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https://www.readbyqxmd.com/read/27919761/evaluating-the-impact-of-brain-metastasis-location-and-relative-volume-on-overall-survival-after-stereotactic-radiosurgery
#1
Ashley Emery, Daniel M Trifiletti, Kara D Romano, Nirav Patel, Mark E Smolkin, Jason P Sheehan
OBJECTIVE: Most evidence describing outcomes of patients with brain metastases is based upon the number of brain metastases, rather than location or volume. We sought to evaluate the impact of tumor location and each location's relative volume on overall survival (OS) among a large cohort of patients treated with stereotactic radiosurgery (SRS). METHODS: Clinical, radiographic, and dosimetric data were collected on patients treated with their first (if multiple) SRS for brain metastases...
December 2, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27917372/which-prognostic-index-is-most-appropriate-in-the-setting-of-delayed-stereotactic-radiosurgery-for-brain-metastases
#2
Timothy Malouff, Nathan R Bennion, Vivek Verma, Gabriel A Martinez, Nathan Balkman, Abhijeet Bhirud, Tanner Smith, Chi Lin
OBJECTIVES: To determine if five commonly used prognostic indices (PIs) - recursive partitioning analysis (RPA), Score Index for Radiosurgery (SIR), Basic Score for Brain Metastases (BSBM), graded prognostic assessment (GPA), and the diagnosis-specific GPA - are valid following delay between diagnosis and treatment of brain metastases. METHODS: In a single-institutional cohort, records of patients who underwent stereotactic radiosurgery (SRS) more than 30 days from diagnosis of brain metastases were collected, and five PI scores were calculated for each patient...
2016: Frontiers in Oncology
https://www.readbyqxmd.com/read/27913800/the-transvenous-pressure-cooker-technique-a-treatment-for-brain-arteriovenous-malformations
#3
Guang Zhang, Shiyi Zhu, Pei Wu, Shancai Xu, Huaizhang Shi
The treatment of brain arteriovenous malformations (AVMs) remains a significant challenge, especially hemorrhagic AVMs which are unsuitable for microsurgery or radiosurgery. We demonstrate an AVM located in the left basal ganglia area, supplied by slender arteries, and treated by the transvenous pressure cooker technique. Herein, we describe the procedure and outline the crucial points and indications for this technique.
December 2, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27911450/uveal-melanoma-relatively-rare-but-deadly-cancer
#4
REVIEW
S Kaliki, C L Shields
Although it is a relatively rare disease, primarily found in the Caucasian population, uveal melanoma is the most common primary intraocular tumor in adults with a mean age-adjusted incidence of 5.1 cases per million per year. Tumors are located either in iris (4%), ciliary body (6%), or choroid (90%). The host susceptibility factors for uveal melanoma include fair skin, light eye color, inability to tan, ocular or oculodermal melanocytosis, cutaneous or iris or choroidal nevus, and BRCA1-associated protein 1 mutation...
December 2, 2016: Eye
https://www.readbyqxmd.com/read/27911249/international-multicenter-cohort-study-of-pediatric-brain-arteriovenous-malformations-part-2-outcomes-after-stereotactic-radiosurgery
#5
Robert M Starke, Dale Ding, Hideyuki Kano, David Mathieu, Paul P Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Pediatric patients (age < 18 years) harboring brain arteriovenous malformations (AVMs) are burdened with a considerably higher cumulative lifetime risk of hemorrhage than adults. Additionally, the pediatric population was excluded from recent prospective comparisons of intervention versus conservative management for unruptured AVMs. The aims of this multicenter, retrospective cohort study are to analyze the outcomes after stereotactic radiosurgery for unruptured and ruptured pediatric AVMs. METHODS We analyzed and pooled AVM radiosurgery data from 7 participating in the International Gamma Knife Research Foundation...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27911248/international-multicenter-cohort-study-of-pediatric-brain-arteriovenous-malformations-part-1-predictors-of-hemorrhagic-presentation
#6
Dale Ding, Robert M Starke, Hideyuki Kano, David Mathieu, Paul P Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Brain arteriovenous malformations (AVMs) are the most common cause of spontaneous intracranial hemorrhage in pediatric patients (age < 18 years). Since the cumulative lifetime risk of AVM hemorrhage is considerable in children, an improved understanding of the risk factors influencing hemorrhagic presentation may aid in the management of pediatric AVMs. The aims of this first of a 2-part multicenter, retrospective cohort study are to evaluate the incidence and determine the predictors of hemorrhagic presentation in pediatric AVM patients...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27911235/robustness-of-the-neurological-prognostic-score-in-brain-metastasis-patients-treated-with-gamma-knife-radiosurgery
#7
Toru Serizawa, Yoshinori Higuchi, Osamu Nagano, Shinji Matsuda, Kyoko Aoyagi, Junichi Ono, Naokatsu Saeki, Yasuo Iwadate, Tatsuo Hirai, Shinya Takemoto, Yuta Shibamoto
OBJECTIVE The neurological prognostic score (NPS) was recently proposed as a means for predicting neurological outcomes, such as the preservation of neurological function and the prevention of neurological death, in brain metastasis patients treated with Gamma Knife radiosurgery (GKRS). NPS consists of 2 groups: Group A patients were expected to have better neurological outcomes, and Group B patients were expected to have poorer outcomes. NPS robustness was tested in various situations. METHODS In total, 3040 patients with brain metastases that were treated with GKRS were analyzed...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27910213/dedifferentiated-chordoid-meningioma-with-rhabdomyosarcomatous-differentiation-on-the-middle-cranial-fossa
#8
Hirotaka Fudaba, Tatsuya Abe, Masaki Morishige, Yasutomo Momii, Kenji Kashima, Akira Yamada, Hirofumi Nagatomi, Atsushi Natsume, Junko Hirato, Yoichi Nakazato, Minoru Fujiki
A 46-year-old woman presented with headache and right hemiparesis. MRI demonstrated a mass in the left middle fossa. Total resection was performed. A histological examination of the tumor specimen showed several characteristic morphological features. A chordoid meningioma showing an epithelial-like palisade arrangement was observed. An anaplastic short spindle cell tumor exhibiting a fascicular pattern was considered to be a rhabdomyosarcoma. After conventional radiotherapy, the tumor was well controlled without any neurological deficit for 20 months...
December 2016: Neuropathology: Official Journal of the Japanese Society of Neuropathology
https://www.readbyqxmd.com/read/27908165/a-comparison-of-two-prospective-risk-analysis-methods-traditional-fmea-and-a-modified-healthcare-fmea
#9
Jeong-Eun Rah, Ryan P Manger, Adam D Yock, Gwe-Ya Kim
PURPOSE: To examine the abilities of a traditional failure mode and effects analysis (FMEA) and modified healthcare FMEA (m-HFMEA) scoring methods by comparing the degree of congruence in identifying high risk failures. METHODS: The authors applied two prospective methods of the quality management to surface image guided, linac-based radiosurgery (SIG-RS). For the traditional FMEA, decisions on how to improve an operation were based on the risk priority number (RPN)...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27903198/dosimetric-characterization-of-hypofractionated-gamma-knife-radiosurgery-of-large-or-complex-brain-tumors-versus-linear-accelerator-based-treatments
#10
Peng Dong, Angélica Pérez-Andújar, Dilini Pinnaduwage, Steve Braunstein, Philip Theodosopoulos, Michael McDermott, Penny Sneed, Lijun Ma
OBJECTIVE Noninvasive Gamma Knife (GK) platforms, such as the relocatable frame and on-board imaging, have enabled hypofractionated GK radiosurgery of large or complex brain lesions. This study aimed to characterize the dosimetric quality of such treatments against linear accelerator-based delivery systems that include the CyberKnife (CK) and volumetric modulated arc therapy (VMAT). METHODS Ten patients treated with VMAT at the authors' institution for large brain tumors (> 3 cm in maximum diameter) were selected for the study...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903197/upfront-boost-gamma-knife-leading-edge-radiosurgery-to-flair-mri-defined-tumor-migration-pathways-in-174-patients-with-glioblastoma-multiforme-a-15-year-assessment-of-a-novel-therapy
#11
Christopher M Duma, Brian S Kim, Peter V Chen, Marianne E Plunkett, Ralph Mackintosh, Marlon S Mathews, Ryan M Casserly, Gustavo A Mendez, Daniel J Furman, Garrett Smith, Nathan Oh, Chad A Caraway, Ami R Sanathara, Robert O Dillman, Azzurra-Sky Riley, David Weiland, Lian Stemler, Ruslana Cannell, Daniela Alexandru Abrams, Alexa Smith, Christopher M Owen, Burton Eisenberg, Michael Brant-Zawadzki
OBJECTIVE Glioblastoma multiforme (GBM) is composed of cells that migrate through the brain along predictable white matter pathways. Targeting white matter pathways adjacent to, and leading away from, the original contrast-enhancing tumor site (termed leading-edge radiosurgery [LERS]) with single-fraction stereotactic radiosurgery as a boost to standard therapy could limit the spread of glioma cells and improve clinical outcomes. METHODS Between December 2000 and May 2016, after an initial diagnosis of GBM and prior to or during standard radiation therapy and carmustine or temozolomide chemotherapy, 174 patients treated with radiosurgery to the leading edge (LE) of tumor cell migration were reviewed...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903196/the-impact-of-cobalt-60-source-age-on-biologically-effective-dose-in-high-dose-functional-gamma-knife-radiosurgery
#12
Benjamin H Kann, James B Yu, John M Stahl, James E Bond, Christopher Loiselle, Veronica L Chiang, Ranjit S Bindra, Jason L Gerrard, David J Carlson
OBJECTIVE Functional Gamma Knife radiosurgery (GKRS) procedures have been increasingly used for treating patients with tremor, trigeminal neuralgia (TN), and refractory obsessive-compulsive disorder. Although its rates of toxicity are low, GKRS has been associated with some, if low, risks for serious sequelae, including hemiparesis and even death. Anecdotal reports have suggested that even with a standardized prescription dose, rates of functional GKRS toxicity increase after replacement of an old cobalt-60 source with a new source...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903195/dosimetric-effects-of-onyx-embolization-on-gamma-knife-arteriovenous-malformation-dose-distributions
#13
David J Schlesinger, Håkan Nordström, Anders Lundin, Zhiyuan Xu, Jason P Sheehan
OBJECTIVE Patients with arteriovenous malformations (AVMs) treated with Gamma Knife radiosurgery (GKRS) subsequent to embolization suffer from elevated local failure rates and differences in adverse radiation effects. Onyx is a common embolic material for AVMs. Onyx is formulated with tantalum, a high atomic number (Z = 73) element that has been investigated as a source of dosimetric uncertainty contributing to the less favorable clinical results. However, prior studies have not modeled the complicated anatomical and beam geometries characteristic of GKRS...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903194/building-a-bridge-to-the-future-of-intracranial-stereotactic-radiosurgery
#14
Jason Sheehan
No abstract text is available yet for this article.
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903193/three-dimensional-assessment-of-the-effects-of-high-density-embolization-material-on-the-absorbed-dose-in-the-target-for-gamma-knife-radiosurgery-of-arteriovenous-malformations
#15
Yoichi Watanabe, Divyajot Sandhu, Leighton Warmington, Sean Moen, Ramachandra Tummala
OBJECTIVE Arteriovenous malformation (AVM) is an intracranial vascular disorder. Gamma Knife radiosurgery (GKRS) is used in conjunction with intraarterial embolization to eradicate the nidus of AVMs. Clinical results indicate that patients with prior embolization tend to gain less benefit from GKRS. The authors hypothesized that this was partly caused by dosimetric deficiency. The actual dose delivered to the target may be smaller than the intended dose because of increased photon attenuation by high-density embolic materials...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903192/stereotactic-radiosurgery-for-idiopathic-glossopharyngeal-neuralgia-an-international-multicenter-study
#16
Hideyuki Kano, Dusan Urgosik, Roman Liscak, Bruce E Pollock, Or Cohen-Inbar, Jason P Sheehan, Mayur Sharma, Danilo Silva, Gene H Barnett, David Mathieu, Nathaniel D Sisterson, L Dade Lunsford
OBJECTIVE The goal of this study was to evaluate the outcomes of Gamma Knife stereotactic radiosurgery (SRS) when used for patients with intractable idiopathic glossopharyngeal neuralgia. METHODS Six participating centers of the International Gamma Knife Research Foundation identified 22 patients who underwent SRS for intractable glossopharyngeal neuralgia between 1998 and 2015. The median patient age was 60 years (range 34-83 years). The median duration of symptoms before SRS was 46 months (range 1-240 months)...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903191/cost-effectiveness-of-stereotactic-radiosurgery-versus-whole-brain-radiation-therapy-for-up-to-10-brain-metastases
#17
Nataniel H Lester-Coll, Arie P Dosoretz, William J Magnuson, Maxwell S Laurans, Veronica L Chiang, James B Yu
OBJECTIVE The JLGK0901 study found that stereotactic radiosurgery (SRS) is a safe and effective treatment option for treating up to 10 brain metastases. The purpose of this study is to determine the cost-effectiveness of treating up to 10 brain metastases with SRS, whole-brain radiation therapy (WBRT), or SRS and immediate WBRT (SRS+WBRT). METHODS A Markov model was developed to evaluate the cost effectiveness of SRS, WBRT, and SRS+WBRT in patients with 1 or 2-10 brain metastases. Transition probabilities were derived from the JLGK0901 study and modified according to the recurrence rates observed in the Radiation Therapy Oncology Group (RTOG) 9508 and European Organization for Research and Treatment of Cancer (EORTC) 22952-26001 studies to simulate the outcomes for patients who receive WBRT...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903190/prognostic-value-of-diffusion-tensor-imaging-parameters-for-gamma-knife-radiosurgery-in-meningiomas
#18
Herwin Speckter, Jose Bido, Giancarlo Hernandez, Diones Rivera Mejía, Luis Suazo, Santiago Valenzuela, Eddy Perez-Then, Peter Stoeter
OBJECTIVE Diffusion tensor imaging (DTI) parameters are able to differentiate between meningioma subtypes. The hypothesis that there is a correlation between DTI parameters and the change in tumor size after Gamma Knife radiosurgery (GKRS) was analyzed. METHODS DTI parameters were measured using MRI before GKRS in 26 patients with meningiomas. The findings were correlated with the change in tumor size after treatment as measured at the last follow-up (range 12.5-45 months). RESULTS Only those meningiomas that showed the highest fractional anisotropy (FA), the lowest spherical index of the tensor ellipsoid (Cs), and the lowest radial diffusivity (RD) either increased or remained stable in terms of volume, whereas all other meningiomas decreased in volume...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903189/grade-ii-meningiomas-and-gamma-knife-radiosurgery-analysis-of-success-and-failure-to-improve-treatment-paradigm
#19
Charles A Valery, Matthieu Faillot, Ioannis Lamproglou, Jean-Louis Golmard, Catherine Jenny, Matthieu Peyre, Karima Mokhtari, Jean-Jacques Mazeron, Philippe Cornu, Michel Kalamarides
OBJECTIVE Grade II meningiomas, which currently account for 25% of all meningiomas, are subject to multiple recurrences throughout the course of the disease and represent a challenge for the neurosurgeon. Radiosurgery is increasingly performed for the treatment of Grade II meningiomas and is quite efficient in controlling relapses locally at the site of the lesion, but it cannot prevent margin relapses. The aim of this retrospective study was to analyze the technical parameters involved in producing marginal relapses and to optimize loco-marginal control to improve therapeutic strategy...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903187/stereotactic-diffusion-tensor-imaging-tractography-for-gamma-knife-radiosurgery
#20
Cormac G Gavin, H Ian Sabin
OBJECTIVE The integration of modern neuroimaging into treatment planning has increased the therapeutic potential and safety of stereotactic radiosurgery. The authors report their method of integrating stereotactic diffusion tensor imaging (DTI) tractography into conventional treatment planning for Gamma Knife radiosurgery (GKRS). The aim of this study was to demonstrate the feasibility of this technique and to address some of the technical limitations of previously reported techniques. METHODS Twenty patients who underwent GKRS composed the study cohort...
December 2016: Journal of Neurosurgery
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