• Clinical and Experimental Pediatrics
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• v.49 no.1
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• pp.76-81
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• 2006

Purpose : This study evaluated the clinical characteristics of brain tumors in children according to their location, the parental delay and the doctor's delay between the onset of symptoms and the diagnosis of a pediatric brain tumor. In addition, this study compared the relationship between the pre-diagnostic symptomatic interval and the tumor location. Methods : A retrospective study was undertaken of 45 children with primary brain tumors admitted to Inha Hospital from July, 1986 to June, 2004. A diagnosis of the tumor location was made using brain MRI. Results : The male to female ratio was 1 : 0.67. The median age at diagnosis was 6.0 years in supratentorial tumors, 7.0 years in infratentorial tumors. Twenty four cases(53.3 percent) were located in the supratentorial area, 21 cases(46.6 percent) were located in the infratentorial area. The distribution of supratentorial tumors were 14(58.3 percent) in the cerebral hemisphere and temporal lobe, seven (29.1 percent) in the suprasellar area, and three(12.5 percent) in the pineal gland and posterial lateral ventricle. The distributions of the infratentorial tumors were 12(57.1 percent) in the cerebellar vermis and fourth ventricle, four(19.1 percent) in the brain stem, and five(23.8 percent) in the cerebellar hemisphere. The most common initial symptom was seizure(37.5 percent) in the supratentorial tumor and headache(38.0 percent) in infratentorial tumors. The median pre-diagnostic symptomatic interval (PSI) was 21 days(range 0-240 days). The median PSI with a parental delay in supratentorial tumor was six days(range 1-240 days), and 30 days(range 1-40 days) in the infratentorial tumor. We immediately diagnosed most cases after visiting the hospital. There was no significant relationship between the tumor location and the pre-diagnostic symptomatic interval. Conclusion : The most common symptom of supratentorial tumors and infratentorial tumors was seizure and headache, respectively. Although, the median pre-diagnostic symptomatic interval was shorter than in previous studies, a detailed medical history and a correctly interpreted neurological examination should lead to an earlier diagnosis of pediatric brain tumors.

• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.99-99
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• 2003

To exhibit our clinical experience of diffusion-weighted (DW) MR imaging for various brain pathologies and to determine its role in characterizing brain pathologies in children. DW images in 177 children (M：F＝96：81, mean age, 4.7 years) with various brain pathologies were retrospectively collected over past 3 years. DW images (b value： 1000 s/mm) were reviewed along with corresponding apparent diffusion coefficient (ADC) maps. Brain pathologies included cystic or solid brain tumor (n = 55), cerebral infarct (n = 32), cerebritis with or without brain abscess (n = 21), metabolic or toxic brain disorder (n = 19), demyelinating disease (n = 16), hypoxic-ischemic encephalopathy (n = 16), intracerebral hemorrhage including traumatic brain lesion (n = 15), and posterior reversible leukoencephalopathy (n = 3). We reviewed whether DW images and ADCmaps contribute to further characterization of brain pathologies by defining a chronological age of lesions, the presence of cytotoxic edema in lesions, and the nature of cystic lesions.

• Investigative Magnetic Resonance Imaging
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• v.1 no.1
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• pp.125-129
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• 1997

Purpose: The aim of this study was to find correlation between the expression of epidermal growth factor receptor (EGFR) and MR findings in the brain glioma. Materials and Methods: MR features including edema, margin, necrosis, heterogeneity, hemorrhage and contrast enhancement were retrospectively analyzed with preoperative MR images in 41 patients with proven brain gliomas (8 low grade astrocytomas, 12 anaplastic astrocytomas, 21 glioblastoma multiformes). Immunohistochemical study of EGFR was done and their expressions were graded by both stained distribution and intensity. Correlation analysis between the MR features and EGFR expressions was done. Results: Peritumoral edema was correlated with both distribution (r=0.71, p=0.00) and stain intensity (r=0.69, p=0.00) of EGFR expression. Other MR features showed no statistical correlation with EGFR expression. Conclusion: MRI is useful in evaluation of brain glioma, and peritumoral edema is useful finding that suggests EGFR expression as well as malignant histopathologic grade of the tumor.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3607-3612
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• 2014

Background: In recent years, numerous studies have been performed to investigate the CCND1 G870A gene polymorphism impact on brain tumors susceptibility. Unfortunately, the results of previous studies were inconsistent. Therefore, we performed a meta-analysis to derive a more precise estimation of any association. Materials and Methods: We conducted a search in PubMed, Embase and CNKI covering all published papers up to November, 2013. Odds ratios (ORs) and their 95% confidence intervals (95%CIs) were applied to assess associations. Results: A total of 6 publications including 9 case-control studies met the inclusion criteria. The pooled ORs for the total included studies showed significant association among comparison A vs G (OR= 1.246, 95%CI= 1.092-1.423, p= 0.001), homozygote comparison AA vs GG (OR= 1.566, 95%CI= 1.194-2.054, p= 0.001), heterozygote comparison AG vs GG (OR= 1.290, 95%CI= 0.934-1.782, p= 0.122), dominant model AA/GA vs GG (OR= 1.381, 95%CI= 1.048-1.821, p= 0.022) and recessive model AA vs GA/GG (OR= 1.323, 95%CI= 1.057-1.657, p= 0.015) especially in glioma. Conclusions: CCND1 G870A polymorphism may increase brain tumor risk, especially for gliomas. However, more primary large scale and well-designed studies are still required to evaluate the interaction of CCND1 G870A polymorphism with brain tumor risk.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.467-487
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• 2020

Anatomical imaging is the basis of the diagnosis and treatment response assessment of brain tumors. Among the existing imaging techniques currently available in clinical practice, diffusion-weighted imaging and perfusion imaging provide additional information. Recently, with the increasing importance of evaluation of the genomic variation and heterogeneity of tumors, clinical application of imaging techniques using radiomics and deep learning is expected. In this review, we will describe recommendations for magnetic resonance imaging protocols focusing on anatomical images that are still important in the clinical application of brain tumor imaging, and the basic principles of diffusion-weighted imaging and perfusion imaging among the advanced imaging techniques, as well as their pathophysiological background and clinical application. Finally, we will review the future perspectives of radiomics and deep learning applications in brain tumor imaging, which have been studied to a great extent due to the development of computer technology.

• Clinical Pain
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• v.20 no.1
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• pp.39-42
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• 2021

A 29-year-old woman had 1-month history of back pain radiating into lower extremities, motor weakness, and sensory abnormalities in both lower extremities. Contrast-enhanced spinal magnetic resonance imaging (MRI) revealed a homogeneously enhancing mass at the T12~L1 and several intradural enhancing nodular lesions at L2~S1. Tumor resection surgery was performed and following histological examination showed that the tumor satisfied the diagnostic criteria for atypical choroid plexus papilloma (CPP). To find primary tumor sites, contrast-enhanced brain MRI, whole spine MRI, and PET-CT were carried out and additional lesions were detected at the fourth ventricle, right cerebellum, and upper thoracic spinal cord. This is a very rare case of metastatic atypical CPP that involves brain, upper thoracic spinal cord, and cauda equina with initial manifestation of radicular symptoms without clinical signs of primary brain lesion.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.308-315
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• 2023

Recent updates in genomic-integrated glioma classification have caused confusion in current clinical practice, as management protocols and health insurance systems are based on evidence from previous diagnostic classifications. The Korean Brain Tumor Society conducted an electronic questionnaire for society members, asking for their ideas on risk group categorization and preferred treatment for each individual diagnosis listed in the new World Health Organization (WHO) classification of gliomas. Additionally, the current off-label drug use (OLDU) protocols for glioma management approved by the Health Insurance Review and Assessment Service (HIRA) in Korea were investigated. A total of 24 responses were collected from 20 major institutes in Korea. A consensus was reached on the dichotomic definition of risk groups for glioma prognosis, using age, performance status, and extent of resection. In selecting management protocols, there was general consistency in decisions according to the WHO grade and the risk group, regardless of the individual diagnosis. As of December 2022, there were 22 OLDU protocols available for the management of gliomas in Korea. The consensus and available options described in this report will be temporarily helpful until there is an accumulation of evidence for effective management under the new classification system for gliomas.

• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.252-256
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• 2009

Meningioangiomatosis (MA) is a rare congenital tumor that occurs mostly in 5-15 year old children. There have been only 5 cases previously reported that described the cystic nature within these tumors. We present a case of a MA accompanied by a separate macrocyst. A normally developed 2 year-old female patient presented with partial and generalized seizures. The brain computerized tomogram and magnetic resonance imaging revealed the presence of a calcified mass accompanied by a cyst in the right parietal area, surrounded by low density and high attenuation edema and hemorrhage. Upon right parietal craniotomy, a $1.6cm{\times}1.2cm{\times}0.5cm$ sized plate-like, gray-white, slightly hard mass was seen and it was completely excised. Approximately 1 cm from the mass in the anterior lateral direction, a cyst was found and subsequent biopsy of the cyst wall revealed no tumor tissue, and therefore the cyst was not removed. Pathologic report demonstrated the meningioangiomatosis. Follow up examination 2 years later showed no recurrence of the tumor, and there was no evidence of neurological deficits. Authors suggest that cysts that arise in the surrounding tissues of tumors may not be tumor cysts, and do not require surgical removal.

• Journal of Korean Neurosurgical Society
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• v.53 no.3
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• pp.197-200
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• 2013

Diagnosis of cerebral syphilitic gumma is frequently determined at the time of surgery, because imaging and laboratory findings demonstrate the elusive results. A 59-year-old woman presenting dysarthria showed a mass on her brain computed tomography. She was first suspected of brain tumor, but histological results from surgical resection revealed cerebral gumma due to neurosyphilis. After operation, she presented fever and rash with an infiltration on a chest X-ray. Histological assessment of skin was consistent with syphilis. Fluorescent treponemal antibody absorbed test IgG in cerebrospinal fluid was positive. She was successfully treated with ceftriaxone for 14 days.

• Korean Journal of Radiology
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• v.2 no.2
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• pp.108-112
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• 2001

We report two cases of supratentorial gangliocytomas mimicking an extra-axial tumor. MR imaging indicated that the tumors were extra-axial, and meningiomas were thus initially diagnosed. Relative to gray matter, the tumors were hypointense on T1-weighted images and hyperintense on T2-weighted images. On contrast-enhanced T1-weighted images, homogeneous enhancement was observed, while CT scanning revealed calcification in one of the two cases.