricular Stenting in Awake Patients with ESM for Convexity Cysts: Three Case Reports and a Systematic Review. Reviewed International journal

Eriko Okumura, Kazuhito Takeuchi, Yuichi Nagata, Kenichiro Iwami, Kazuya Motomura, Fumiharu Ohka, Yoshiki Sato, Toshiaki Hirose, Ryuta Saito

World neurosurgery Vol. 193 page： 108 - 118 2025.1

Language：English Publishing type：Research paper (scientific journal)

Surgical interventions for arachnoid cysts and glioependymal cysts primarily focus on cyst decompression and establishing communication with cerebrospinal fluid (CSF) spaces. However, a standardized surgical strategy for symptomatic convexity cysts lacking surrounding CSF space is still lacking due to the limited number of cases. This systematic review aims to evaluate surgical interventions for symptomatic convexity cysts and proposes a safe and effective treatment approach we have developed. A systematic review of the literature was conducted following PRISMA guidelines. Surgical techniques were categorized into cystoperitoneal (CP) shunt, cyst excision, cyst fenestration, cyst ventriculostomy, and several uniquely modified methods. Using a method different from these previous reports, we performed endoscopic cystoventricular stenting via burr hole in three cases of convexity cysts. While traditional methods have proven effective, CP shunt may lead to malfunction, infection, and subdural hematoma; wall excision is invasive and increases morbidity risks. Fenestration and cystoventriculostomy have also reported cases of recurrence. Other methods also pose issues, including off-label use of instruments and inadequate consideration for removal. The method we performed for placing the stent catheter with multiple side holes demonstrated long-term effectiveness. Furthermore, the surgery was conducted with the patient fully awake, and the use of electrical stimulation mapping enabled preservation of higher neurocognitive functions, including language, working memory, and spatial cognition, at the puncture site. This novel approach offers advantages such as minimally invasive procedure, preservation of safe brain function, and long-term patency. Further studies are warranted to validate these findings and improve surgical strategies for convexity cysts.

DOI： 10.1016/j.wneu.2024.10.031

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Efficacy and safety of carmustine wafers, followed by radiation, temozolomide, and bevacizumab therapy, for newly diagnosed glioblastoma with maximal resection

Kanamori, M; Shibahara, I; Shimoda, Y; Akiyama, Y; Beppu, T; Ohba, S; Enomoto, T; Ono, T; Mitobe, Y; Hanihara, M; Mineharu, Y; Ishida, J; Asano, K; Yoshida, Y; Natsumeda, M; Nomura, S; Abe, T; Yonezawa, H; Katakura, R; Shibui, S; Kuroiwa, T; Suzuki, H; Takei, H; Matsushita, H; Saito, R; Arakawa, Y; Sonoda, Y; Hirose, Y; Kumabe, T; Yamaguchi, T; Endo, H; Tominaga, T

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY Vol. 30 ( 1 ) page： 51 - 61 2025.1

特集頸椎神経根症再考頸椎神経根症に対する頸椎前方固定術

西村由介, 永島吉孝, 齋藤竜太

脊椎脊髄ジャーナル Vol. 37 ( 11 ) page： 993 - 1000 2024.12

A case of traumatic middle meningeal artery pseudoaneurysm presenting with an intracerebral hematoma

Ishikawa Kojiro, Wakabayashi Kenichi, Ohito Masato, Mizuno Shohei, Ienaga Jumpei, Kawaguchi Tomomi, Nakamura Shigekazu, Tanei Takafumi, Saito Ryuta

Neurotraumatology Vol. 47 ( 2 ) page： 94 - 100 2024.12

Language：Japanese Publisher：The Japan Society of Neurotraumatology

Although various types of vascular disorders are associated with head trauma, a rare case is a traumatic middle meningeal artery pseudoaneurysm (tMMAP). We report a case of a 70–year–old man with tMMAP presenting with an intracerebral hematoma (ICH). He was rushed to the hospital in a poor state of consciousness after a traumatic fall. A computer tomography (CT) scan taken on admission revealed a traumatic left temporal lobe ICH, subarachnoid hemorrhage, and bilateral acute subdural hematoma. After conservative treatment, his consciousness improved, except for disorientation on day 3 of hospitalization, and a CT scan revealed resolution of ICH. However, on day 10 of hospitalization, he suddenly fell into a coma, and a CT scan revealed that the hematoma in the left temporal lobe had grown and caused a midline shift. We conducted an emergency craniotomy and hematoma removal, during which we encountered an intractable arterial bleeding at the left middle skull base. We could barely stop the bleeding using aneurysmal clips. Suspecting the possibility of a vascular abnormality, we performed a postoperative cerebral angiography that revealed a pseudoaneurysm in the left middle meningeal artery. We determined that this pseudoaneurysm was the source of the bleeding and performed an endovascular parent vessel occlusion. After the endovascular surgery, there was no recurrence of hemorrhage. The patient was transferred to a rehabilitation facility because of residual cognitive dysfunction. tMMAP is a rare disorder, and its rupture generally causes an epidural hematoma; however, in some cases, it can cause an ICH. Although it is difficult to predict the rupture in advance, tMMAP must be recognized as a delayed complication of traumatic vascular disorders as it can lead to severe conditions.

DOI： 10.32187/neurotraumatology.47.2_94

CiNii Research

A multi-center, open-label, randomized clinical trial evaluating the preventive effect of perampanel on craniotomy-induced epileptogenesis in seizure-naive patients with supratentorial brain tumors: study protocol for a GRAMPAS trial. International journal Open Access

Junya Yamaguchi, Fumiharu Ohka, Kazuya Motomura, Tomotaka Ishizaki, Norimoto Nakahara, Shigeru Fujitani, Tetsuya Nagatani, Masasuke Ohno, Masahiko Ando, Yachiyo Kuwatsuka, Kazuki Nishida, Ryuta Saito

Trials Vol. 25 ( 1 ) page： 849 - 849 2024.12

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Early seizures after craniotomy are significant perioperative complications that can adversely impact patient outcomes. Despite current guidelines advising against the routine use of antiseizure drugs for seizure after craniotomy prevention due to limited efficacy data, many clinicians continue prescribing them. This discrepancy highlights the need for robust evidence to guide clinical practice. This multi-center, randomized clinical trial was designed to investigate the efficacy of perampanel in preventing early seizures after craniotomy. METHOD: This multi-center, open-label, randomized clinical trial will be conducted across five hospitals in Nagoya, Japan, from February 2024 to December 2026. A total of 142 seizure-naive patients with supratentorial brain tumors will be recruited and randomized (1:1) into the treatment and control groups. The treatment group will receive 2 mg of perampanel starting 2 days preoperatively and continuing for 28 days postoperatively, while the control group will receive no antiseizure drugs. The primary outcome is the incidence of seizures within 28 days after craniotomy. Secondary outcomes are length of hospital and intensive care unit stays and postoperative complications. DISCUSSION: This study addresses the critical need for evidence-based recommendations regarding antiseizure drug use for preventing early seizures after craniotomy. As the first multi-center, randomized trial evaluating perampanel's efficacy in this setting, the findings may significantly influence clinical guidelines and perioperative practices. TRIAL REGISTRATION: This trial was registered with the Japan Registry of Clinical Trials (approval number: jRCTs041230117) on December 18, 2023, a member of the Primary Registry Network of the World Health Organization's International Clinical Trials Registry Platform.

DOI： 10.1186/s13063-024-08693-7

Isolation of ependymal cilia from mouse brain( vol 409, 110198, 2024) Reviewed

Mizuno, A; Takeuchi, K; Nagata, Y; Harada, H; Yamamoto, T; Ishikawa, T; Maeda, S; Ohka, F; Ueno, H; Saito, R

JOURNAL OF NEUROSCIENCE METHODS Vol. 412 page： 110293 2024.12

Language：English Publisher：Journal of Neuroscience Methods

The authors regret that the affiliation information was incomplete in the original article. The correct and complete affiliation information should be as follows: Akihiro Mizunoa,b a Department of Neurosurgery, Komaki City Hospital, Aichi, Japan b Department of Neurosurgery, Nagoya University, Nagoya, Japan This research was conducted while the author was affiliated with Nagoya University. The addition of this affiliation is important for accurately reflecting the research context. The authors would like to apologize for any inconvenience caused.

DOI： 10.1016/j.jneumeth.2024.110293

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Femoral Nerve Injury After Prone-Position Lumbar Discectomy: A Case Report Highlighting the Role of Ultrasound in Recovery Monitoring.

Matsuo M, Nagashima Y, Nishimura Y, Saito R

Cureus Vol. 16 ( 12 ) page： e76653 2024.12

Prognosis and Treatment Effectiveness of Austrian Syndrome: A Case Report and Systematic Review

Takahiko Fukui, Shinsuke Muraoka, Takumi Asai, Toshihisa Nisizawa, Yoshio Araki, Ryuta Saito

Cureus Vol. 16 ( 12 ) page： e74971 2024.12

Regression of bilateral persistent primitive ophthalmic artery: a case report

Takeuchi, I; Izumi, T; Nishihori, M; Goto, S; Hanyu, T; Suzuki, K; Takayanagi, K; Kawasaki, Y; Saito, R

SURGICAL AND RADIOLOGIC ANATOMY Vol. 47 ( 1 ) page： 42 2024.12

Real-world clinical results of CGRP monoclonal antibody treatment for medication overuse headache of migraine without abrupt drug discontinuation and no hospitalization. International journal Open Access

Takafumi Tanei, Yutaro Fuse, Satoshi Maesawa, Yusuke Nishimura, Tomotaka Ishizaki, Yoshitaka Nagashima, Manabu Mutoh, Yoshiki Ito, Miki Hashida, Takahiro Suzuki, Syun Yamamoto, Toshihiko Wakabayashi, Ryuta Saito

Heliyon Vol. 10 ( 22 ) page： e40190 2024.11

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Abrupt discontinuation of overused medications is standard treatment for medication overuse headache (MOH), but discontinuation is difficult to maintain. The aim was to evaluate the real-world clinical results of anti-calcitonin gene-related peptide monoclonal antibody (CGRP-mAb) treatment for migraine with MOH without abrupt drug discontinuation and no hospitalization. METHODS: Data were collected before starting CGRP-mAb injections (baseline) and 1 month after each injection. The following items were compared between baseline and after the first, second, and third CGRP-mAb injections, monthly headache days (MHD), monthly migraine days (MMD), monthly acute medication use (AMU) days, monthly total amount of AMU tablets, headache impact test-6 (HIT-6), and the migraine-specific quality of life questionnaire (MSQ). Achieving reduction rates ≥50 % in the frequency of each headache and migraine was defined as a good response. Achieving reduction rates of both AMU days and tablets ≥50 % was defined as effective in reducing AMU. RESULTS: This study included 33 patients with migraine with MOH. After the third CGRP-mAb injection, MHD and MMD were significantly decreased from median 30.0 to 9.5 days, and 10.0 to 1.5 days, respectively. In addition, monthly AMU days and tablets were significantly decreased from median 28.0 to 8.0 days, and 30.0 to 9.5 tablets, respectively. After the third CGRP-mAb injection, the good MHD and MMD responder rates were 75.0 % and 85.7 %, respectively. The rate of reducing AMU was 78.6 %. HIT-6 and MSQ scores decreased significantly from baseline to after each CGRP-mAb injection. CONCLUSIONS: When CGRP-mAb was administered to migraine with MOH, frequency of headache symptoms and AMU were reduced without abrupt drug discontinuation and no hospitalization.

DOI： 10.1016/j.heliyon.2024.e40190

Image-based Re-evaluation of the JCOG0911 Study Focusing on Tumor Volume and Survival, Disease Progression Diagnosis, and Radiomic Prognostication for Newly Diagnosed Glioblastoma

Manabu Kinoshita, Yasutaka Fushimi, Tomohiko Masumoto, Keita Sasaki, Tetsuya Sekita, Atsushi Natsume, Toshihiko Wakabashi, Takashi Komori, Shunsuke Tsuzuki, Yoshihiro Muragaki, Kazuya Motomura, Ryuta Saito, Kenichi Sato, Takaaki Beppu, Masamichi Takahashi, Jun-Ichiro Kuroda, Yukihiko Sonoda, Keiichi Kobayashi, Kazuhiko Mishima, Koichi Mitsuya, Fumiyuki Yamasaki, Akihiro Inoue, Tomoo Matsutani, Hideo Nakamura, Shigeru Yamaguchi, Eiichi Ishikawa, Masato Nakaya, Shota Tanaka, Kenta Ujifuku, Hiroyuki Uchida, Masayuki Kanamori, Ryohei Otani, Noriyuki Kijima, Namiko Nishida, Atsuo Yoshino, Yohei Mineharu, Yoshiki Arakawa, Haruhiko Fukuda, Yoshitaka Narita

Magnetic Resonance in Medical Sciences Vol. advpub ( 0 ) 2024.11

Language：English Publishing type：Research paper (scientific journal) Publisher：Japanese Society for Magnetic Resonance in Medicine

Purpose: To re-evaluate images recovered from JCOG0911, a randomized phase 2 trial for newly diagnosed glioblastoma (nGBM) conducted by the Japan Clinical Oncology Group (JCOG) Brain Tumor Study Group.Methods: The correlation between tumor volumes and survival was evaluated, followed by progression-free survival (PFS) analysis by independent central review based on Response Assessment in Neuro-Oncology (RANO) criteria using MRI recovered from 118 nGBM patients enrolled in the JCOG0911 trial. A radiomic analysis was also performed to identify radiomic features predictive of nGBM prognosis.Results: The distribution of the Gd-enhancing and T2-weighted image/fluid attenuated inversion recovery-high intensity lesions mainly occupied white matter. JCOG0911 consisted of more subjects with right-sided lesions. The median extent of resection of the Gd-enhancing lesions was 99%. The overall survival showed a nonsignificant negative trend with postoperative Gd-enhancing lesion volume (P = 0.22), with the hazard ratio increasing in parallel with its volume. The median PFS after registration was 302 and 308 days for local Response Evaluation Criteria in Solid Tumors (RECIST)-based and central RANO-based diagnoses. However, an apparent discrepancy was observed between the two in the early phase, presumably due to the misdiagnosis of pseudoprogression by local RECIST-based diagnosis. Radiomic analysis identified 28 radiomic features predictive of nGBM prognosis, 5 of which were those previously identified in a separate cohort. The constructed radiomics-based prognostic model stratified the cohort into high- and low-risk groups (P = 0.028).Conclusion: Novel analytical methods that could be incorporated into future clinical trials were successfully tested. RANO and RECIST may not differ in progression calls if pseudoprogression is appropriately handled.

DOI： 10.2463/mrms.mp.2024-0103

DIAGNOSIS AND TREATMENT OF BRAIN TUMORS USING METHIONINE PET

Shiba, Y; Maeda, S; Yamaguchi, J; Deguchi, S; Ohka, F; Saito, R

NEURO-ONCOLOGY Vol. 26 2024.11

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Papers - SAITO Ryuta