T2-FLAIR mismatch sign: a roadmap of pearls and pitfalls

Author(s):  
Catarina Pinto ◽  
Carolina Noronha ◽  
Ricardo Taipa ◽  
Cristina Ramos

T2-FLAIR mismatch sign has been advocated to be 100% specific for IDH-mutant 1p/19q non-codeleted gliomas (diffuse astrocytomas). However, false positives have been reported in recent works. Loose application of the criteria may lead to erroneous classification, especially by non-trained neuroradiologists. In this pictorial essay, we aim to bring attention to the need for strict criteria for the application of T2-FLAIR mismatch sign and to discuss the potential pitfalls in the application of these criteria. For that, a series of adult brain tumour cases are presented to demonstrate how to apply this radiological sign in the clinical practice.

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii31-ii32
Author(s):  
L Pointon ◽  
R Grant ◽  
S Peoples ◽  
S Erridge ◽  
P Sherwood ◽  
...  

Abstract BACKGROUND Most primary brain tumour patients rely on informal caregivers (i.e. family members or friends) for practical and emotional support. While caregiving can be rewarding, it also commonly leads to significant burden. In developing support for caregivers, it is vital to distinguish between caregivers’ unmet needs, and their actual wish for support to resolve unmet needs. We aimed to 1) identify the presence and magnitude of unmet needs; 2) examine associations between unmet needs and desire for support; 3) evaluate perceived usefulness of caregiver needs screening in clinical practice. MATERIAL AND METHODS Family caregivers of patients with primary brain tumours were recruited and asked to complete an adapted version of the Caregiver Needs Screen (CNS). This covered the level of distress resulting from 33 common issues in neuro-oncology caregiving (scale 0–10), and wish for information or support for any issue (yes/no). In addition, participants were asked to rank (0–7) their experience of using the CNS based on items covering ‘ease of us’, ‘usefulness’ and ‘satisfaction’. Descriptive and correlational analyses were applied. RESULTS Caregivers (N=79) reported between 1–33 unmet needs (M=17.20, sd=7.98) but did not always wish for support for each need (range 0–28, M=4.71, sd=6.63). Most distressing items were patient’s fatigue (M=5.58), recognising signs of disease progression (M=5.23), changes in patients’ thinking or behaviour (M=5.04), patient distress or sadness (M=4.68), and changes in caregivers’ own emotional health (M=4.44). A weak correlation was found between the total number of unmet needs and the desire for support (r=0.296, p=0.014). Caregivers most often desired support with recognising disease progression (N=24), managing medications and side-effects (N=18), and least often with managing spiritual issues (N=0), communication with (grand)children (N=2) and communication with family members and friends (N=3). Caregivers evaluated the CNS tool positively (mean item scores ranging 4.19–6.21 out of 7). CONCLUSION Family caregivers of brain tumour patients experience distress resulting from many neuro-oncology specific needs, but this is not directly related to a wish for support or information. Caregiver needs screening could be useful to tailor support or information to suit caregivers’ preferences in clinical practice.


2014 ◽  
Vol 58 (3) ◽  
pp. 320-326 ◽  
Author(s):  
Jolandi van Heerden ◽  
Patricia M Desmond ◽  
Pramit M Phal

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi162-vi163
Author(s):  
Lucy Pointon ◽  
Robin Grant ◽  
Sharon Peoples ◽  
Sara Erridge ◽  
Paula Sherwood ◽  
...  

Abstract BACKGROUND Most primary brain tumour patients rely on informal caregivers (i.e. family members or friends) for practical and emotional support. While caregiving can be rewarding, it may lead to significant burden. To develop support it is therefore vital to distinguish between unmet needs, and an actual wish for support. Study aims: 1) identify the presence and magnitude of caregivers’ unmet needs; 2) examine associations between unmet needs and wish for support; 3) evaluate perceived usefulness of caregiver needs screening in clinical practice. METHODS Family caregivers of primary brain tumour patients were recruited and asked to complete an adapted version of the Caregiver Needs Screen (CNS) which consisted of 33 common issues in neuro-oncology caregiving (scale 0-10), and the wish for support (yes/no). Participants ranked (0-7) their experience of using the CNS with a study-specific evaluation questionnaire. Descriptive and correlational analyses were applied. RESULTS Caregivers (N=79) reported between 1-33 unmet needs (M=17.20, sd=7.98) but did not always wish for support (range 0-28, M=4.71, sd=6.63). Most distressing items were changes in patient’s memory or concentration (M=5.75, SD=3.29), followed closely by patient’s fatigue (M=5.58, SD= 3.43), and recognising signs of disease progression (M=5.23, SD= 3.15). A weak correlation was found between the total number of unmet needs and wish for support (r=0.296, p=0.014). Caregivers most often wished for support with recognising disease progression (N=24, 34.78%), and least often with managing spiritual issues (N=0, 0%). Caregivers evaluated the CNS tool positively (mean item scores ranging 4.19-6.21 out of 7). CONCLUSIONS Family caregivers experience distress resulting from many neuro-oncology specific needs, but this is not directly related to a wish for support. Caregiver needs screening could be useful to tailor support to suit caregivers’ preferences in clinical practice.


Author(s):  
Jorge Leite ◽  
Munir Boodhwani ◽  
Felipe Fregni

This chapter focuses on two important concepts: subgroup analysis and meta-analysis. Subgroup analysis is especially concerned about variability and how treatment effects can differ due to specific characteristics of the population. Important issues, however, arise when planning for subgroup analysis, such as dealing with false positives and methods for dealing with multiple statistical comparisons. The chapter also points out that the analysis of data from subgroups of patients with certain baseline characteristics is typically insufficient to change general clinical practice. The second section of this chapter focuses on meta-analysis, which is a method of pooling data from several studies in order to quantify the overall effect of an intervention or exposure, and thus potentially change clinical practice. This section discusses data search and synthesis, quantification of heterogeneity, choice of fixed or random model, as well as sensitivity analysis.


2019 ◽  
Vol 13 (5) ◽  
pp. 653-662 ◽  
Author(s):  
Chelsea Nicol ◽  
Tamara Ownsworth ◽  
Lee Cubis ◽  
William Nguyen ◽  
Matthew Foote ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document