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.
Please review the program website for further program description
Interested applications should complete an application.
- Board eligible or certified for diagnostic radiology or its foreign equivalent
- Have completed an ACGME approved neuroradiology 1 year fellowship or its foreign equivalent.
- Have interest in oncologic imaging and research.
Goals and Objectives:
- Educate and provide experience for trainees in all facets of oncology as it applies to the central nervous system to include MR and CT techniques, functional MRI, diffusion and diffustion tensor MRI, perfusion MR and CT, and MR spectroscopy.
- Prepare the next generation of oncological neuroradiologists in providing excellent clinical care and meaningful research.
Duties and Responsibilities of Trainees:
- Review and interpret cases with an attending neuroradiologist
- Assist in neuro-interventional cases which include head and neck biopsies, tumor embolization procedures, vertebroplasty/kyphoplasty and other spine procedures
- Present at resident case conferences and multidisciplinary tumor boards
- Develop (with faculty assistance) a research project of sufficient quality for journal submission and/or national meeting presentation.
A collegial atmosphere exists between the neuroradiology section and its major referral groups (primarily the Brain and Spine Center and the Department of Head and Neck Surgery), which provides an excellent opportunity for additional learning and research.
Completed application and all required documents must be uploaded prior to application review for interviewing.
Any questions please contact:
Program Director: Komal Shah, M.D.
Program Manager: Patricia Alaniz
Program Coordinator: Esmeralda Fuentes
(Contact information can be found on the website above)…
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 …