2024
154 Elucidating the Immune Landscape of Radiation Necrosis Through Single Cell Analysis of Recurrent Brain Lesions in Patients After Stereotactic Radio Surgery
Robert S, Kiziltug E, Lu B, Arnal-Estape A, Nguyen D, Chiang V. 154 Elucidating the Immune Landscape of Radiation Necrosis Through Single Cell Analysis of Recurrent Brain Lesions in Patients After Stereotactic Radio Surgery. Neurosurgery 2024, 70: 35-36. DOI: 10.1227/neu.0000000000002809_154.Peer-Reviewed Original ResearchRadiation necrosisFluorescence-activated cell sortingInterferon-stimulated genesStereotactic radiosurgeryNatural killerMyeloid cellsImmune cellsRadiosurgical treatment of brain metastasesTreatment of brain metastasesCD4+ T cellsExpression of immune cellsMorbid side effectsTreatment of RNSubpopulations of myeloid cellsStereotactic radio surgeryMetastatic brain tumorsInvasive brain biopsyCellular immune profilesInflammatory immune responseCSF of patientsRN patientsBrain metastasesCD8+Immunotherapy optionsMetastatic tumors
2023
SURG-32. EFFICACY OF LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR BIOPSY-PROVEN RADIATION NECROSIS IN RADIOGRAPHICALLY RECURRENT BRAIN METASTASES
Strowd R, Chan M, Tatter S, Chiang V, Fecci P, Prabhu S, Hadjipanayis C, Kirkpatrick J, Sun D, Sinicrope K, Mohammadi A, Sevak P, Abram S, Kim A, Leuthardt E, Chao S, Phillips J, Lacroix M, Williams B, Placantonakis D, Silverman J, Baumgartner J, Piccioni D, Laxton A. SURG-32. EFFICACY OF LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR BIOPSY-PROVEN RADIATION NECROSIS IN RADIOGRAPHICALLY RECURRENT BRAIN METASTASES. Neuro-Oncology 2023, 25: v269-v269. PMCID: PMC10640195, DOI: 10.1093/neuonc/noad179.1031.Peer-Reviewed Original ResearchLaser interstitial thermal therapyKarnofsky performance statusRadiation necrosisInterstitial thermal therapyBrain metastasesRadiographic progressionKaplan-MeierStereotactic radiosurgeryLocal controlMedian Karnofsky performance statusFuture radiographic progressionRadiotherapeutic treatment optionsResults Ninety patientsBrain metastasis patientsMulti-center registryRecurrent brain metastasesMedian hospitalization timeLesional progressionMultivariable FineNinety patientsSymptom controlCumulative incidenceMetastasis patientsPerformance statusSystemic therapyJS09.5.A18F-FLUCICLOVINE PET FOR DETECTION OF RECURRENT BRAIN METASTASES AFTER RADIATION THERAPY: IMAGE INTERPRETATION CRITERIA RESULTS FROM PURSUE, A PROSPECTIVE PHASE 2 TRIAL
Kotecha R, Chiang V, Tom M, Nabavizadeh A, Zan E, Peddi S, Sulman E, Siegel B, Huang J, Brem S, Ware M, Kesari S, Parent E, Pope W, Holmes R, Chau A, Teoh E, Chao S, Aboian M. JS09.5.A18F-FLUCICLOVINE PET FOR DETECTION OF RECURRENT BRAIN METASTASES AFTER RADIATION THERAPY: IMAGE INTERPRETATION CRITERIA RESULTS FROM PURSUE, A PROSPECTIVE PHASE 2 TRIAL. Neuro-Oncology 2023, 25: ii12-ii13. PMCID: PMC10489492, DOI: 10.1093/neuonc/noad137.034.Peer-Reviewed Original ResearchRecurrent brain metastasesImage interpretation criteriaBrain metastasesRadiation therapyLesion uptakeDiagnostic performancePredictive valueProspective phase 2 trialSolid tumor brain metastasesTumor brain metastasesPhase 2 trialInterpretation criteriaNegative predictive valueLow background uptakePositive predictive valueExcellent diagnostic performanceBM recurrencePost-MRIPrimary endpointSecondary endpointsRadiation necrosisReference lesionsUnnecessary surgeryHistopathological analysisInitial cohortEvaluating the diagnostic performance of 18F-fluciclovine for detection of recurrent brain metastases after radiation therapy: Results from a prospective phase 2 trial.
Kotecha R, Chiang V, Tom M, Nabavizadeh A, Zan E, Peddi S, Sulman E, Siegel B, Huang J, Brem S, Ware M, Kesari S, Parent E, Pope W, Holmes R, Chau A, Teoh E, Chao S, Aboian M. Evaluating the diagnostic performance of 18F-fluciclovine for detection of recurrent brain metastases after radiation therapy: Results from a prospective phase 2 trial. Journal Of Clinical Oncology 2023, 41: 2001-2001. DOI: 10.1200/jco.2023.41.16_suppl.2001.Peer-Reviewed Original ResearchRecurrent brain metastasesImage interpretation criteriaF-fluciclovine PETF-fluciclovine uptakeBrain metastasesF-fluciclovineRadiation therapyDiagnostic performanceHistopathological analysisSUV maxFirst prospective multicenter trialProspective phase 2 trialSolid tumor brain metastasesTumor brain metastasesPhase 2 trialProspective multicenter trialIndependent blinded readersFluciclovine uptakePost-MRIPrimary endpointSecondary endpointsMulticenter trialRadiation necrosisRecurrent tumorsFuture trials465 Defining the Immune Profile of Radiation Necrosis Through Single-cell Analysis of Intracranial Lesions
Robert S, Lu B, Arnal-Estape A, Nguyen D, Chiang V. 465 Defining the Immune Profile of Radiation Necrosis Through Single-cell Analysis of Intracranial Lesions. Neurosurgery 2023, 69: 97-98. DOI: 10.1227/neu.0000000000002375_465.Peer-Reviewed Original ResearchRadiation necrosisFluorescence-activated cell sortingImmune profileNatural killer (NK) cellsIncidence of radiation necrosisManagement of brain metastasesMetastatic brain tumor patientsMorbid side effectsTreatment of RNRecurrent metastatic diseaseExpression of Foxp3Cytotoxic T cellsInvasive brain biopsyCellular immune profilesInterleukin-7 receptorBrain tumor patientsBrain metastasesMetastatic diseaseMetastatic tumorsImmune landscapeIntraoperative samplesPatient survivalT cellsBrain biopsyIntracranial lesionsEfficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases
Chan M, Tatter S, Chiang V, Fecci P, Strowd R, Prabhu S, Hadjipanayis C, Kirkpatrick J, Sun D, Sinicrope K, Mohammadi A, Sevak P, Abram S, Kim A, Leuthardt E, Chao S, Phillips J, Lacroix M, Williams B, Placantonakis D, Silverman J, Baumgartner J, Piccioni D, Laxton A. Efficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases. Neuro-Oncology Advances 2023, 5: vdad031. PMID: 37114245, PMCID: PMC10129388, DOI: 10.1093/noajnl/vdad031.Peer-Reviewed Original ResearchLaser interstitial thermal therapyKarnofsky performance statusRadiation necrosisInterstitial thermal therapyBrain metastasesLocal controlMedian Karnofsky performance statusRecurrent brain metastasesMedian hospitalization timeLow patient morbidityLesional progressionMultivariable FineCumulative incidenceOverall survivalPerformance statusSymptom controlHospitalization timeSystemic therapyMedian timeNeurological deathSymptom managementKaplan-MeierPatient morbiditySeizure prevalenceUS Centers
2022
IMMU-01. DEFINING THE IMMUNE PROFILE OF RADIATION NECROSIS THROUGH SINGLE-CELL ANALYSIS OF INTRACRANIAL LESIONS
Robert S, Lu B, Kiziltug E, Estape A, Nguyen D, Chiang V. IMMU-01. DEFINING THE IMMUNE PROFILE OF RADIATION NECROSIS THROUGH SINGLE-CELL ANALYSIS OF INTRACRANIAL LESIONS. Neuro-Oncology 2022, 24: vii131-vii131. DOI: 10.1093/neuonc/noac209.499.Peer-Reviewed Original ResearchRadiation necrosisFluorescence-activated cell sortingNatural killer (NK) cellsIncidence of radiation necrosisManagement of brain metastasesMetastatic brain tumor patientsMorbid side effectsTreatment of RNRecurrent metastatic diseaseExpression of Foxp3Invasive brain biopsyCellular immune profilesInterleukin-7 receptorBrain tumor patientsNeuroimmune profileBrain metastasesMetastatic diseaseCytotoxic TMetastatic tumorsImmune landscapeIntraoperative samplesImprove patient diagnosisImmune profilePatient survivalBrain biopsyHistological changes associated with laser interstitial thermal therapy for radiation necrosis: illustrative cases
Fomchenko EI, Leelatian N, Darbinyan A, Huttner AJ, Chiang VL. Histological changes associated with laser interstitial thermal therapy for radiation necrosis: illustrative cases. Journal Of Neurosurgery Case Lessons 2022, 4: case21373. PMID: 35855352, PMCID: PMC9257400, DOI: 10.3171/case21373.Peer-Reviewed Original ResearchLaser interstitial thermal therapyRadiation necrosisInterstitial thermal therapyBrain metastasesAssociated cerebral edemaStage IV diseaseUse of immunotherapyPredictors of responseOngoing immunotherapySurgical decompressionCerebral edemaPerilesional edemaSurgical approachClinical historyLung cancerNeurological compromiseGood patientHistological changesStereotactic radiosurgeryPatientsEarly reductionSized lesionsImmunotherapyTherapyThermal therapy513 Surveilling Cerebrospinal Fluid Protein Biomarkers in Brain Metastasis
Cheok S, Arnal-Estape A, Wei W, Nguyen D, Chiang V. 513 Surveilling Cerebrospinal Fluid Protein Biomarkers in Brain Metastasis. Neurosurgery 2022, 68: 129-129. DOI: 10.1227/neu.0000000000001880_513.Peer-Reviewed Original ResearchBrain metastasesCerebrospinal fluidIntraparenchymal diseaseCentral nervous system pathologyCerebrospinal fluid (CSF) protein biomarkersIntraparenchymal brain metastasesManagement of patientsNormal pressure hydrocephalusNervous system pathologyCurrent diagnostic standardNon-malignant samplesWarrants further explorationCSF profilePressure hydrocephalusRadiation necrosisLung cancerSimilar pathogenesisBrain parenchymaInflammatory diseasesIntracranial diseaseBreast cancerClinical dataCSF leakTreatment responsePatients
2021
Recognition and Management of Adverse Radiation Effects
Cheok S, Hansen J, Chiang V. Recognition and Management of Adverse Radiation Effects. 2021, 391-404. DOI: 10.1201/9781003167464-36.ChaptersAdverse radiation effectsRadiation necrosisStereotactic radiosurgeryRole of SRSImmune-mediated componentLaser interstitial thermotherapyMore brain lesionsBrain metastasesSystemic therapyIntracranial pathologyMalignant pathologyBrain lesionsNecrosisInterstitial thermotherapyPathologyContemporary evidenceBevacizumabCraniotomyMetastasisTherapyLesionsRadiosurgerySteroidsReirradiation With Stereotactic Radiosurgery After Local or Marginal Recurrence of Brain Metastases From Previous Radiosurgery
Kowalchuk RO, Niranjan A, Lee CC, Yang HC, Liscak R, Guseynova K, Tripathi M, Kumar N, Peker S, Samanci Y, Hess J, Chiang V, Iorio-Morin C, Mathieu D, Pikis S, Wei Z, Lunsford LD, Trifiletti DM, Sheehan JP. Reirradiation With Stereotactic Radiosurgery After Local or Marginal Recurrence of Brain Metastases From Previous Radiosurgery. International Journal Of Radiation Oncology • Biology • Physics 2021, 112: 726-734. PMID: 34644606, DOI: 10.1016/j.ijrobp.2021.10.008.Peer-Reviewed Original ResearchConceptsLocal tumor controlRepeat stereotactic radiosurgeryRadiation necrosisStereotactic radiosurgeryBrain metastasesTumor controlMaximum doseMarginal recurrenceBiopsy-proven non-small cell lung cancerIsodose lineNon-small cell lung cancerRisk of RNPreoperative stereotactic radiosurgeryPrior stereotactic radiosurgerySymptomatic radiation necrosisNeuro-Oncology criteriaCell lung cancerPrescription isodose linePrevious radiosurgeryMargin dosePrimary endpointPrior immunotherapyLung cancerMajor indicationTumor volumeSURG-02. Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (SRS) as a treatment strategy for brain metastasis that recurred locally after initial radiosurgery (BMRS): a collaborative institutional experience
Pena-Pino I, Ma J, Hori Y, Fomchenko E, Dusenbery K, Reynolds M, Wilke C, Yuan J, Barnett G, Chiang V, Mohammadi A, Chen C. SURG-02. Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (SRS) as a treatment strategy for brain metastasis that recurred locally after initial radiosurgery (BMRS): a collaborative institutional experience. Neuro-Oncology Advances 2021, 3: iii23-iii23. PMCID: PMC8351296, DOI: 10.1093/noajnl/vdab071.095.Peer-Reviewed Original ResearchStereotactic laser ablationStereotactic radiosurgeryOverall survivalTreatment strategiesLocal controlDays of SRSSymptomatic radiation necrosisMedian overall survivalSystemic disease progressionRepeat stereotactic radiosurgeryIndependent clinical trialsInitial radiosurgerySteroid therapyBrain metastasesClinical outcomesRadiation necrosisFavorable outcomeClinical trialsDisease progressionFLAIR volumeInstitutional experiencePatientsCE volumeRadiosurgeryLocal failureIntracranial Complications From Immune Checkpoint Therapy in a Patient With NSCLC and Multiple Sclerosis: Case Report
Lu BY, Isitan C, Mahajan A, Chiang V, Huttner A, Mitzner JR, Wesley SF, Goldberg SB. Intracranial Complications From Immune Checkpoint Therapy in a Patient With NSCLC and Multiple Sclerosis: Case Report. JTO Clinical And Research Reports 2021, 2: 100183. PMID: 34590030, PMCID: PMC8474265, DOI: 10.1016/j.jtocrr.2021.100183.Peer-Reviewed Original ResearchImmune checkpoint inhibitorsMultiple sclerosisRadiation necrosisBrain lesionsWhole-brain radiation therapyImmune checkpoint therapyViable tumor cellsPaucity of dataBrain metastasesCheckpoint inhibitorsMetastatic NSCLCAdverse eventsCheckpoint therapyDurable responsesNeurologic declineRadiographic benefitIntracranial complicationsPathologic findingsAutoimmune disordersAutoimmune diseasesCase reportIntracranial diseaseRadiation therapyStereotactic radiosurgeryAnticancer benefits
2020
Laser interstitial thermal therapy in neuro-oncology applications
Hong CS, Kundishora AJ, Elsamadicy AA, Chiang VL. Laser interstitial thermal therapy in neuro-oncology applications. Surgical Neurology International 2020, 11: 231. PMID: 32874734, PMCID: PMC7451173, DOI: 10.25259/sni_496_2019.Peer-Reviewed Original ResearchLaser interstitial thermal therapyRadiation necrosisInterstitial thermal therapyBrain tumorsNeurosurgical oncologyMultiple intracranial pathologiesRole of LITTStandard craniotomy approachesOptimal patient selectionMetastatic brain tumorsOpen surgical resectionInvasive surgical treatmentLesion-specific characteristicsSymptomatic peritumoral edemaNeuro-oncology applicationsMedical comorbiditiesBrain metastasesSurgical resectionSurgical treatmentPatient selectionRecurrent tumorsTumor characteristicsOpen surgeryCare treatmentCraniotomy approachLITT for Metastatic In-Field Recurrence
Sujijantarat N, Danish S, Chiang V. LITT for Metastatic In-Field Recurrence. 2020, 51-64. DOI: 10.1007/978-3-030-48047-9_5.Peer-Reviewed Original ResearchLaser interstitial thermal therapyNeurological outcomeRadiation necrosisProgression-free survival ratesInitiation of steroidsMulticenter prospective seriesSystemic therapy optionsAdverse neurological outcomesLarge prospective studiesSuitable surgical candidatesBlood-brain barrierInterstitial thermal therapyContrast-enhancing volumeBrain metastasesSurgical candidatesProspective seriesClinical outcomesImaging changesSymptom managementCancer survivorsProspective studyTherapeutic managementTherapy optionsFLAIR volumeInvasive approachLaser interstitial thermal therapy for treatment of cerebral radiation necrosis
Hong CS, Beckta JM, Kundishora AJ, Elsamadicy AA, Chiang VL. Laser interstitial thermal therapy for treatment of cerebral radiation necrosis. International Journal Of Hyperthermia 2020, 37: 68-76. PMID: 32672119, DOI: 10.1080/02656736.2020.1760362.Peer-Reviewed Original ResearchConceptsLaser interstitial thermal therapyInterstitial thermal therapyRadiation necrosisRecurrent tumorsCerebral radiation necrosisPeri-operative morbidityBrain metastasis patientsFirst-line therapyAlternative surgical optionReal-time imaging guidanceOpen surgical resectionPersistence of symptomsTreatment of patientsDeep-seated lesionsTissue inflammatory responseAmenable lesionsChronic steroidsBrain metastasesMetastasis patientsSurgical resectionSymptomatic patientsMedical managementSurgical optionsSurgical historyIntracranial pathologyLaser interstitial thermal therapy (LITT) vs. bevacizumab for radiation necrosis in previously irradiated brain metastases
Sujijantarat N, Hong CS, Owusu KA, Elsamadicy AA, Antonios JP, Koo AB, Baehring JM, Chiang VL. Laser interstitial thermal therapy (LITT) vs. bevacizumab for radiation necrosis in previously irradiated brain metastases. Journal Of Neuro-Oncology 2020, 148: 641-649. PMID: 32602021, DOI: 10.1007/s11060-020-03570-0.Peer-Reviewed Original ResearchConceptsLaser interstitial thermal therapyLonger overall survivalRadiation necrosisInterstitial thermal therapyBrain metastasesOverall survivalMedian volume decreaseMedian volume increaseBrain metastasis patientsPre-treatment patient characteristicsRetrospective chart reviewResultsTwenty-five patientsPre-treatment factorsBevacizumab patientsChart reviewMetastasis patientsLocal recurrencePatient characteristicsTreatment optionsTreatment responseBevacizumabPatientsLesional volumeThermal therapyStatistical significanceRadiation Necrosis Following the Radiosurgical Treatment of Brain Metastases
Robert S, Chiang V. Radiation Necrosis Following the Radiosurgical Treatment of Brain Metastases. 2020, 393-405. DOI: 10.1007/978-3-030-42958-4_28.ChaptersMetastatic brain lesionsRadiation necrosisBrain lesionsStereotactic radiosurgeryRadiation-induced side effectsImmune system involvementEffective treatment modalityMetastatic intracranial tumorsBrain metastasesSystemic cancerTreatment modalitiesUnderlying pathophysiologySystem involvementDisease entityIntracranial tumorsRadiosurgical treatmentSide effectsTumor progressionBrain tissueNecrosisConcurrent useLesionsRadiosurgeryImaging modalitiesLife expectancyLaser Ablation of Abnormal Neurological Tissue Using Robotic NeuroBlate System (LAANTERN): 12-Month Outcomes and Quality of Life After Brain Tumor Ablation
Kim AH, Tatter S, Rao G, Prabhu S, Chen C, Fecci P, Chiang V, Smith K, Williams BJ, Mohammadi AM, Judy K, Sloan A, Tovar-Spinoza Z, Baumgartner J, Hadjipanayis C, Leuthardt EC. Laser Ablation of Abnormal Neurological Tissue Using Robotic NeuroBlate System (LAANTERN): 12-Month Outcomes and Quality of Life After Brain Tumor Ablation. Neurosurgery 2020, 87: e338-e346. PMID: 32315434, PMCID: PMC7534487, DOI: 10.1093/neuros/nyaa071.Peer-Reviewed Original ResearchConceptsKarnofsky performance scorePrimary tumorBaseline Karnofsky performance scoreCancer Therapy-BrainPostprocedure hospital stayReal-world registryPatient-reported QOLNeurological tissuesHigh-grade gliomasQuality of lifeReal-world outcomesBaseline comorbiditiesHospital stayAdverse eventsMost patientsOverall survivalMedian ageBrain tumor ablationRadiation necrosisPatient populationMetastatic cancerFunctional assessmentSurvival rateBaseline levelsQoLMRI-Guided Laser Interstitial Thermal Therapy for Radiation Necrosis in Previously Irradiated Brain Arteriovenous Malformations
Hong CS, Cord BJ, Kundishora AJ, Elsamadicy AA, Beckta JM, Huttner A, Chiang VL, Matouk CC. MRI-Guided Laser Interstitial Thermal Therapy for Radiation Necrosis in Previously Irradiated Brain Arteriovenous Malformations. Practical Radiation Oncology 2020, 10: e298-e303. PMID: 32068154, DOI: 10.1016/j.prro.2020.02.003.Peer-Reviewed Original Research