The LUMIERE dataset: Longitudinal Glioblastoma MRI with expert RANO evaluation.

Publicly available Glioblastoma (GBM) datasets predominantly include pre-operative Magnetic Resonance Imaging (MRI) or contain few follow-up images for each patient. Access to fully longitudinal datasets is critical to advance the refinement of treatment response assessment. We release a single-center longitudinal GBM MRI dataset with expert ratings of selected follow-up studies according to the response assessment in neuro-oncology criteria (RANO). The expert rating includes details about the rationale of the ratings. For a subset of patients, we provide pathology information regarding methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter status and isocitrate dehydrogenase 1 (IDH1), as well as the overall survival time. The data includes T1-weighted pre- and post-contrast, T2-weighted, and fluid-attenuated inversion recovery (FLAIR) MRI. Segmentations from state-of-the-art automated segmentation tools, as well as radiomic features, complement the data. Possible applications of this dataset are radiomics research, the development and validation of automated segmentation methods, and studies on response assessment. This collection includes MRI data of 91 GBM patients with a total of 638 study dates and 2487 images

Evaluating automated longitudinal tumor measurements for glioblastoma response assessment.

Automated tumor segmentation tools for glioblastoma show promising performance. To apply these tools for automated response assessment, longitudinal segmentation, and tumor measurement, consistency is critical. This study aimed to determine whether BraTumIA and HD-GLIO are suited for this task. We evaluated two segmentation tools with respect to automated response assessment on the single-center retrospective LUMIERE dataset with 80 patients and a total of 502 post-operative time points. Volumetry and automated bi-dimensional measurements were compared with expert measurements following the Response Assessment in Neuro-Oncology (RANO) guidelines. The longitudinal trend agreement between the expert and methods was evaluated, and the RANO progression thresholds were tested against the expert-derived time-to-progression (TTP). The TTP and overall survival (OS) correlation was used to check the progression thresholds. We evaluated the automated detection and influence of non-measurable lesions. The tumor volume trend agreement calculated between segmentation volumes and the expert bi-dimensional measurements was high (HD-GLIO: 81.1%, BraTumIA: 79.7%). BraTumIA achieved the closest match to the expert TTP using the recommended RANO progression threshold. HD-GLIO-derived tumor volumes reached the highest correlation between TTP and OS (0.55). Both tools failed at an accurate lesion count across time. Manual false-positive removal and restricting to a maximum number of measurable lesions had no beneficial effect. Expert supervision and manual corrections are still necessary when applying the tested automated segmentation tools for automated response assessment. The longitudinal consistency of current segmentation tools needs further improvement. Validation of volumetric and bi-dimensional progression thresholds with multi-center studies is required to move toward volumetry-based response assessment

SLOW: A novel spectral editing method for whole-brain MRSI at ultra high magnetic field.

PURPOSE At ultra-high field (UHF), B1 + -inhomogeneities and high specific absorption rate (SAR) of adiabatic slice-selective RF-pulses make spatial resolved spectral-editing extremely challenging with the conventional MEGA-approach. The purpose of the study was to develop a whole-brain resolved spectral-editing MRSI at UHF (UHF, B0  ≥ 7T) within clinical acceptable measurement-time and minimal chemical-shift-displacement-artifacts (CSDA) allowing for simultaneous GABA/Glx-, 2HG-, and PE-editing on a clinical approved 7T-scanner. METHODS Slice-selective adiabatic refocusing RF-pulses (2π-SSAP) dominate the SAR to the patient in (semi)LASER based MEGA-editing sequences, causing large CSDA and long measurement times to fulfill SAR requirements, even using SAR-minimized GOIA-pulses. Therefore, a novel type of spectral-editing, called SLOW-editing, using two different pairs of phase-compensated chemical-shift selective adiabatic refocusing-pulses (2π-CSAP) with different refocusing bandwidths were investigated to overcome these problems. RESULTS Compared to conventional echo-planar spectroscopic imaging (EPSI) and MEGA-editing, SLOW-editing shows robust refocusing and editing performance despite to B1 + -inhomogeneity, and robustness to B0 -inhomogeneities (0.2 ppm ≥ ΔB0  ≥ -0.2 ppm). The narrow bandwidth (∼0.6-0.8 kHz) CSAP reduces the SAR by 92%, RF peak power by 84%, in-excitation slab CSDA by 77%, and has no in-plane CSDA. Furthermore, the CSAP implicitly dephases water, lipid and all the other signals outside of range (≥ 4.6 ppm and ≤1.4 ppm), resulting in additional water and lipid suppression (factors ≥ 1000s) at zero SAR-cost, and no spectral aliasing artifacts. CONCLUSION A new spectral-editing has been developed that is especially suitable for UHF, and was successfully applied for 2HG, GABA+, PE, and Glx-editing within 10 min clinical acceptable measurement time

Recombinant protein expression by targeting pre-selected chromosomal loci

<p>Abstract</p> <p>Background</p> <p>Recombinant protein expression in mammalian cells is mostly achieved by stable integration of transgenes into the chromosomal DNA of established cell lines. The chromosomal surroundings have strong influences on the expression of transgenes. The exploitation of defined loci by targeting expression constructs with different regulatory elements is an approach to design high level expression systems. Further, this allows to evaluate the impact of chromosomal surroundings on distinct vector constructs.</p> <p>Results</p> <p>We explored antibody expression upon targeting diverse expression constructs into previously tagged loci in CHO-K1 and HEK293 cells that exhibit high reporter gene expression. These loci were selected by random transfer of reporter cassettes and subsequent screening. Both, retroviral infection and plasmid transfection with eGFP or antibody expression cassettes were employed for tagging. The tagged cell clones were screened for expression and single copy integration. Cell clones producing > 20 pg/cell in 24 hours could be identified. Selected integration sites that had been flanked with heterologous recombinase target sites (FRTs) were targeted by Flp recombinase mediated cassette exchange (RMCE). The results give proof of principle for consistent protein expression upon RMCE. Upon targeting antibody expression cassettes 90-100% of all resulting cell clones showed correct integration. Antibody production was found to be highly consistent within the individual cell clones as expected from their isogenic nature. However, the nature and orientation of expression control elements revealed to be critical. The impact of different promoters was examined with the tag-and-targeting approach. For each of the chosen promoters high expression sites were identified. However, each site supported the chosen promoters to a different extent, indicating that the strength of a particular promoter is dominantly defined by its chromosomal context.</p> <p>Conclusion</p> <p>RMCE provides a powerful method to specifically design vectors for optimized gene expression with high accuracy. Upon considering the specific requirements of chromosomal sites this method provides a unique tool to exploit such sites for predictable expression of biotechnologically relevant proteins such as antibodies.</p

Novel flexible cell lines for the production of recombinant proteins and retroviral vectors

Die vorhersagbare und stabile Expression rekombinanter Proteine in Säugerzellen ist von großem Interesse für viele Anwendungen in der Biotechnologie. Konventionelle Methoden zur Etablierung von Klonen mit guten Produktionseigenschaften sind mit hohem Screeningaufwand verbunden. Das Ziel dieser Arbeit war die Entwicklung einer Austauschstrategie, welche die Etablierung von Masterzelllinien mit einer austauschbaren Expressionskassette beinhaltet. Dazu wurden chromosomale Loci in HEK293, CHO-K1 und BHK-21-Zellen retroviral markiert. Die markierten Klone wurden hinsichtlich einer optimalen und stabilen Reportergenexpression untersucht und isoliert. Anschließend wurden mittels RMCE verschiedene Expressionskassetten in ausgewählte Loci integriert. Durch die Komplettierung eines Selektionsmarkers aufgrund der sequenzspezifischen Rekombination konnte der korrekte Kassettenaustausch in 90-100% der Klone gezeigt werden. Die isogenen Subklone eines Parentalklons zeichneten sich durch ein homogenes Expressionsverhalten aus. Die Stabilität und die Höhe der Expression waren allerdings von der Konstruktion und dem Aufbau der Expressionskassette beeinflusst.Die Austauschstrategie wurde ebenfalls für die Etablierung einer neuen retroviralen Produzentenzelllinie verwendet. Mehrere retrovirale Vektoren wurden spezifisch in den markierten Locus einer Masterzelllinie integriert. Es konnten hohe und vorhersagbare Virustiter mit diesen Vektoren erzielt werden.Die präzise Integration von Expressionskassetten in einen definierten chromosomalen Locus führt zu einer vorhersagbaren Expression, sowohl für die Produktion von rekombinanten Proteinen, als auch für die Generierung von Retroviren. Die Strategie ist flexibel und auf beliebige Austauschvektoren anwendbar. Die Etablierung von Produzentenzellen und des gesamten Produktionsprozesses kann so vereinfacht und die Produktion von Proteinen und therapeutischen Viren für klinische Applikationen beschleunigt werden.Predictable and stable recombinant protein expression from mammalian cell lines is of interest for many applications in fundamental research and biotechnology. Most approaches make use of screening efforts to identify clones that lead to a high and stable production. The aim of this work was to develop a strategy that involves random tagging of chromosomal loci, screening for optimal expression and cassette exchange to integrate a new cassette at the defined pre-selected site. Due to exchange of a single vector cassette at the defined chromosomal site protein production is predictable and the cellular properties are preserved. HEK293, CHO-K1 and BHK21 cells were transduced with a tagging vector and were screened for chromosomal loci that support stable and high level expression. Cell clones were subjected to Flp mediated gene targeting with vectors coding for an IgG. Due to complementation of antibiotic resistance gene, integration into the preselected chromosomal sites was highly specific and 90-100% of selected clones showed correct cassette exchange. Isogenic subclones provided homogeneous, high and stable expression characteristics of the IgG gene. The strategy was also applied for generating a novel retroviral producer cell line in which the retroviral vector is specifically integrated into a pre-screened high level integration site. With this approach, high level and predictable virus titres were obtained with any virus vector tested. Thus, the precise integration of expression vectors into predefined chromosomal loci leads to predictable expression both for protein production and for virus generation. The strategy is flexible and applicable to any expression vector of choice. It simplifies the generation of producer cells, the establishment of the optimal production conditions and also the characterization of the producer cells. Finally, it significantly speeds up the generation of recombinant proteins and therapeutic viruses for clinical applications

Radiomics for glioblastoma survival analysis in pre-operative MRI: exploring feature robustness, class boundaries, and machine learning techniques

Background: This study aims to identify robust radiomic features for Magnetic Resonance Imaging (MRI), assess feature selection and machine learning methods for overall survival classification of Glioblastoma multiforme patients, and to robustify models trained on single-center data when applied to multi-center data. Methods: Tumor regions were automatically segmented on MRI data, and 8327 radiomic features extracted from these regions. Single-center data was perturbed to assess radiomic feature robustness, with over 16 million tests of typical perturbations. Robust features were selected based on the Intraclass Correlation Coefficient to measure agreement across perturbations. Feature selectors and machine learning methods were compared to classify overall survival. Models trained on single-center data (63 patients) were tested on multi-center data (76 patients). Priors using feature robustness and clinical knowledge were evaluated. Results: We observed a very large performance drop when applying models trained on single-center on unseen multi-center data, e.g. a decrease of the area under the receiver operating curve (AUC) of 0.56 for the overall survival classification boundary at 1 year. By using robust features alongside priors for two overall survival classes, the AUC drop could be reduced by 21.2%. In contrast, sensitivity was 12.19% lower when applying a prior. Conclusions: Our experiments show that it is possible to attain improved levels of robustness and accuracy when models need to be applied to unseen multi-center data. The performance on multi-center data of models trained on single-center data can be increased by using robust features and introducing prior knowledge. For successful model robustification, tailoring perturbations for robustness testing to the target dataset is key

Intraoperative monopolar mapping during 5-ALA-guided resections of glioblastomas adjacent to motor eloquent areas: evaluation of resection rates and neurological outcome.

OBJECT Resection of glioblastoma adjacent to motor cortex or subcortical motor pathways carries a high risk of both incomplete resection and postoperative motor deficits. Although the strategy of maximum safe resection is widely accepted, the rates of complete resection of enhancing tumor (CRET) and the exact causes for motor deficits (mechanical vs vascular) are not always known. The authors report the results of their concept of combining monopolar mapping and 5-aminolevulinic acid (5-ALA)-guided surgery in patients with glioblastoma adjacent to eloquent tissue. METHODS The authors prospectively studied 72 consecutive patients who underwent 5-ALA-guided surgery for a glioblastoma adjacent to the corticospinal tract (CST; < 10 mm) with continuous dynamic monopolar motor mapping (short-train interstimulus interval 4.0 msec, pulse duration 500 μsec) coupled to an acoustic motor evoked potential (MEP) alarm. The extent of resection was determined based on early (< 48 hours) postoperative MRI findings. Motor function was assessed 1 day after surgery, at discharge, and at 3 months. RESULTS Five patients were excluded because of nonadherence to protocol; thus, 67 patients were evaluated. The lowest motor threshold reached during individual surgery was as follows (motor threshold, number of patients): > 20 mA, n = 8; 11-20 mA, n = 13; 6-10 mA, n = 10; 4-5 mA, n = 13; and 1-3 mA, n = 23. Motor deterioration at postsurgical Day 1 and at discharge occurred in 30% (n = 20) and 10% (n = 7) of patients, respectively. At 3 months, 3 patients (4%) had a persisting postoperative motor deficit, 2 caused by vascular injury and 1 by mechanical injury. The rates of intra- and postoperative seizures were 1% and 0%, respectively. Complete resection of enhancing tumor was achieved in 73% of patients (49/67) despite proximity to the CST. CONCLUSIONS A rather high rate of CRET can be achieved in glioblastomas in motor eloquent areas via a combination of 5-ALA for tumor identification and intraoperative mapping for distinguishing between presumed and actual motor eloquent tissues. Continuous dynamic mapping was found to be a very ergonomic technique that localizes the motor tissue early and reliably

Early re-do surgery for glioblastoma is a feasible and safe strategy to achieve complete resection of enhancing tumor.

BACKGROUND Complete resection of enhancing tumor as assessed by early (<72 hours) postoperative MRI is regarded as the optimal result in glioblastoma surgery. As yet, there is no consensus on standard procedure if post-operative imaging reveals unintended tumor remnants. OBJECTIVE The current study evaluated the feasibility and safety of an early re-do surgery aimed at completing resections with the aid of 5-ALA fluorescence and neuronavigation after detection of enhancing tumor remnants on post-operative MRI. METHODS From October 2008 to October 2012 a single center institutional protocol offered a second surgery within one week to patients with unintentional incomplete glioblastoma resection. We report on the feasibility of the use 5-ALA fluorescence guidance, the extent of resection (EOR) rates and complications of early re-do surgery. RESULTS Nine of 151 patients (6%) with glioblastoma resections had an unintentional tumor remnant with a volume >0.175 cm(3). 5-ALA guided re-do surgery completed the resection (CRET) in all patients without causing neurological deficits, infections or other complications. Patients who underwent a re-do surgery remained hospitalized between surgeries, resulting in a mean length of hospital stay of 11 days (range 7-15), compared to 9 days for single surgery (range 3-23; p=0.147). CONCLUSION Our early re-do protocol led to complete resection of all enhancing tumor in all cases without any new neurological deficits and thus provides a similar oncological result as intraoperative MRI (iMRI). The repeated use of 5-ALA induced fluorescence, used for identification of small remnants, remains highly sensitive and specific in the setting of re-do surgery. Early re-do surgery is a feasible and safe strategy to complete unintended subtotal resections