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J. Bradley White, Gary M. Miller, Kennith F. Layton, and William E. Krauss

nonenhancing intramedullary spinal cord tumors. The final diagnosis for the pathological entities found in those patients is shown in Table 1 . Most of the tumors were either ependymomas or astrocytomas. TABLE 1 Breakdown of tumor types analyzed retrospectively in 130 patients Diagnosis No. of Patients (%) No. of Nonenhancing Tumors ependymoma 83 (64) 0 astrocytoma 35 (27) 10 ganglioglioma 3 (2) 0 hemangioblastoma 3 (2) 0 subependymoma 2 (2) 1 meningioma 1 (1) 0 oligoastrocytoma 1 (1) 0

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Shawn L. Hervey-Jumper, Hugh J. L. Garton, Darryl Lau, David Altshuler, Douglas J. Quint, Patricia L. Robertson, Karin M. Muraszko, and Cormac O. Maher

cohort of 6 patient medulloblastoma samples representing 3 enhancing and 3 nonenhancing tumors were selected for VEGFR, CD31, and microvessel density analysis (no partially enhancing tumors were used). All 3 enhancing specimens had the classic histological signs, while the nonenhancing specimens included 2 with classic histology and 1 with desmoplastic histology. All specimens were handled in accordance with the policies established by the Institutional Review Board at the University of Michigan. F ig . 1. Representative axial MR images of medulloblastomas

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Wajd N. Al-Holou, Dima Suki, Tiffany R. Hodges, Richard G. Everson, Jacob Freeman, Sherise D. Ferguson, Ian E. McCutcheon, Sujit S. Prabhu, Jeffrey S. Weinberg, Raymond Sawaya, and Frederick F. Lang

supply to the surrounding brain. Any large arteries and veins overlying the tumor should be preserved. FIG. 3. MRI sequences and intraoperative photographs of right frontal premotor tumor resection using the SGR technique. A: Preoperative FLAIR MRI sequence showing nonenhancing tumor located in the middle frontal gyrus anterior to and abutting the motor cortex. The depth of the posterior sulcus often demarcates the depth of the tumor ( arrow ). B: Postoperative FLAIR MRI sequence showing complete resection. C: Intraoperative photograph of brain after awake

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Quan Zhou and Gordon Li

-infrared light and fluorescence signal was collected with the handheld imager. 2:08 Residual Tumor. Residual tumor was identified with high fluorescence intensity and removed from resection cavity. 2:15 Wound Bed. Minimal fluorescence, likely from nonenhancing tumor, remained in the final wound bed outside the contrast-enhancing margin on MRI, and thus not removed per standard-of-care protocol. 2:25 IGP: NIR. Resected tumor pieces were imaged in a near-infrared instrument free from ambient light. 6 2:35 Postoperative MRI: T1+C. Postoperative MRI confirmed gross

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Kaisorn L. Chaichana, Thomas Kosztowski, Ashwini Niranjan, Alessandro Olivi, Jon D. Weingart, John Laterra, Henry Brem, and Alfredo Quiñones-Hinojosa

MR imaging. Tumor recurrence was defined as evidence of either tumor recurrence or progressive growth on MR imaging. As such, patient survival is a more reliable outcome measure as compared with tumor recurrence. Also, it is inherent that it is easier to detect tumor progression for contrast-enhancing tumors as compared with nonenhancing tumors. Thus, FLAIR imaging was primarily used to detect tumor recurrence to minimize this inherent limitation. Nonetheless, although these factors may be interrelated, examining the role of contrast enhancement as it relates to

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Tracy R. McKnight, Kathleen R. Lamborn, Tonya D. Love, Mitchel S. Berger, Susan Chang, William P. Dillon, Andrew Bollen, and Sarah J. Nelson

the predictive capabilities of combined MR spectroscopic measures involving Cho, we ranked the Cho/NAA ratio, Cho/Cr ratio, CNI, and CCI by patient and again performed a univariate regression. The analyses were repeated on data from three subgroups: Grade II tumors (11 tumors), Grade III tumors (10 tumors), and nonenhancing tumors (14 tumors). In interpreting the results of our analyses, it is important to take into account the issue of multiple comparisons. For the purpose of highlighting potentially interesting results, correlations were declared to be

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Michael A. Vogelbaum, Cathy Brewer, Gene H. Barnett, Alireza M. Mohammadi, David M. Peereboom, Manmeet S. Ahluwalia, and Shenqiang Gao

contrast, corresponding intensity heat-maps, and original 3D MRI sequences were visualized in ImageIQ’s 3D-rendering software using various opacity and isosurface representations. We performed a t-test to compare the volumes of distribution within enhancing versus nonenhancing tumor. This analysis was performed with use of R Statistical Programming Environment (version 3.4.1). Safety was evaluated with the use of CTCAE v.4.0. While the primary analysis was focused on the safety of the CMC device, we also recognized that there also was risk associated with the device

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Michael A. Vogelbaum, Cathy Brewer, Gene H. Barnett, Alireza M. Mohammadi, David M. Peereboom, Manmeet S. Ahluwalia, and Shenqiang Gao

contrast, corresponding intensity heat-maps, and original 3D MRI sequences were visualized in ImageIQ’s 3D-rendering software using various opacity and isosurface representations. We performed a t-test to compare the volumes of distribution within enhancing versus nonenhancing tumor. This analysis was performed with use of R Statistical Programming Environment (version 3.4.1). Safety was evaluated with the use of CTCAE v.4.0. While the primary analysis was focused on the safety of the CMC device, we also recognized that there also was risk associated with the device

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Christoph Bettag, Katharina Schregel, Philip Langer, Carolina Thomas, Daniel Behme, Christine Stadelmann, Veit Rohde, and Dorothee Mielke

tissue and CSF was 1213.2 cm 3 (± 98.5 cm 3 ). The mean postoperative volume of the brain parenchyma without the resection cavity and CSF was 1151.2 cm 3 (± 106.3 cm 3 ). The mean contrast-enhancing tumor volume was 52.2 cm 3 (± 31.8 cm 3 ). The mean volume of the resection cavity was 32.9 cm 3 (± 21.1 cm 3 ). The mean volume of the nonenhancing tumor tissue was 62.0 cm 3 (± 46.1 cm 3 ), and the volume of the overall resected fluorescent tissue was 114.2 cm 3 (± 70.0 cm 3 ; Table 1 ). Extent of Resection In 9 of 12 patients (75%), the resection cavity was

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Frederick A. Boop

diffuse lesions, enhancing or nonenhancing. As one might anticipate, those children with focal nonenhancing tumors tended to have low-grade histology and a more indolent clinical course. Those with diffuse nonenhancing tumors documented on MR imaging all had DIPGs, and 90% of those with diffuse enhancing tumors had DIPGs. Thus, the authors have provided a nice validation of Albright's 1992 study. 1 They were able to obtain diagnostic tissue in 93.1% of patients, although the study does not address the issue of sampling error. Nine percent of children developed new