World Neurosurg
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Multicenter Study
Machine Learning-Based Multi-parametric MRI Radiomics for prediction of H3 K27M Mutation in Midline Gliomas.
H3K27M mutation in gliomas has prognostic implications. Previous magnetic resonance imaging (MRI) studies have reported variable rates of tumoral enhancement, necrotic changes, and peritumoral edema in H3K27M-mutant gliomas, with no distinguishing imaging features compared with wild-type gliomas. We aimed to construct an MRI machine learning (ML)-based radiomic model to predict H3K27M mutation in midline gliomas. ⋯ Our multi-institutional study suggests that ML-based radiomic analysis of multiparametric MRI can be a promising noninvasive technique to predict H3K27M mutation status in midline gliomas.
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Cone-beam computed tomography (CBCT) images for skull base tumors provide detailed vascular information and localization in regard to surrounding bony structures. We report use of the CBCT fusion technique for skull base meningiomas. ⋯ CBCT fusion images clearly visualized the feeders from each arterial system, the vascular compartments within the tumor, and possible peritumoral anastomoses. This technique provides a substantial contribution to both preoperative embolization and surgical resection of skull base meningiomas.
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Single-stage surgical treatment of cranial intraosseous meningiomas includes complete tumor resection followed by aesthetic reconstruction. Tailored tumor resection with a computer-aided design/computer-aided manufacturing custom-made implant for the defect has been advocated in recent years to achieve a satisfactory cosmetic result with reduced operative time and fewer complications. However, several technical nuances related to the area of osseous removal may compromise cranioplasty. ⋯ Custom templates based in cranial sutures may benefit single-step frame-guided resection and reconstruction of intraosseous tumors with compelling results.
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Skull base osteosarcoma is a rare and aggressive tumor that is most commonly treated with primary surgical resection and adjuvant chemoradiation. Using the National Cancer Database, we analyzed demographic and clinical prognosticators for overall survival (OS). ⋯ Tumor histologic subtype, advanced tumor grade, and greater tumor size are predictors of worse OS in skull base osteosarcoma. No significant differences in OS were identified based on treatment modality, which warrants further investigation.
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Comparative Study
Comparison between Three- and Four-level Anterior Cervical Discectomy and Fusion: Patient-Reported and Radiographic Outcomes.
We compared the long-term clinical and radiographic outcomes after 3- and 4-level anterior cervical discectomy and fusion (ACDF) in a retrospective cohort study. ⋯ Patients undergoing both 3- and 4-level ACDF experienced significant clinical improvement without significant differences between the 2 groups. The radiographic measures of segmental lordosis and SVA also correlated with the changes in clinical outcomes.