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Primary central nervous system lymphoma (PCNSL) is an aggressive extranodal non- Hodgkin lymphoma exclusively localized into the nervous system. The aim of this study is to evaluate the MRI imaging characteristics of the peritumoral area (PTA) and to correlate this information to pathological findings.
Primary central nervous system lymphoma (PCNSL) is an aggressive extranodal non- Hodgkin lymphoma exclusively localized into the nervous system. It is a relatively rare disorder, accounting for only 3% of all primary brain tumors but due to its anatomical localization represents an important clinical and diagnostic challenge in onco-hematology. different MRI patterns of the peritumoral area (PTA) might correlate with different histopathological sensitivity regarding diagnostic potential out of contrast-enhanced region (CER). Improvements in the understanding of PTA diagnostic potentials is of great help in diagnosing patients with deep-seated lesions, who would otherwise be not eligible for stereotactic biopsy and therefore for a consequent adequate treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Included patients | Adult patients (>18 years) candidates to stereotactic biopsy for histopathological diagnosis of intra-axial lesions suspected for primary central nervous system lymphoma (PCNSLs). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MRI imaging | Diagnostic Test | To characterize the peritumoral area in PCNLs through the use of advanced MRI sequences. |
|
| Measure | Description | Time Frame |
|---|---|---|
| MRI imaging | Peritumoral area (PTA) volumes in T1w sequence Units: cm3. | Baseline (before surgery) |
| MRI imaging | Peritumoral area (PTA) volumes in T2w sequence. Units: cm3. | Baseline (before surgery) |
| MRI imaging | Peritumoral area (PTA) volumes in FLAIR sequence. Units: cm3. | Baseline (before surgery) |
| MRI imaging | Peritumoral area (PTA) mean ADC value in PTA. Units: mm2/s | Baseline (before surgery) |
| Define immunopathological features | Number of immune cells infiltrating the lesion. Units: number/mm3 | 1 week after surgical procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy of fluoresceine guided stereotactic biopsy | Number of patients with samples positively stained with fluoresceine. Units: number of samples/patients | 1 week after surgical procedure |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients, undergoing stereotactic biopsy for newly diagnosed PSNCLs at our Institution, able to express informed consent.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Laura Sincinelli | Contact | +390226435568 | sincinelli.laura@hsr.it |
| Name | Affiliation | Role |
|---|---|---|
| Pietro Mortini, MD, Prof. | IRCCS San Raffaele Scientific Institute | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| IRCCS San Raffaele Scientific Institute | Recruiting | Milan | Milan | 20132 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31632903 | Background | Akshulakov SK, Kerimbayev TT, Biryuchkov MY, Urunbayev YA, Farhadi DS, Byvaltsev VA. Current Trends for Improving Safety of Stereotactic Brain Biopsies: Advanced Optical Methods for Vessel Avoidance and Tumor Detection. Front Oncol. 2019 Oct 2;9:947. doi: 10.3389/fonc.2019.00947. eCollection 2019. | |
| 19729544 | Background |
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| Cerebral biopsy | Diagnostic Test | To evaluate the predictive value of sodium fluorescence to confirm ex-vivo the diagnostic tumor tissue prior to histopathological examination. |
|
| Barajas RF Jr, Rubenstein JL, Chang JS, Hwang J, Cha S. Diffusion-weighted MR imaging derived apparent diffusion coefficient is predictive of clinical outcome in primary central nervous system lymphoma. AJNR Am J Neuroradiol. 2010 Jan;31(1):60-6. doi: 10.3174/ajnr.A1750. Epub 2009 Sep 3. |
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| 18224529 | Background | Koc K, Anik I, Cabuk B, Ceylan S. Fluorescein sodium-guided surgery in glioblastoma multiforme: a prospective evaluation. Br J Neurosurg. 2008 Feb;22(1):99-103. doi: 10.1080/02688690701765524. |
| 23851210 | Background | Li Y, Rey-Dios R, Roberts DW, Valdes PA, Cohen-Gadol AA. Intraoperative fluorescence-guided resection of high-grade gliomas: a comparison of the present techniques and evolution of future strategies. World Neurosurg. 2014 Jul-Aug;82(1-2):175-85. doi: 10.1016/j.wneu.2013.06.014. Epub 2013 Jul 9. |