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https://www.readbyqxmd.com/read/29332357/management-of-b3-lesions-of-the-breast-implementations-of-current-recommendations-in-clinical-practice
#1
Konstantinos Stergios, Ashraf Patel, Vasilios Pergialiotis
PURPOSE: Stereotactic needle breast biopsy and vacuum assisted breast biopsy have replaced wide local excision in the last decades. B3 lesions of the breast represent a particular subgroup which is difficult to manage. The purpose of the present study was to present our experience with this specific type of lesions and to examine the conformity of Princess Margaret Hospital with current recommendations. METHODS: We retrospectively searched for patients that attended the Breast Clinic of Princess Alexandra Hospital during the period 2012-2015, and were diagnosed with B3 lesions during stereotactic needle core biopsy...
November 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29332083/deep-brain-stimulation-interventional-and-intraoperative-mri-approaches
#2
Paul S Larson, Philip A Starr, Alastair J Martin
Interventional and intraoperative MRI approaches to deep brain stimulator implantation are relatively new, and in their purest form represent a distinct departure from traditional stereotactic techniques. They employ a novel means of stereotaxis based on regions of interest in the MR space and simple geometric principles, which eliminate the need for a stereotactic frame. This approach is appropriate for targets that are MR visible, and for whom the local anatomy and function are well characterized. It may also be appropriate for targets that do not have a well-described physiologic signature and for which clinical response to macrostimulation does not play a critical role...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332082/frameless-functional-stereotactic-approaches
#3
Viktoras Palys, Kathryn L Holloway
The stereotactic frame has served as the gold standard apparatus for accurate and precise targeting of deep brain structures since 1947. Despite passing the test of time, the stereotactic frame has several limitations from the perspective of both neurosurgeons and patients. Therefore, there was a need to develop a frameless system that had equivalent accuracy and reliability to the frame. This need was met with 3 commercially available frameless stereotactic systems designed specifically for deep brain stimulation surgery: Nexframe, STarFix, and ClearPoint...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332081/radiosurgical-subthalamic-nucleotomy
#4
Jean Régis, Romain Carron, Tatiana Witjas
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is the reference technique in Parkinson's disease (PD) at different stages of complications. Some patients cannot afford DBS due to anticoagulation or comorbidities or due to pecuniary reasons. Radiosurgery is a minimally invasive stereotactic technique, with no craniotomy and subsequently no risk of bleeding or infection. Its good safety efficacy profile has been established in the treatment of tremor, and the postoperative care issues are simple with a much shorter hospital stay (mean 48 h)...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332077/stereotactic-radiofrequency-lesioning-for-movement-disorders
#5
Takaomi Taira, Shiro Horisawa, Nobuhiko Takeda, Prajakta Ghate
During the past 2 decades, deep brain stimulation (DBS) took over the position of radiofrequency (RF) lesioning of thalamic or pallidal targets for control of movement disorders. Superiority of DBS over RF lesioning is widely accepted, and most neurosurgeons even regard RF lesioning to be old-fashioned and dangerous. Such concepts emerged from the data of old stereotactic operations with ventriculography and without computerized planning. Hardware-related complications are not negligible in long-term DBS therapy, and DBS only controls the symptoms...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332072/medical-management-of-movement-disorders
#6
Marina Picillo, Renato P Munhoz
Pharmacological treatment is the cornerstone in the management of movement disorders. Although most available treatment options have no impact on the underlying process of each movement disorder, symptomatic therapies can significantly improve patient's quality of life and level of disability. Here, we review the current knowledge on clinical symptomatic management of Parkinson's disease (both early and advanced stages), essential tremor, dystonia, and chorea. Ideally, treatment should be carried out by specialists with reasonable experience in movement disorders, as it needs to be tailored for each patient depending on several appraisals, including but not limited to patients' needs, compliance issues, potential side effects, caregiver support, and presence of comorbidities...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332069/the-history-of-movement-disorder-brain-surgery
#7
L Dade Lunsford, Ajay Niranjan
The first surgical procedures for abnormal movement disorders began in the 1930s, when surgeons first proposed ablative techniques of the caudate nucleus or transection of motor (pyramidal) pathways to reduce involuntary movements in patients with Parkinson's related tremor. During the 50-year interval between 1945 and 1995, the development of precise intracranial guiding devices, brain maps, and advanced imaging led to the refinement of appropriate deep brain targets affecting extrapyramidal pathways. Lesional surgery and subsequent neuroaugmentation using deep brain stimulation extended the role of deep brain surgery for a wider group of patients with tremor, rigidity, dyskinesia, and other involuntary movement disorders...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29331746/canadian-neurosurgery-educators-views-on-stereotactic-radiosurgery-in-residency-training
#8
Nardin Samuel, Justine Philteos, Naif M Alotaibi, Christopher Ahuja, Alireza Mansouri, Abhaya V Kulkarni
OBJECTIVE: Despite the increasing prominence of stereotactic radiosurgery (SRS) in treating intracranial and spinal pathologies, there is currently a dearth of exposure to this modality in neurosurgical residency. To address this gap, the aim of this study is to assess neurosurgery educators' views regarding the current state of SRS exposure, and to identify potential approaches to improve residency education in this domain. METHODS: Qualitative thematic analysis and constructivist grounded theory methodology were employed...
January 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29331745/tumefactive-multiple-sclerosis-masquerading-as-high-grade-glioma
#9
Michelle Lin, Patrick Reid, Joshua Bakhsheshian
Tumefactive multiple sclerosis is a demyelinating lesion that can radiographically mimic high-grade gliomas during acute episodes, impacting clinical decision making. Delay in appropriate diagnoses may result in unnecessary invasive resections. The following case is a patient who presented with unilateral weakness and radiologic findings concerning for a high grade glioma. Peripheral studies were equivocal. The decision was made to proceed with a stereotactic biopsy, yielding a definitive diagnosis of tumefactive demyelinating lesion (TDL)...
January 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29331227/the-impact-of-technology-on-the-changing-practice-of-lung-sbrt
#10
REVIEW
Marianne Camille Aznar, Samantha Warren, Mischa Hoogeman, Mirjana Josipovic
Stereotactic body radiotherapy (SBRT) for lung tumours has been gaining wide acceptance in lung cancer. Here, we review the technological evolution of SBRT delivery in lung cancer, from the first treatments using the stereotactic body frame in the 1990's to modern developments in image guidance and motion management. Finally, we discuss the impact of current technological approaches on the requirements for quality assurance as well as future technological developments.
January 10, 2018: Physica Medica: PM
https://www.readbyqxmd.com/read/29330810/correlation-of-glioma-proliferation-and-hypoxia-by-luciferase-magnetic-resonance-and-positron-emission-tomography-imaging
#11
Michael Karsy, David L Gillespie, Kevin P Horn, Lance D Burrell, Jeffery T Yap, Randy L Jensen
Gliomas are the most common type of primary, malignant brain tumor and significantly impact patients, who have a median survival of ~1 year depending on mutational background. Novel imaging modalities such as luciferase bioluminescence, micro-magnetic resonance imaging (micro-MRI), micro-computerized tomography (micro-CT), and micro-positron emission tomography (micro-PET) have expanded the portfolio of tools available to study this disease. Hypoxia, a key oncogenic driver of glioma and mechanism of resistance, can be studied in vivo by the concomitant use of noninvasive MRI and PET imaging...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29330751/prospective-trial-evaluating-the-sensitivity-and-specificity-of-3-4-dihydroxy-6-18f-fluoro-l-phenylalanine-18f-dopa-pet-and-mri-in-patients-with-recurrent-gliomas
#12
Ryan S Youland, Deanna H Pafundi, Debra H Brinkmann, Val J Lowe, Jonathan M Morris, Bradley J Kemp, Christopher H Hunt, Caterina Giannini, Ian F Parney, Nadia N Laack
Treatment-related changes can be difficult to differentiate from progressive glioma using MRI with contrast (CE). The purpose of this study is to compare the sensitivity and specificity of 18F-DOPA-PET and MRI in patients with recurrent glioma. Thirteen patients with MRI findings suspicious for recurrent glioma were prospectively enrolled and underwent 18F-DOPA-PET and MRI for neurosurgical planning. Stereotactic biopsies were obtained from regions of concordant and discordant PET and MRI CE, all within regions of T2/FLAIR signal hyperintensity...
January 13, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29328861/radiofrequency-ablation-versus-stereotactic-body-radiotherapy-for-localized-hepatocellular-carcinoma-in-nonsurgically-managed-patients-analysis-of-the-national-cancer-database
#13
Devalkumar J Rajyaguru, Andrew J Borgert, Angela L Smith, Reggie M Thomes, Patrick D Conway, Thorvardur R Halfdanarson, Mark J Truty, A Nicholas Kurup, Ronald S Go
Purpose Data that guide selection of optimal local ablative therapy for the management localized hepatocellular carcinoma (HCC) are lacking. Because there are limited prospective comparative data for these treatment modalities, we aimed to compare the effectiveness of radiofrequency ablation (RFA) versus stereotactic body radiotherapy (SBRT) by using the National Cancer Database. Methods We conducted an observational study to compare the effectiveness of RFA versus SBRT in nonsurgically managed patients with stage I or II HCC...
January 12, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29328005/a-novel-use-of-the-neuroblate-sidefire-probe-for-minimally-invasive-disconnection-of-a-hypothalamic-hamartoma-in-a-child-with-gelastic-seizures
#14
James M Wright, Michael D Staudt, Andrea Alonso, Jonathan P Miller, Andrew E Sloan
The authors describe the case of a 22-month-old boy who presented with gelastic seizures and developmental delay. Magnetic resonance imaging and video-electroencephalography monitoring revealed a primarily intraventricular hypothalamic hamartoma and gelastic seizures occurring 20-30 times daily. The patient was treated with various regimens of antiepileptic medications for 16 months, but the seizures remained medically intractable. At 3 years of age, he underwent stereotactic laser ablation with an aim of disconnection of the lesion...
January 12, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29327241/a-suvmax-based-propensity-matched-analysis-of-stereotactic-body-radiotherapy-versus-surgery-in-stage-i-non-small-cell-lung-cancer-unveiling-the-role-of-18f-fdg-pet-ct-in-clinical-decision-making
#15
L Ye, F Xu, S Shi, Z Zeng, X Jin, Y Huang, C Lu, J Gu, D Ge, J He
BACKGROUND: The value of maximum standard uptake value (SUVmax) was overlooked in current studies comparing stereotactic body radiotherapy (SBRT) versus surgery for stage I non-small cell lung cancer (NSCLC). Herein, we aimed to compare the 3-year outcomes based on patients for whom SUVmax were available, and to explore the role of SUVmax in clinical decision-making. METHODS: From January 2010 to June 2016, data of eligible patients were collected. Patient variables and clinical outcomes were compared in both unmatched and matched groups using propensity score matching (PSM)...
January 11, 2018: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29327180/chemotherapy-with-or-without-definitive-radiation-therapy-in-inoperable-pancreatic-cancer
#16
Jim Zhong, Jeffrey Switchenko, Madhusmita Behera, David Kooby, Shishir K Maithel, Mark W McDonald, Jolinta Y Lin, Richard J Cassidy, Bassel El-Rayes, Jerome Landry, Pretesh R Patel
BACKGROUND: The LAP07 randomized trial calls into question the role of radiation therapy (RT) in the modern treatment of locally advanced pancreatic cancer (LAPC). However, advances in chemotherapy and RT limit application of the LAP07 results to current clinical practice. Here we utilize the National Cancer Database (NCDB) to evaluate the effects of RT in patients receiving chemotherapy for LAPC. METHODS: Using the NCDB, patients with American Joint Committee on Cancer (AJCC) clinical stage T2-4, N0-1, M0 adenocarcinoma of the pancreas from 2004 to 2014 were analyzed...
January 11, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29327171/efficacy-of-adjuvant-radiotherapy-in-the-intracranial-hemangiopericytoma
#17
Seung Hyuck Jeon, Sung-Hye Park, Jin Wook Kim, Chul-Kee Park, Sun Ha Paek, Il Han Kim
We retrospectively evaluated an efficacy of adjuvant radiotherapy (RT) in the intracranial hemangiopericytoma (HPC) and analyzed prognostic factors influencing treatment outcomes. Among 49 patients diagnosed as localized intracranial HPC between 1995 and 2016, 31 patients received adjuvant RT after surgery; 26 with fractionated RT and 5 with stereotactic radiosurgery using Gamma Knife. After gross total resection (GTR) (n = 32) and subtotal resection (STR) (n = 17), histopathological grade was confirmed to be grade II (n = 9) or grade III (n = 40)...
January 11, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29327096/-focused-ultrasound-ablation-as-tremor-treatment
#18
REVIEW
Sebastian R Schreglmann, Stefan Hägele-Link, Beat Werner, Ernst Martin, Georg Kägi
BACKGROUND: The development of high-intensity magnetic resonance imaging (MRI)-guided focused ultrasound (MRIgFUS) ablation has widened the spectrum of interventional techniques for stereotactic functional neurosurgery of lesions. This has resulted in novel incisionless intervention approaches for the therapy of tremor disorders. The safety and efficacy is documented by recent study data. OBJECTIVES: This article encompasses a description of the technological basis and typical course of MRIgFUS interventions, a comparison to alternative open or incisionless surgical techniques as well as a review of the current evidence base for MRIgFUS ablation in the context of lesional interventions to treat tremor...
January 11, 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/29327059/immunotherapy-and-symptomatic-radiation-necrosis-in-patients-with-brain-metastases-treated-with-stereotactic-radiation
#19
Allison M Martin, Daniel N Cagney, Paul J Catalano, Brian M Alexander, Amanda J Redig, Jon D Schoenfeld, Ayal A Aizer
No abstract text is available yet for this article.
January 11, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29326012/stereotactic-body-radiotherapy-sbrt-for-patients-with-locally-advanced-pancreatic-cancer-a-single-center-experience
#20
Raphaël Jumeau, Guila Delouya, David Roberge, David Donath, Dominic Béliveau-Nadeau, Marie-Pierre Campeau
INTRODUCTION: Despite advances in treatment, notably in systemic therapy, the prognosis of pancreatic adenocarcinoma (PADC) remains dismal. Stereotactic body radiotherapy (SBRT) is an emerging tool in the complex management of PADC. We review outcomes of SBRT for PADC at our institution. METHODS: We reviewed patients treated with SBRT for either unresectable PADC or locally recurrent PADC after surgery. Treatment was delivered using a robotic radiosurgery system with respiratory tracking...
December 21, 2017: Digestive and Liver Disease
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