Purpose: Synaptophysin (SYP) gene expression levels correlate with the survival rate of glioma patients. This study aimed to explore the feasibility of applying a multiparametric magnetic resonance imaging (MRI) radiomics model composed of a convolutional neural network to predict the SYP gene expression in patients with glioma.Method: Using the TCGA database, we examined 614 patients diagnosed with glioma. First, the relationship between the SYP gene expression level and outcome of survival rate was investigated using partial correlation analysis. Then, 7266 patches were extracted from each of the 108 low-grade glioma patients who had available multiparametric MRI scans, which included preoperative T1-weighted images (T1WI), T2-weighted images (T2WI), and contrast-enhanced T1WI images in the TCIA database. Finally, a radiomics features-based model was built using a convolutional neural network (ConvNet), which can perform autonomous learning classification using a ROC curve, accuracy, recall rate, sensitivity, and specificity as evaluation indicators.Results: The expression level of SYP decreased with the increase in the tumor grade. With regard to grade II, grade III, and general patients, those with higher SYP expression levels had better survival rates. However, the SYP expression level did not show any significant association with the outcome in Level IV patients.Conclusion: Our multiparametric MRI radiomics model constructed using ConvNet showed good performance in predicting the SYP gene expression level and prognosis in low-grade glioma patients.

To assess the quantitative gray matter volume of the limbic system in growth hormone-secreting pituitary adenoma (GHPAs) patients and its correlation to cognitive function. 91 right-handed patients with pituitary adenomas were retrospectively included from the First Affiliated Hospital of Sun Yat-sen University −48 with GHPAs and 43 with non-functioning pituitary adenomas (NFPAs). Participants underwent serum hormone assessment, regular sellar MRI scanning with T1WI-MPRAGE. Cognitive function was gauged using MoCA and MMSE. Brain region auto-segmentation and gray matter volume calculation were conducted on the Brainsite platform. Compared to NFPAs patients, GHPAs patients had higher gray matter volume (758,285 vs 674,610 mm³, p < 0.001). No significant volumetric differences in both sides of limbic system gray matter while there were evident differences in the relative volumes of limbic system gray matter between groups. GHPAs patients scored lower on MOCA (24.0 (2.18) vs 25.1 (2.28), p < 0.031), with no difference in MMSE. We observed a significant correlation between the relative limbic volume and MOCA scales, while no evident correlation was found between relative limbic volume and serum hormone or tumor aggressiveness. Univariate and multivariate Logistic regression showed that hippocampus and limbic cortex (parahippocampal gyrus and internal olfactory area) of advantageous hemisphere correlated significantly with occurrence of mild cognitive impairment with the C-statistic reaching 0.90. Patients with GHPAs show a relative decrease in limbic gray matter volume, especially in the hippocampus and limbic cortex of the dominant hemisphere, which is associated with mild cognitive impairment.

Original Article Using 2-dimensional hand photographs to predict postoperative biochemical remission in acromegaly patients: a transfer learning approach Mengqi Wang, Chengbin Duan, Shun Yao, Jinping Chen, Shaolin Zhang, Zongming Wang, Bin Hu, Zhigang Mao, Haijun Wang, Yonghong Zhu, Wenli Chen

Among pituitary adenomas, prolactin‑secreting pituitary neuroendocrine tumours (PRL‑PitNETs) are unique in that pharmacotherapy, specifically cabergoline (CAB), can be used as a first‑line treatment, and it is the recommended therapeutic option. However, the mechanisms underlying CAB resistance remain incompletely understood. In the present study, gene microarray analysis and clinical tissue specimens were used to identify circular RNAs (circRNAs) associated with CAB resistance. circOMA1 expression was quantified in PRL‑PitNET tissues and patient plasma using reverse transcription‑quantitative PCR, and its diagnostic potential was evaluated in 219 patients with pituitary adenoma. Gain‑ and loss‑of‑function assays, combined with molecular biology techniques, were used to investigate the biological function of circOMA1 and the underlying molecular mechanism. circOMA1 was identified as a critical circular RNA influencing CAB resistance and prognosis in PRL‑PitNET. Mechanistically, circOMA1 acted as a miR‑145‑5p sponge, leading to upregulation of the E3 ubiquitin ligase Kelch‑repeat and BTB domain‑containing protein 7. This promoted ubiquitination of the CAB‑specific, high‑affinity G‑protein‑coupled receptor dopamine D2 receptor. Consequently, downstream autophagy was attenuated, and AKT pathway inhibition was impaired, which underlied the resistance. Furthermore, in vitro and in vivo studies demonstrated that circOMA1 was transported via exosomes, facilitating the transmission of CAB resistance among PRL‑PitNET cells. Plasma exosomal circOMA1 levels were significantly elevated in PRL‑PitNET patients preoperatively. These findings established circOMA1 as a key mediator of CAB resistance and a potential prognostic indicator in patients with a PRL‑PitNET.

OBJECTIVE: Acromegaly is a rare neuroendocrine condition that can lead to significant morbidity; therefore, large studies are invaluable for understanding the disease burden. Despite China’s vast population size, studies on acromegaly remain sparse. In this report, we aimed to investigate clinical characteristics and predictors of biochemical remission after surgery for acromegaly. METHODS: A retrospective nationwide study was conducted using patient-reported data from the China Acromegaly Patient Association (CAPA) from 1998 to 2018. Univariate analyses were performed using Wilcoxon rank-sum tests, two-sample t-tests, and chi-squared tests. Using the purposeful selection method, multivariate logistic regression analysis was employed to determine independent predictors of biochemical remission at 3 months in patients after surgery. RESULTS: Of the 575 cases (mean age: 37.3 years; 59% female), macroadenomas and invasive tumors (Knosp score 3-4) were 87% and 61%, respectively. Ninety-five percent of patients were treated first with surgery (5.1% transcranial and 94.9% endonasal) and 38.3% exhibited biochemical remission at 3-months postoperatively. The following independent predictors of biochemical remission were identified: preoperative growth hormone (GH) levels between 12 and 28 μg/L [odds ratio (OR)=0.61; 95% confidence interval (CI), 0.39-0.96; p=0.031], preoperative GH levels >28 μg/L (OR=0.56; 95% CI, 0.35-0.90; p=0.016), macroadenoma (OR=0.57; 95% CI, 0.33-0.97; p=0.041), giant adenomas (OR=0.17; 95% CI, 0.06-0.44; p=0.0005), Knosp score 3-4 (OR=0.39; 95% CI, 0.25-0.59; p<0.0001), and preoperative medication usage (OR=2.16; 95% CI, 1.38-3.39; p=0.0008). CONCLUSIONS: In this nationwide study spanning over two decades, we highlight that higher preoperative GH levels, large tumor size, and greater extent of tumor invasiveness are associated with a lower likelihood of biochemical remission at 3-months after surgery, while preoperative medical therapy increases the chance of remission.