Elshafeey N, Hassan I, Zinn PO, Colen RR. From K-space to Nucleotide. Top Magn Reson Imaging. 2017;26(1):1. doi:10.1097/RMR.0000000000000114.
Radiogenomics is a relatively new field within radiology that links different imaging features with diverse genomic events. Genomics advances provided by the Cancer Genome Atlas and the Human Genome Project have enabled researchers to harness and integrate this information with noninvasive imaging phenotypes to create a better 3-dimensional understanding of tumor behavior and biology. This review summarizes the radiogenomic literature regarding brain tumors, both glioblastoma and lower grades.
As you know, the typical gross appearance of glioblastoma on MR is characterized as an irregular, ring-enhancing tumor with a central necrotic core and surrounding area of FLAIR hyperintensity. Each of these 3 imaging components (aka. phenotypes) of the tumor reflect a distinct tumor biology such as neovascularization and active tumor [contrast-enhancing component], edema/invasion (peritumoral T2/FLAIR hyperintensity), or cell death (necrosis). As an example of the potential power of volumetric features of glioblastoma on prognosis, in a cohort of 78 patients glioblastoma tumor volumes were quantified and combined with patient age and Karnofsky performance score (KPS) to create an easy-to-use 3-step scoring system VAK (Volume-Age, KPS) that can predict patient outcome.
Additionally, specific genomic and epigenetic events have shown a predilection for specific locations within the brain. As background, MGMT, a gene that encodes for a DNA repair enzyme, is associated with a better survival in those patients with MGMT promoter methylation receiving alkylating agents such as temozolomide. In treatment-naive glioblastoma patients, it has been found that patients with unmethylated O-6- methylguanine-DNA methyltransferase (MGMT) promoter predominated in the right temporal lobe. Glioblastoma with MGMT promoter methylation, EGFR amplification, and EGFRvIII mutations tended to occur in in the left temporal lobe. Most IDH1-mutated and intact PTEN tumors were in the frontal lobe.
Roberto Vialle L, ed. Wang JC, Lamartina C, guest eds. AOSpine Masters Series, Volume 8: Back Pain. Thieme; 2016; 230 pp; 133 ill; $119.99
AOSpine Masters Series is a collection of 10 volumes covering various topics of the spine. This review will cover Volume 8: Back Pain. One of the most common chief complaints encountered by our family physicians and orthopedic surgeons is back pain. At times, treating back pain is very challenging to our healthcare providers and places a significant social and economic burden on our healthcare system. This book reports that the prevalence of back pain ranges from 70–85%.
This publication is organized into 16 chapters covering a broad range of topics that include social aspects, physical exam, imaging, and treatment. There are also specific chapters dedicated to specific pathology, including that of the sacroiliac joints, myopathies, neuromuscular disease, and infection. Additional chapters discuss back pain in pediatric and adult populations. Within each chapter, the subtopics are clearly identified and tables are nicely labeled. One neat feature of each chapter is the “pearls and pitfalls,” which provides bolded teaching points.
The chapter on imaging provides a broad overview of indications, imaging techniques, and modalities available for back pain. The chapter provides a few pictorial examples of pathology affecting the spine. The imaging discussed in this chapter would be useful for the general practitioner, as it explains the algorithm behind radiographic work-up of back pain. This chapter also further explains the pros and cons of imaging modalities such as plain films and MRI. The images are of good size and quality.
At the end of each chapter, the authors cite the references used, making it easy to correlate the chapter content. The majority of the references are from peer-reviewed journals. One good feature is the authors’ highlighted “5 …
Mattle H, Mumenthaler M. Fundamentals of Neurology: An Illustrated Guide. 2nd ed. Thieme; 2017; 456 pp; 567 ill; $79.99
Fundamentals of Neurology: An Illustrated Guide is an introductory textbook of clinical neurology. It provides a comprehensive overview of common neurologic and muscular disorders, with numerous supporting illustrations that serve to further clarify the content of this book. The intended audiences are medical students, residents, and practicing clinicians. Indeed, the textbook’s format, concise language, and straightforward illustrations will appeal to physicians of all training levels.
The textbook’s organization is easy to follow, starting from the first page where each chapter is listed and assigned a color that is used for the remainder of the book to designate the corresponding pages of the chapter. Furthermore, the material of each chapter is divided in a way that is easy to digest through the use of sections, which begin by summarizing the key points, and subsections, which have the important ideas highlighted. This approach allows the reader to use the textbook either for detailed studying or for a quick reference. Moreover, the tables, diagrams, and radiologic images are of high quality and are well annotated. In fact, if time is a limiting factor, the reader can still gain a strong understanding of the most important information by just reviewing the provided illustrations.
The textbook’s content primarily provides a clinical approach to understanding various neurologic disorders, with only a superficial focus on diagnostic radiology, especially when compared with more well-known textbooks written for the field of neuroradiology. While the initial chapters concentrate on techniques for obtaining a good patient history and physical exam, as well as ordering appropriate ancillary tests, the second half of the book discusses symptoms and common neurologic disorders in a way that neuroradiologists will also find relevant. For example, there …