scholarly journals A pilot study of machine-learning based automated planning for primary brain tumours

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Derek S. Tsang ◽  
Grace Tsui ◽  
Chris McIntosh ◽  
Thomas Purdie ◽  
Glenn Bauman ◽  
...  
Keyword(s):  
Machine Learning ◽  
Young Adults ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Organs At Risk ◽  
Image Features ◽  
High Quality ◽  
Primary Brain Tumours ◽  
Children And Young Adults ◽  
Testing Set

Abstract Purpose High-quality radiotherapy (RT) planning for children and young adults with primary brain tumours is essential to minimize the risk of late treatment effects. The feasibility of using automated machine-learning (ML) to aid RT planning in this population has not previously been studied. Methods and materials We developed a ML model that identifies learned relationships between image features and expected dose in a training set of 95 patients with a primary brain tumour treated with focal radiotherapy to a dose of 54 Gy in 30 fractions. This ML method was then used to create predicted dose distributions for 15 previously-treated brain tumour patients across two institutions, as a testing set. Dosimetry to target volumes and organs-at-risk (OARs) were compared between the clinically-delivered (human-generated) plans versus the ML plans. Results The ML method was able to create deliverable plans in all 15 patients in the testing set. All ML plans were generated within 30 min of initiating planning. Planning target volume coverage with 95% of the prescription dose was attained in all plans. OAR doses were similar across most structures evaluated; mean doses to brain and left temporal lobe were lower in ML plans than manual plans (mean difference to left temporal, – 2.3 Gy, p = 0.006; mean differences to brain, – 1.3 Gy, p = 0.017), whereas mean doses to right cochlea and lenses were higher in ML plans (+ 1.6–2.2 Gy, p < 0.05 for each). Conclusions Use of an automated ML method to aid RT planning for children and young adults with primary brain tumours is dosimetrically feasible and can be successfully used to create high-quality 54 Gy RT plans. Further evaluation after clinical implementation is planned.

scholarly journals Astroblastoma

Pulse ◽  
2011 ◽  
Vol 4 (1) ◽  
pp. 38-39
Author(s):  
A Khaled ◽  
A Joarder ◽  
M Chandy ◽  
TA Nasir
Keyword(s):  
Young Adults ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Histological Picture ◽  
Children And Young Adults ◽  
Unusual Type

Aims and Objectives: Astroblastoma is one of the very unusual type of brain tumours, whose histogenesis has not been clarified. It occurs mainly among children and young adults. Astroblastoma has characteristic histological picture and varied biological behavioural. We report a 10-year old girl diagnosed as a case of astroblastoma.Clinical presentation: A 10-year old girl was examined for intermittent frontal headache and convulsion for two years. MRI revealed brain tumour which was later confirmed as astroblastoma by histopathological examination.Conclusion: Astroblastoma is rare because of its varied biological behaviour.DOI: http://dx.doi.org/10.3329/pulse.v4i1.6966Pulse Vol.4 January 2010 p.38-39

scholarly journals Mortality due to primary brain tumours in China and detection rate in people with suspected symptoms: a nationally representative cross-sectional survey

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Bin Jiang ◽  
Hongmei Liu ◽  
Dongling Sun ◽  
Haixin Sun ◽  
Xiaojuan Ru ◽  
...  
Keyword(s):  
Brain Tumour ◽  
Brain Tumours ◽  
Detection Rate ◽  
Epidemiological Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Detection Rates ◽  
Primary Brain Tumours ◽  
Symptom Screening ◽  
Nationally Representative

Abstract Background and purpose Epidemiological data on primary brain tumours (PBTs) are lacking due to the difficulty in case ascertainment among the population. Thus, we aimed to estimate mortality due to PBTs in China nationwide and the detection rate in people with suspected symptoms. Methods A multistage, complex sampling survey regarding mortality due to PBTs in Chinese individuals was carried out by reviewing all causes of death within a year. The detection rates in people with suspected symptoms were estimated based on PBT symptom screening and neurologist reviews and compared between groups by logistic regression analysis. Results Weighted mortality due to PBT was 1.6 (0.8–3.3) per 100,000 population in Chinese individuals, 1.8 (0.7–4.6) per 100,000 population in men, and 1.5 (0.5–4.5) per 100,000 population in women. Among 14,990 people with suspected symptoms, the PBT detection rate was 306.9 (95% CI 224.7–409.3) per 100,000 population in the total population, 233.0 (95% CI 135.7–373.1) per 100,000 population in men, and 376.9 (95% CI 252.4–546.3) per 100,000 population in women. People with an unsteady gait (OR 2.46; 95% CI 1.09–5.51; P=0.029), visual anomalies (3.84; 1.88–7.85; P<0.001), and headache (2.06; 1.10–3.86; P=0.023) were more likely to have a brain tumour than those without corresponding symptoms, while people with dizziness/vertigo were less likely to have a brain tumour than those without corresponding symptoms (0.45; 0.23–0.87; P=0.017). Conclusions Mortality due to PBT in China was low, with a nationwide estimate of 21,215 (10,427–43,165) deaths attributable to PBTs annually. However, the detection rate of PBTs can be greatly improved based on symptom screening in the population.

scholarly journals Developing guidelines for the management of brain tumour related epilepsy

2021 ◽  
Vol 23 (Supplement_4) ◽  
pp. iv3-iv4
Author(s):  
Elizabeth Vacher ◽  
Miguel Rodriguez Ruiz ◽  
Jeremy Rees
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Current Evidence ◽  
Low Grade ◽  
Clinical Nurse Specialists ◽  
Primary Brain Tumours ◽  
Low Incidence

Abstract Aims Brain Tumour Related Epilepsy (BTRE) has a significant impact on Quality of Life with implications for driving, employment and social and domestic activities. Management of BTRE is complex due to the higher incidence of pharmacoresistance and the potential for interaction between anti-cancer therapy and anti-epileptic drugs (AEDs). Neurologists, oncologists, palliative care physicians and clinical nurse specialists treating these patients would benefit from up-to-date clinical guidelines. We aim to review the current evidence to adapt current NICE guidelines for Epilepsy and to outline specific recommendations for the optimal treatment of BTRE, encompassing both primary and metastatic brain tumours. Method A comprehensive search of the literature from the past 20 years on BTRE was carried out in three databases: Embase, Medline and EMCARE. A broad search strategy was used and the evidence was evaluated and graded based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence. Results All patients with BTRE should be treated with AEDs. There is no proven benefit for the use of prophylactic AEDs, although there are no randomised trials testing newer agents. Seizure frequency varies between 10-40% (Class 2a evidence) in patients with Brain Metastases (BM) and from 30% (high-grade gliomas) to 90% (low-grade gliomas) (Class 2a evidence) in patients with Primary Brain Tumours (PBT). In patients with BM, risk factors include number of BM and melanoma histology (Class 2b evidence). In patients with PBT, risk factors include frontal and temporal location, oligodendroglial histology, IDH mutation and cortical infiltration (Class 2b evidence). There is a low incidence of seizures (13%) after stereotactic radiosurgery for BM (Class 2b evidence). Non-enzyme inducing AEDs are recommended as first line treatment for BTRE, but up to 50% of patients with BTRE due to PBT remain resistant (Class 2b evidence). Conclusion The review has highlighted the relative dearth of high quality evidence for the management of BTRE, and provides a framework for further studies aiming to improve seizure control, quality of life, and indications for AEDs.

scholarly journals Diagnosing brain tumours by routine blood tests using machine learning

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Simon Podnar ◽  
Matjaž Kukar ◽  
Gregor Gunčar ◽  
Mateja Notar ◽  
Nina Gošnjak ◽  
...  
Keyword(s):  
Machine Learning ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Blood Test ◽  
Neurological Diseases ◽  
Blood Tests ◽  
Routine Blood ◽  
Routine Blood Test ◽  
Tumour Diagnosis ◽  
Neurological Patients

Abstract Routine blood test results are assumed to contain much more information than is usually recognised even by the most experienced clinicians. Using routine blood tests from 15,176 neurological patients we built a machine learning predictive model for the diagnosis of brain tumours. We validated the model by retrospective analysis of 68 consecutive brain tumour and 215 control patients presenting to the neurological emergency service. Only patients with head imaging and routine blood test data were included in the validation sample. The sensitivity and specificity of the adapted tumour model in the validation group were 96% and 74%, respectively. Our data demonstrate the feasibility of brain tumour diagnosis from routine blood tests using machine learning. The reported diagnostic accuracy is comparable and possibly complementary to that of imaging studies. The presented machine learning approach opens a completely new avenue in the diagnosis of these grave neurological diseases and demonstrates the utility of valuable information obtained from routine blood tests.

scholarly journals Soluble PD-L1 is associated with local and systemic inflammation markers in primary and secondary brain tumours

ESMO Open ◽  
2020 ◽  
Vol 5 (6) ◽  
pp. e000863
Author(s):  
Maximilian J Mair ◽  
Sahra Pajenda ◽  
Aysegül Ilhan-Mutlu ◽  
Ariane Steindl ◽  
Barbara Kiesel ◽  
...  
Keyword(s):  
Brain Tumour ◽  
Systemic Inflammation ◽  
Brain Tumours ◽  
Death Receptor ◽  
Immunohistochemical Analysis ◽  
Tumour Microenvironment ◽  
Clinical Activity ◽  
Lower Grade ◽  
Protein Levels ◽  
Primary Brain Tumours

BackgroundImmune-modulatory treatments have so far shown limited clinical activity in primary brain tumours. We aimed to investigate soluble programmed death receptor ligand 1 (sPD-L1) as systemic inflammation parameter in patients with brain tumour.MethodsEDTA plasma was collected from 81 glioma (55 glioblastoma (GBM), 26 lower-grade glioma (LGG)), 17 meningioma and 44 brain metastasis (BM) patients and 24 controls. sPD-L1 concentrations were determined by ELISA. Correlations with the local tumour microenvironment were assessed by immunohistochemical analysis for PD-L1, CD3 and CD8.ResultssPD-L1 was detected in 62 out of 166 (37.7%) patients (glioma: 41/81, 50.6%; meningioma: 5/17, 29.4%; BM: 7/44, 15.9%; controls: 9/24, 37.5%; p=0.002). sPD-L1 concentrations were lower in BM than in LGG (p=0.003) or GBM (p<0.001). Membranous PD-L1 expression on tumour cells was not associated with sPD-L1 concentrations (p=0.953). sPD-L1 concentration was inversely correlated with the density of CD8+ (r=−0.713, p=0.001) and CD3+ (r=−0.484, p=0.042) tumour-infiltrating lymphocytes in LGG. sPD-L1 is correlated with neutrophil counts (r=−0.318, p=0.045) and C reactive protein levels (r=−0.363, p=0.008) in GBM. sPD-L1+ patients had longer overall survival in GBM (p=0.006) and worse OS in LGG (p=0.028).ConclusionssPD-L1 is detectable in a fraction of patients with brain tumour. Although it is not correlated with tissue PD-L1 expression, correlations with other local and systemic inflammation parameters could be detected in LGG and GBM.

Exploring access to rehabilitation services from allied health professionals for patients with primary high-grade brain tumours

2011 ◽  
Vol 25 (8) ◽  
pp. 788-796 ◽  
Author(s):  
Aileen McCartney ◽  
Claire Butler ◽  
Sue Acreman
Keyword(s):  
Brain Tumour ◽  
Brain Tumours ◽  
Healthcare Professionals ◽  
Treatment Options ◽  
Primary Objective ◽  
Rehabilitation Services ◽  
Structured Interviews ◽  
Allied Health Professionals ◽  
Primary Brain Tumours ◽  
The Uk

Primary brain tumours account for less than 2% of cancer diagnoses in the UK but more people under 40 die from a brain tumour than from any other cancer. Despite developments in some treatment options, survival remains poor and patients suffer with considerable functional and cognitive deficits. Rehabilitation for patients with primary brain tumours produces statistically and clinically significant improvements in function. When compared, similar functional gains are made following rehabilitation for brain tumour patients and for those following stroke and traumatic brain injury. There have been very few studies looking at access to rehabilitation for this group of patients as a primary objective. However, existing studies and clinical experience suggest that patients with brain tumours do not access rehabilitation services frequently or easily, either locally or nationally. Therefore, this qualitative study addressed the reasons for this through semi-structured interviews of healthcare professionals, investigating their experiences of rehabilitation for this patient group and describing commonly identified barriers under key themes. The interviews gauged the views of eight healthcare professionals representing three professions in different settings, including hospital and community based. The resultant barriers fell under the following themes: professional knowledge and behaviours; services and systems; and the disease and its effects. Suggested solutions were wide ranging and included education, multidisciplinary meetings and specialist clinicians to co-ordinate care. The barriers to accessing rehabilitation for this group of patients are complex, but some of the solutions could be reached through education and co-ordination of services. Further research into the benefits of, and access to, rehabilitation for this group of patients is essential to ensure that patients with brain tumours are given opportunity to gain from the benefits of rehabilitation in the same way as other diagnoses, both cancer and non-cancer.

P14.45 The incidence of major subtypes of primary brain tumours in adults in England 1995–2017

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii46-ii47
Author(s):  
H Wanis
Keyword(s):  
Brain Tumour ◽  
Brain Tumours ◽  
Incidence Rates ◽  
Diagnostic Tools ◽  
Cancer Registration ◽  
Molecular Testing ◽  
Malignant Tumours ◽  
Primary Brain Tumours ◽  
Primary Brain Tumour ◽  
European Standard Population

Abstract BACKGROUND Primary brain tumours are a complex heterogenous group of benign and malignant tumours. Reports on their occurrence in the English population by sex, age, and morphological subtype and on their incidence are currently not available. Using data from the National Cancer Registration and Analysis Service (NCRAS), the incidence of adult primary brain tumour by major subtypes in England will be described. METHODS Data on all adult English patients diagnosed with primary brain tumour between 1995 and 2017, excluding spinal, endocrinal and other CNS tumours, were extracted from NCRAS. Incidence rates were standardised to the 2013 European Standard Population. Results are presented by sex, age, and morphological subtype. RESULTS Between 1995 and 2017, a total of 133,669 cases of adult primary brain tumour were registered in England. Glioblastoma was the most frequent tumour subtype (31.8%), followed by meningioma (27.3%). The age-standardised incidence for glioblastoma increased from 3.27 per 100,000 population per year in 1995 to 7.34 in men in 2013 and from 2.00 to 4.45 in women. Meningioma incidence also increased from 1.89 to 3.41 per 100,000 in men and from 3.40 to 7.46 in women. The incidence of other astrocytic and unclassified brain tumours declined between 1995 and 2007 and remained stable thereafter. CONCLUSION Part of the increase in the incidence of major subtypes of brain tumours in England could be explained by advances in clinical practice including the adoption of new diagnostic tools, classifications and molecular testing, and improved cancer registration practices.

[[18F]Fluorothymidine Positron Emission Tomography Imaging in Primary Brain Tumours: A Systematic Review

2021 ◽  
Vol 17 ◽  
Author(s):  
Guglielmo Priscilla ◽  
Quartuccio Natale ◽  
Rossetti Virginia ◽  
Celli Monica ◽  
Alongi Pierpaolo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Positron Emission Tomography ◽  
Brain Tumour ◽  
Pet Imaging ◽  
Brain Tumours ◽  
Response To Therapy ◽  
Emission Tomography ◽  
Primary Brain Tumours ◽  
Flt Pet ◽  
Positron Emission

Purpose : This review aimed to summarize the available literature on the clinical application of [18F]FLT PET imaging in primary brain tumours. Methods : A comprehensive search strategy based on Pubmed/Medline, Scopus, Web of Science, Cochrane Library, Google Scholar, and the Embase databases was carried on using the following search string: ('3` Fluorothymidine'/exp OR 'FLT' OR '[18F]-FLT' OR '[18F]Fluorothymidine') AND ('pet'/exp OR 'pet' OR 'positron emission tomography') AND ('glioma'/exp OR 'glioma' OR 'brain tumour'/exp OR 'brain tumour’). The search was updated till March 2021 and only articles in English and studies investigating the clinical applications of [18F]FLT PET and PET/CT in primary brain tumours were considered eligible for inclusion. Results: The literature search ultimately yielded 52 studies to be included in the systematic review, with main results as follows: a) the uptake of [18F]FLT may guide stereotactic biopsy but does not discriminate between grade II and III glioma. b) [18F]FLT uptake and texture parameters correlate with overall survival (OS) in newly diagnosed gliomas. c) In patients with recurrent glioma, proliferative volume (PV) and tumour-to-normal brain (T/N) uptake ratio are independent predictors of survival. d) Patients demonstrating response to therapy at [18F]FLT PET scan show longer OS compared to non-responders. e) [18F]FLT PET demonstrated good performance in discriminating tumour recurrence from radionecrosis. However, controversial results exist in comparative literature examining the performance of [18F]FLT vs. other radiotracers in the assessment of recurrence. Conclusion : [18F]FLT PET imaging has demonstrated potential benefits for grading, diagnostic and prognostic purposes, despite the small sample size studies due to the relatively low availability of the radiotracer.

scholarly journals Proton therapy for brain tumours in the area of evidence-based medicine

2020 ◽  
Vol 93 (1107) ◽  
pp. 20190237 ◽  
Author(s):  
Damien C Weber ◽  
Pei S Lim ◽  
Sebastien Tran ◽  
Marc Walser ◽  
Alessandra Bolsi ◽  
...  
Keyword(s):  
Brain Tumour ◽  
Proton Therapy ◽  
Brain Tumours ◽  
Organs At Risk ◽  
The United States ◽  
Quality Data ◽  
Cancer Management ◽  
Randomized Design ◽  
Prospective Trials ◽  
The Brain

Proton therapy (PT) has been administered for many years to a number of cancers, including brain tumours. Due to their remarkable physical properties, delivering their radiation to a very precise brain volume with no exit dose, protons are particularly appropriate for these tumours. The decrease of the brain integral dose may translate with a diminution of neuro-cognitive toxicity and increase of quality of life, particularly so in children. The brain tumour patient’s access to PT will be substantially increased in the future, with many new facilities being planned or currently constructed in Europe, Asia and the United States. Although approximately 150’000 patients have been treated with PT, no level I evidence has been demonstrated for this treatment. As such, it is this necessary to generate high-quality data and some new prospective trials will include protons or will be activated to compare photons to protons in a randomized design. PT comes however with an additional cost factor that may contribute to the ever-growing health’s expenditure allocated to cancer management. These additional costs and financial toxicity will have to be analysed in the light of a more conformal radiation delivery, non-target brain irradiation and lack of potential for dose escalation when compared to photons. The latter is due to the radiosensitivity of organs at risk in vicinity of the brain tumour, that photons cannot spare optimally. Consequentially, radiation-induced toxicities and tumour recurrences, which are cost-intensive, may decrease with PT resulting in an optimized photon/proton financial ratio in the end. Advances in knowledge: This review details the indication of brain tumors for proton therapy and give a list of the open prospective trials for these challenging tumors.

Sign in / Sign up

Export Citation Format

Share Document