Background: Although intracranial Rosai-Dorfman disease is a principally benign lymphohistiocytosis, some patients run a relapsing or progressive course. However, reports about long-term follow-up are extremely rare. Case Description: In two patients, initial tumor resection was incomplete or followed by recurrences over 3 years, which finally subsided after application of chemotherapy, and patients remained tumor-free for more than 7 years thereafter. Conclusion: Up to now there is no agreement on how to treat complicated cases of intracranial Rosai-Dorfman disease; our good experience with adjuvant chemotherapy and long-term follow-up will contribute to treatment planning in complicated cases.
Background/Objectives: Gamma knife radiosurgery (GKRS) is widely performed as an adjuvant management of patients with residual or recurrent pituitary adenoma (PA). However, the variability in the tumor volume response to GKRS emphasizes the need for reliable predictors of treatment outcomes. The application of radiomics, an analytical approach for quantitative imaging, remains unexplored in predicting treatment responses for PAs. This study aimed to pioneer the use of radiomic MRI analysis to predict the volumetric response of PA to GKRS. Methods: This retrospective observational cohort study involved 81 patients who underwent GKRS for PA. Pre-treatment 3-Tesla MRI scans were used to extract radiomic features capturing the intensity, shape, and texture of the tumors. Radiomic signatures were generated using the least absolute shrinkage and selection operator (LASSO) for feature selection, in conjunction with several classifiers: random forest, naïve Bayes, kNN, logistic regression, neural network, and SVM. Results: The models demonstrated predictive performance in the test folds, with AUC values ranging from 0.759 to 0.928 and R2 values between 0.272 and 0.665. Single-sequence T1w, dual-sequence T1w + CE-T1w, and multi-modality including clinicopathological (CP) parameters (CP + T1w + CE-T1w) achieved rather similar prognostic performance in the test folds, with respective AUCs of 0.928, 0.899, and 0.909. All these radiomics models significantly outperformed a benchmark model involving only CP features (AUC = 0.846). Conclusions: This study represents a radiomic analysis focused on predicting the volume response of PAs to GKRS to facilitate treatment individualization. The developed MRI-based radiomics models exhibited superior classification performance compared with the benchmark model composed solely of standard clinicopathological parameters.
Introduction. Neurocysticercosis (NCC), a possible cause of epilepsy with limited epidemiological data in the Dominican Republic, is endemic in four provinces in the country's south-western region. This study aimed to determine the association between NCC and epilepsy among people living in these endemic regions, and to obtain preliminary data on the prevalence of NCC in these provinces. Patients and methods. A case-control design was used, consisting of 111 patients with epilepsy with unknown causes, and 60 controls without epilepsy or NCC. The diagnosis of NCC was based on computed tomography and magnetic resonance imaging of the skull, as well as Western immunoblotting for serum antibodies using Taenia solium, following the criteria of Del Brutto et al. Results. NCC was found in 27% of the epileptic patients (n = 30/111) and in 5% of the controls (n = 3/60); the probability of the epileptic patients having NCC was seven times higher than the controls (odds ratio = 7.04, 95% confidence interval: 2.04-24.18; p < 0.001). The participants' sociodemographic characteristics, including their age, sex, level of education, occupation, and province of residence presented no statistical significance in terms of their association with NCC. Conclusions. This study suggests that NCC is strongly associated with epilepsy in the south-western region of the Dominican Republic, and highlights the need for public health measures to improve the prevention, diagnosis and treatment of both diseases.