Time-dependent MR diffusion analysis of functioning and nonfunctioning pituitary adenomas/pituitary neuroendocrine tumors Kiyohisa Kamimura, Tomohiro Tokuda, Junki Kamizono, Tsubasa Nakano, Tomohito Hasegawa, Masanori Nakajo, Fumitaka Ejima, Fumiko Kanzaki, Koji Takumi, Masatoyo Nakajo, Shingo Fujio, Ryosuke Hanaya, Akihide Tanimoto, Takashi Iwanaga, Hiroshi Imai, Thorsten Feiweier, Takashi Yoshiura Journal of Neuroimaging, 2025 Background and PurposeDifferentiation between functioning and nonfunctioning pituitary adenomas/pituitary neuroendocrine tumors (PAs) is clinically relevant. The goal of this study was to determine the feasibility of using time‐dependent diffusion MRI (dMRI) for microstructural characterization of PAs.MethodsThe study included 54 participants, 24 with functioning PA and 30 with nonfunctioning PA. Time‐dependent dMRI of the pituitary gland was performed using an inner field‐of‐view echo‐planar imaging based on 2‐dimensional‐selective radiofrequency excitations with oscillating gradient and pulsed gradient preparation (effective diffusion time: 7.1 and 36.3 ms) at b‐values of 0 and 1000 seconds/mm2. Each tumor had its apparent diffusion coefficients (ADCs) measured at two diffusion times (ADC7.1 ms and ADC36.3 ms), its ADC change (cADC), and relative ADC change. The mean values of diffusion parameters were compared between functioning and nonfunctioning PAs. We compared the diffusion parameters of nonfunctioning PAs with those of each type of hormone‐producing PAs. The diagnostic performances of the diffusion parameters were assessed.ResultsThe cADC was significantly higher in functioning PAs than nonfunctioning PAs (p = .0124). The receiver operating characteristic (ROC) curve analysis revealed that cADC (area under the ROC curve [AUC] = .677, p = .017) is effective in distinguishing between functioning and nonfunctioning PAs. The cADC was significantly higher in growth hormone (GH)‐producing PAs compared to nonfunctioning PAs (p = .006). The ROC curve analysis indicated that cADC (AUC = .771, p < .001) effectively distinguishes between GH‐producing and nonfunctioning PAs.ConclusionsThe cADC derived from time‐dependent dMRI could distinguish between functioning and nonfunctioning PAs, particularly those producing GH.
Prognosis prediction via histological evaluation of cellular heterogeneity in glioblastoma Mari Kirishima, Seiya Yokoyama, Toshiaki Akahane, Nayuta Higa, Hiroyuki Uchida, Hajime Yonezawa, Kei Matsuo, Junkoh Yamamoto, Koji Yoshimoto, Ryosuke Hanaya, Akihide Tanimoto Scientific Reports, 2024 Glioblastomas (GBMs) are the most aggressive types of central nervous system tumors. Although certain genomic alterations have been identified as prognostic biomarkers of GBMs, the histomorphological features that predict their prognosis remain elusive. In this study, following an integrative diagnosis of 227 GBMs based on the 2021 World Health Organization classification system, the cases were histologically fractionated by cellular variations and abundance to evaluate the relationship between cellular heterogeneity and prognosis in combination with O-6-methylguanine-DNA methyltransferase gene promoter methylation (mMGMTp) status. GBMs comprised four major cell types: astrocytic, pleomorphic, gemistocytic, and rhabdoid cells. t-distributed stochastic neighbor embedding analysis using the histological abundance of heterogeneous cell types identified two distinct groups with significantly different prognoses. In individual cell component analysis, the abundance of gemistocytes showed a significantly favorable prognosis but confounding to mMGMTp status. Conversely, the abundance of epithelioid cells was correlated with the unfavorable prognosis. Linear model analysis showed the favorable prognostic utility of quantifying gemistocytic and epithelioid cells, independent of mMGMTp. The evaluation of GBM cell histomorphological heterogeneity is more effective for prognosis prediction in combination with mMGMTp analysis, indicating that histomorphological analysis is a practical and useful prognostication tool in an integrative diagnosis of GBMs.
Primary spinal cord gliomas: Pathologic features associated with prognosis Yuki Tanaka, Manabu Natsumeda, Masayuki Ohashi, Rie Saito, Nayuta Higa, Toshiaki Akahane, Hideki Hashidate, Junko Ito, Satoshi Fujii, Atsushi Sasaki, Akihide Tanimoto, Ryosuke Hanaya, Kei Watanabe, Makoto Oishi, Hiroyuki Kawashima, Akiyoshi Kakita Journal of Neuropathology and Experimental Neurology, 2024 Primary spinal cord gliomas are rare and are associated with high mortality. Unlike brain tumors, the clinicopathological features of spinal cord gliomas are not well defined. We analyzed clinical, histopathology, and immunohistochemical features and overall survival (OS) of 25 patients with primary spinal cord gliomas treated between 1994 and 2023 at 4 institutions. IDH1 R132H, H3K27M, and p53 were assessed by immunohistochemistry (IHC). Four (16%), 5 (20%), 2 (8%), and 13 (52%) patients were diagnosed as having grades 1, 2, 3, and 4 gliomas according to the World Health Organization (WHO) 2021 classification, respectively. One case (4%), with a circumscribed diffuse midline glioma, H3K27-altered, had a rare molecular profile and could not be graded. IHC demonstrated H3K27M positivity, indicative of H3F3A K27M or HIST1H3B K27M mutation, in 9 (36%) patients. H3K27me3-loss was evident in 13 (52%) patients. In one patient with a grade 1 tumor that showed negative staining for H3K27M and H3K27me3 loss, numbers of EZHIP-positive cells were increased, suggesting diffuse midline glioma, H3K27-altered (WHO grade 4). H3K27me3 loss, frequency of p53 positive cells (≥10%), MIB-1 index (≥10%), and high histopathological grades significantly correlated with poor OS. These results indicate the pathological and immunohistochemical characteristics of primary spinal cord gliomas that impact prognosis.
All-in-one bimodal DNA and RNA next-generation sequencing panel for integrative diagnosis of glioma Nayuta Higa, Toshiaki Akahane, Mari Kirishima, Hajime Yonezawa, Ryutaro Makino, Hiroyuki Uchida, Seiya Yokoyama, Tomoko Takajo, Ryosuke Otsuji, Yutaka Fujioka, Yuhei Sangatsuda, Daisuke Kuga, Hitoshi Yamahata, Nobuhiro Hata, Nobutaka Horie, Masamichi Kurosaki, Junkoh Yamamoto, Koji Yoshimoto, Akihide Tanimoto, Ryosuke Hanaya Pathology Research and Practice, 2024 Previously, we constructed a DNA-based next-generation sequencing (NGS) panel for an integrated diagnosis of gliomas according to the 2021 World Health Organization classification system. The aim of the current study was to evaluate the feasibility of a modified panel to include fusion gene detection via RNA-based analysis. Using this bimodal DNA/RNA panel, we analyzed 210 cases of gliomas and others to identify fusion genes in addition to gene alterations, including TERT promoter (TERTp) mutation and 1p/19q co-deletion, in formalin-fixed paraffin-embedded tissues. Of the 210 patients, fusion genes were detected in tumors of 35 patients. Eighteen of 112 glioblastomas (GBs) harbored fusion genes, including EGFR and FGFR3 fusions. In IDH-mutant astrocytoma, 6 of 30 cases showed fusion genes such as MET and NTRK2 fusions. Eleven molecular GBs and 20 not-elsewhere-classified cases harbored no gene fusions. Other 11 tumors including ependymoma, pilocytic astrocytoma, diffuse hemispheric glioma, infant-type hemispheric glioma, and solitary fibrous tumors exhibited diagnostic fusion genes. Overall, our results suggest that the all-in-one bimodal DNA/RNA panel is reliable for detecting diagnostic gene alterations in accordance with the latest WHO classification. The integrative pathological and molecular strategy could be valuable in confirmation of diagnosis and selection of treatment options for brain tumors.
A pituitary gland squeezed upward by intrasellar kissing carotid arteries: Mimicking a pituitary microadenoma Eri Inoue, Shingo Fujio, Hiroshi Hosoyama, Shinichiro Yoshimura, FM Moinuddin, Ryosuke Hanaya, Kazunori Arita Surgical Neurology International, 2024 Background: Intrasellar kissing carotid arteries are a rare variant in which bilateral internal carotid arteries run very near each other at their cavernous sinus portion. We encountered a woman with the pituitary gland mimicking a pituitary microadenoma because the pituitary gland was compressed bilaterally by intrasellar kissing carotid arteries. Case Description: A 61-year-old woman with a chronic headache underwent magnetic resonance imaging, which revealed a sellar mass measuring 10.2 mm in height, 8.2 mm in length, and 4.0 mm in width at the midintercarotid level. Blood levels of all pituitary and target-organ hormones were within normal range. The height and superior convex shape of the sellar mass suggested that it was a nonfunctioning microadenoma, which was monitored over the past 16 years. A recent three-dimensional reconstruction of magnetic resonance angiography clearly showed that the pituitary gland was squeezed upward, compressed bilaterally, and extended superiorly by intrasellar kissing carotid arteries. Conclusion: The pituitary gland can be squeezed upward by intrasellar kissing carotid arteries and mimic pituitary tumor.
Age-independent benefits of postoperative rehabilitation during chemoradiotherapy on functional outcomes and survival in patients with glioblastoma Keisuke Natsume, Akira Yoshida, Harutoshi Sakakima, Hajime Yonezawa, Kentaro Kawamura, Shintaro Akihiro, Ryosuke Hanaya, Megumi Shimodozono Journal of Neuro Oncology, 2024 Purpose To investigate the impact of early and continuous postoperative inpatient rehabilitation during chemoradiotherapy on functional outcomes and overall survival (OS) in patients with glioblastoma (GBM), particularly in different age groups. Methods This retrospective cohort study at a university hospital (2011–2016) included 75 of 119 consecutive patients newly diagnosed with GBM who underwent standardized treatment and postoperative rehabilitation. Patients were divided into older (≥ 65 years, n = 45) and younger (< 65 years, n = 30) groups, engaging in a 50-day rehabilitation program. We assessed rehabilitation progress, Barthel Index (BI), Brunnstrom Recovery Stage (BRS), adverse events, and OS. BI at discharge and survival were analyzed using multivariate and Cox regression models, respectively. Results The mean age was 72.5 ± 6.3 and 52.4 ± 7.8 years in the older and younger groups, respectively. Both groups demonstrated significant improvements in BI and BRS. Despite more adverse events in the older group, no significant difference existed in median OS (older group: 18.7 months vs. younger group: 18.3 months, p = 0.87). Early walking training, reduced fatigue during chemoradiotherapy, and high Karnofsky Performance Status at admission significantly impacted the BI at discharge. Cox regression analysis identified the BI at discharge as a significant predictor of survival (hazard ratio [HR] 0.98, 95% confidence interval [CI] 0.97–0.99, p = 0.008). Conclusion Integrated rehabilitation improves functional outcomes, and enhanced ADL at discharge is associated with improved survival outcomes in patients with GBM, regardless of age. This highlights the need for personalized rehabilitation in treatment protocols. Further prospective studies are warranted to confirm these findings.
Cerebrospinal fluid protein concentration in patients with lumbar spinal stenosis Hitoshi Yamahata, Kosei Ijiri, Fumito Tanabe, Kyoichi Murasumi, Yushi Nagano, Ryutaro Makino, Nayuta Higa, Ryosuke Hanaya Surgical Neurology International, 2024 Background: In this study, we examined the impact and degree of lumbar stenosis on cerebrospinal fluid (CSF) protein concentration. Methods: In this retrospective study, we analyzed protein concentrations in CSF samples of 61 patients with lumbar spinal stenosis (LSS) obtained during pre-operative myelography. Patients were divided into two groups: those showing no block to contrast (Group A) versus those showing medium block to contrast below the lumbar puncture level (Group B). Results: The CSF protein concentration in Group B (104.3 ± 59 g/dL) patients with medium block was significantly greater than that in Group A (65.1 ± 33 g/dL) patients without medium block. Conclusion: A higher average CSF protein concentration was seen in Group B patients with significant lumbar stenosis versus Group A patients without significant lumbar stenosis. Theoretically, damage to the cauda equina in patients with LSS may cause these elevated CSF protein levels.
Initiating an epilepsy surgery program with limited resources in Indonesia Muhamad Thohar Arifin, Ryosuke Hanaya, Yuriz Bakhtiar, Aris Catur Bintoro, Koji Iida, Kaoru Kurisu, Kazunori Arita, Jacob Bunyamin, Rofat Askoro, Surya Pratama Brilliantika, Novita Ikbar Khairunnisa, Zainal Muttaqin Scientific Reports, 2021
Surgery for Radiologically Normal-Appearing Temporal Lobe Epilepsy in a Centre with Limited Resources Muhamad Thohar Arifin, Yuriz Bakhtiar, Erie B. P. S. Andar, Happy Kurnia B., Dody Priambada, Ajid Risdianto, Gunadi Kusnarto, Krisna Tsaniadi, Jacob Bunyamin, Ryosuke Hanaya, Kazunori Arita, Aris Catur Bintoro, Koji Iida, Kaoru Kurisu, Rofat Askoro, Surya P. Briliantika, Zainal Muttaqin Scientific Reports, 2020
Treatable glomerular hyperfiltration in patients with active acromegaly Shingo Fujio, Koji Takano, Hiroshi Arimura, Mika Habu, Manoj Bohara, Horofumi Hirano, Ryosuke Hanaya, Yoshihiko Nishio, Chihaya Koriyama, Yasuyuki Kinoshita, Kazunori Arita European Journal of Endocrinology, 2016
Solitary cranial langerhans cell histiocytosis: Two case reports Hiroshima Journal of Medical Sciences, 2015
Improvement in treatment results of glioblastoma over the last three decades and beneficial factors Hiroto Kawano, Hirofumi Hirano, Hajime Yonezawa, Shunji Yunoue, Kazutaka Yatsushiro, Mikio Ogita, Yoshiyuki Hiraki, Hiroyuki Uchida, Mika Habu, Shingo Fujio, Tatsuki Oyoshi, Yuriz Bakhtiar, Sei Sugata, Hitoshi Yamahata, Ryousuke Hanaya, Hiroshi Tokimura, Kazunori Arita British Journal of Neurosurgery, 2015
Successful treatment of mesial temporal lobe epilepsy with bilateral hippocampal atrophy and false temporal scalp ictal onset: A case report Hiroshima Journal of Medical Sciences, 2012
Zygomatic osteotomy for resection of medial temporal cavernous angioma in dominant hemisphere after subdural grid electroencephalographic study Hiroshima Journal of Medical Sciences, 2006
Contrast enhanced fast fluid-attenuated inversion-recovery MR imaging for diagnosing cerebral venous angioma: Report of two cases Brain and Nerve, 2003
