scholarly journals A New Scoring System for Predicting Extent of Resection in Medial Sphenoid Wing Meningiomas Based on Three-dimensional Multimodality Fusion Imaging

2020 ◽  
Author(s):  
Zilan Wang ◽  
Xiaolong Liang ◽  
Yanbo Yang ◽  
Bixi Gao ◽  
Ling Wang ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Scoring System ◽  
Three Dimensional ◽  
Extent Of Resection ◽  
Fusion Imaging ◽  
Bone Invasion ◽  
Predictive Capacity ◽  
Arterial Involvement ◽  
The Mean ◽  
New Scoring

Abstract Background: Three-dimensional (3D) multimodality fusion imaging has been proved to be a promising neurosurgical tool for presurgical evaluation of tumor removal. We aim to develop a scoring system based on this new tool to predict the resection grade of medial sphenoid wing meningiomas (mSWM) intuitively.Methods: We included 46 patients treated for mSWM from 2014 to 2019 to evaluate their tumors’ location, volume, cavernous sinus involvement, vascular encasement and bone invasion by 3D multimodality fusion imaging. A scoring system based on the significant parameters detected by statistical analysis was created and evaluated.Results: The tumor volumes ranged from 0.8 cm3 to 171.9 cm3. A total of 39 (84.8%) patients had arterial involvement. Cavernous sinus (CS) involvement was observed in 23 patients (50.0%) and bone invasion was noted in 10 patients (21.7%). Simpson I resection was achieved in 10 patients (21.7%) and Simpson II resection was achieved in 17 patients (37.0%). Fifteen patients (32.6%) underwent Simpson III resection and 4 patients (8.7%) underwent Simpson IV resections. A scoring system was created. The score ranged from 1 to 10 and the mean score of our patients was 5.3 ± 2.8. Strong positive monotonic correlation existed between the score and resection grade (Rs = .772, P < .001). The scoring system had good predictive capacity with an accuracy of 69.60%.Conclusions: We described a scoring system that enabled neurosurgeons to predict extent of resection and outcomes for mSWM preoperatively with 3D multimodality fusion imaging.Trial registration: Retrospectively registered.

scholarly journals A New Scoring System for Predicting Extent of Resection in Medial Sphenoid Wing Meningiomas Based on Three-dimensional Multimodality Fusion Imaging

2020 ◽  
Author(s):  
Zilan Wang ◽  
Xiaolong Liang ◽  
Yanbo Yang ◽  
Bixi Gao ◽  
Ling Wang ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Scoring System ◽  
Three Dimensional ◽  
Extent Of Resection ◽  
Fusion Imaging ◽  
Bone Invasion ◽  
Predictive Capacity ◽  
Arterial Involvement ◽  
The Mean ◽  
New Scoring

Abstract Background Three-dimensional (3D) multimodality fusion imaging has been proved to be a promising neurosurgical tool for presurgical evaluation of tumor removal. We aim to develop a scoring system based on this new tool to predict the resection grade of medial sphenoid wing meningiomas (mSWM) intuitively. Methods We included 46 patients treated for mSWM from 2014 to 2019 to evaluate their tumors’ location, volume, cavernous sinus involvement, vascular encasement and bone invasion by 3D multimodality fusion imaging. A scoring system based on the significant parameters detected by statistical analysis was created and evaluated. Results The tumor volumes ranged from 0.8 cm3 to 171.9 cm3. A total of 39 (84.8%) patients had arterial involvement. Cavernous sinus (CS) involvement was observed in 23 patients (50.0%) and bone invasion was noted in 10 patients (21.7%). Simpson I resection was achieved in 10 patients (21.7%) and Simpson II resection was achieved in 17 patients (37.0%). Fifteen patients (32.6%) underwent Simpson III resection and 4 patients (8.7%) underwent Simpson IV resections. A scoring system was created. The score ranged from 1 to 10 and the mean score of our patients was 5.3 ± 2.8. Strong positive monotonic correlation existed between the score and resection grade (Rs = .772, P < .001). The scoring system had good predictive capacity with an accuracy of 69.60%. Conclusions We described a scoring system that enabled neurosurgeons to predict extent of resection and outcomes for mSWM preoperatively with 3D multimodality fusion imaging. Trial registration: Retrospectively registered.

scholarly journals A new scoring system for predicting extent of resection in medial sphenoid wing meningiomas based on three-dimensional multimodality fusion imaging

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Zilan Wang ◽  
Xiaolong Liang ◽  
Yanbo Yang ◽  
Bixi Gao ◽  
Ling Wang ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Scoring System ◽  
Three Dimensional ◽  
Extent Of Resection ◽  
Fusion Imaging ◽  
Bone Invasion ◽  
Predictive Capacity ◽  
Arterial Involvement ◽  
The Mean ◽  
New Scoring

Abstract Background Three-dimensional (3D) fusion imaging has been proved to be a promising neurosurgical tool for presurgical evaluation of tumor removal. We aim to develop a scoring system based on this new tool to predict the resection grade of medial sphenoid wing meningiomas (mSWM) intuitively. Methods We included 46 patients treated for mSWM from 2014 to 2019 to evaluate their tumors’ location, volume, cavernous sinus involvement, vascular encasement, and bone invasion by 3D multimodality fusion imaging. A scoring system based on the significant parameters detected by statistical analysis was created and evaluated. Results The tumor volumes ranged from 0.8 cm3 to 171.9 cm3. A total of 39 (84.8%) patients had arterial involvement. Cavernous sinus (CS) involvement was observed in 23 patients (50.0%) and bone invasion was noted in 10 patients (21.7%). Simpson I resection was achieved in 10 patients (21.7%) and Simpson II resection was achieved in 17 patients (37.0%). Fifteen patients (32.6%) underwent Simpson III resection and 4 patients (8.7%) underwent Simpson IV resections. A scoring system was created. The score ranged from 1 to 10 and the mean score of our patients was 5.3 ± 2.8. Strong positive monotonic correlation existed between the score and resection grade (Rs = 0.772, P < 0.001). The scoring system had good predictive capacity with an accuracy of 69.60%. Conclusions We described a scoring system that enabled neurosurgeons to predict extent of resection and outcomes for mSWM preoperatively with 3D multimodality fusion imaging. Trial registration Retrospectively registered

THREE‐DIMENSIONAL ENDOSCOPIC PITUITARY SURGERY

2009 ◽  
Vol 64 (suppl_5) ◽  
pp. ons288-ons295 ◽  
Author(s):  
Abtin Tabaee ◽  
Vijay K. Anand ◽  
Justin F. Fraser ◽  
Seth M. Brown ◽  
Ameet Singh ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Depth Perception ◽  
Operative Time ◽  
Compound Eye ◽  
Intraoperative Complications ◽  
Three Dimensional ◽  
Pituitary Surgery ◽  
Extent Of Resection ◽  
3 Dimensional ◽  
Transsphenoidal Pituitary Surgery

Abstract OBJECTIVE We describe a novel 3-dimensional (3-D) stereoendoscope and discuss our early experience using it to provide improved depth perception during transsphenoidal pituitary surgery. METHODS Thirteen patients underwent endonasal endoscopic transsphenoidal surgery. A 6.5-, 4.9-, or 4.0-mm, 0- and 30-degree rigid 3-D stereoendoscope (Visionsense, Ltd., Petach Tikva, Israel) was used in all cases. The endoscope is based on “compound eye” technology, incorporating a microarray of lenses. Patients were followed prospectively and compared with a matched group of patients who underwent endoscopic surgery with a 2-dimensional (2-D) endoscope. Surgeon comfort and/or complaints regarding the endoscope were recorded. RESULTS The 3-D endoscope was used as the sole method of visualization to remove 10 pituitary adenomas, 1 cystic xanthogranuloma, 1 metastasis, and 1 cavernous sinus hemangioma. Improved depth perception without eye strain or headache was noted by the surgeons. There were no intraoperative complications. All patients without cavernous sinus extension (7of 9 patients) had gross tumor removal. There were no significant differences in operative time, length of stay, or extent of resection compared with cases in which a 2-D endoscope was used. Subjective depth perception was improved compared with standard 2-D scopes. CONCLUSION In this first reported series of purely 3-D endoscopic transsphenoidal pituitary surgery, we demonstrate subjectively improved depth perception and excellent outcomes with no increase in operative time. Three-dimensional endoscopes may become the standard tool for minimal access neurosurgery.

Endoscopic endonasal surgery for nonadenomatous, nonmeningeal pathology involving the cavernous sinus

2017 ◽  
Vol 126 (3) ◽  
pp. 880-888 ◽  
Author(s):  
Aikaterini Patrona ◽  
Kunal S. Patel ◽  
Evan D. Bander ◽  
Alpesh Mehta ◽  
Apostolos John Tsiouris ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Pituitary Adenomas ◽  
Extent Of Resection ◽  
Gross Total Resection ◽  
Tumor Board ◽  
Benign Tumors ◽  
Total Resection ◽  
Cranial Neuropathies ◽  
The Mean ◽  
Underlying Pathology

OBJECTIVE Surgery within the cavernous sinus (CS) remains a controversial topic because of the delicate and complex anatomy. The risk also varies with tumor consistency. Softer tumors such as pituitary adenomas are more likely to be surgically treated, while firm tumors such as meningiomas are often treated with radiosurgery. However, a wide range of pathologies that can involve the CS are amenable to surgery. The authors describe and analyze their results using endonasal endoscopic “medial-to-lateral” approaches for nonadenomatous, nonmeningeal tumors, in relation to the degree of invasion within the CS. METHODS A prospectively acquired database of consecutive endoscopic approaches for tumors with verified intraoperative CS invasion was reviewed. Pituitary adenomas and meningiomas were excluded. Degree of invasion of the CS was classified using the Knosp-Steiner (KS) grading system as well as the percentage of cavernous carotid artery (CCA) encasement. Extent of resection of the entire tumor and of the CS component was assessed by independent neuroradiologists using volumetric measurements of the pre- and postoperative MRI studies. Demographic data and complications were noted. RESULTS Fifteen patients (mean age 51.1 years who received endoscopic surgery between 2007 and 2013 met the selection criteria. There were 11 malignant tumors, including chordoma, chondrosarcoma, hemangiopericytoma, lymphoma, and metastatic cancer, and 4 benign tumors, including 3 cavernous hemangiomas and 1 dermoid. All cases were discussed before treatment in a tumor board. Adjuvant treatment options included chemotherapy and radiotherapy. The mean pre- and postoperative tumor volumes were 12.74 ml and 3.86 ml. Gross-total resection (GTR; ie, resection greater than 95%) was the goal in 13 cases and was achieved in 6 patients (46%) while in addition 5 patients had a greater than 80% resection. Gross-total resection in the CS was accomplished in 55% of the tumors with KS Grades 1–2 and in 16.6% of the tumors with KS grades 3–4, respectively. Likewise, GTR was accomplished in 55% of the tumors with CCA encasement under 75% and in 14.3% of the lesions with CCA encasement over 75%, irrespective of tumor volume and underlying pathology. There were 18 preexisting cranial neuropathies involving cranial nerves III–VI, of which 9 fully resolved, 4 improved, and 3 remained unchanged; 2 of these worsened with tumor recurrence. Surgical complications included 1 transient new cranial nerve VI palsy associated with Horner's syndrome and 1 case of panhypopituitarism. There were no postoperative CSF leaks and no infections. The mean extended follow-up was 34.4 months. CONCLUSIONS Endonasal endoscopic approaches can play a role in the management of nonmeningeal, nonadenomatous tumors invading the CS, either through biopsy, debulking, or GTR. An advantage of this method is the relief of preexisting cranial neuropathies with low risk for new neurological deficit. Extent of resection within the CS varies with KS grade and degree of carotid encasement irrespective of the underlying pathology. The goals of surgery should be clearly established preoperatively in consultation with radiation and medical oncologists.

Surgical strategies for giant medial sphenoid wing meningiomas: a new scoring system for predicting extent of resection

2008 ◽  
Vol 150 (9) ◽  
pp. 865-877 ◽  
Author(s):  
Sanjay Behari ◽  
Pramod J. Giri ◽  
Dinesh Shukla ◽  
Vijendra K. Jain ◽  
Deepu Banerji
Keyword(s):  
Scoring System ◽  
Extent Of Resection ◽  
Surgical Strategies ◽  
New Scoring

scholarly journals KANET Test: Experience of Zagreb Group

2012 ◽  
Vol 6 (2) ◽  
pp. 166-170
Author(s):  
Ana Tikvica ◽  
Berivoj Miskovic ◽  
Maja Predojevic ◽  
Davor Ivankovic
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Scoring System ◽  
Obstet Gynecol ◽  
Three Dimensional ◽  
Neurological Status ◽  
Developmental Pathway ◽  
New Scoring

ABSTRACT A new scoring system for the assessment of fetal neurological status, Kurjak antenatal neurodevelopmental test (KANET), has been recently published in several journals. Test is based on prenatal assessment of fetal behavior by three-dimensional/fourdimensional (3D/4D) sonography. Assessment of fetal behavior gave a promising opportunity to understand the hidden function of the developmental pathway of the fetal central nervous system. This new test has been proposed by the Zagreb group based on the several years of research. In this review we present the most significant results of the Zagreb group which led to construction of KANET test, basic presumptions of the KANET, and our published results on KANET. How to cite this article Miskovic B, Predojevic M, Stanojevic M, Tikvica A, Kurjak A, Ivankovic D, Vasilj O. KANET Test: Experience of Zagreb Group. Donald School J Ultrasound Obstet Gynecol 2012;6(2):166-170.

Petroclival meningiomas resected via a combined transpetrosal approach: surgical outcomes in 60 cases and a new scoring system for clinical evaluation

2015 ◽  
Vol 122 (2) ◽  
pp. 373-380 ◽  
Author(s):  
Hiroki Morisako ◽  
Takeo Goto ◽  
Kenji Ohata
Keyword(s):  
Scoring System ◽  
Tumor Volume ◽  
Tumor Control ◽  
Early Group ◽  
Petroclival Meningiomas ◽  
The Mean ◽  
Late Group ◽  
New Scoring

OBJECT Petroclival meningiomas are among the most challenging intracranial tumors to treat surgically. Many skull base approaches have been described to improve resection and decrease patient morbidity. The authors undertook this study to evaluate the results of their treatment of petroclival meningiomas using objective measurements of tumor volume and a new impairment scoring system to assess neurological symptoms that severely affect the patient's quality of life, such as impairment of swallowing and speaking, motor function, and consciousness and communication. METHODS Between January 1990 and December 2009, the authors used a combined transpetrosal approach to treat 60 patients with benign (WHO Grade I) petroclival meningiomas. In this retrospective study, all 60 cases were analyzed in detail with regard to tumor volume, extent of resection (EOR), long-term tumor control, neurological outcome, and the patient condition. In addition, patients were divided into 2 groups according to the period during which the surgery was performed: the early group, from 1990 to 1999, and the late group, from 2000 to 2009. A new scoring system, the petroclival meningioma impairment scale (PCMIS), was created for quantitative assessment of 8 categories of neurological functions, with scores assigned in each category according to the level of disability and its impact on the patient. The PCMIS was used preoperatively, at 3 months after surgery, and at the time of the last follow-up examination, and the results for the 2 groups were compared. RESULTS There were 24 cases in the early group (1990–1999), and the mean duration of follow-up was 149.3 months. The mean EOR was 96.1%, and good long-term tumor control was obtained in 22 patients (91.7%). One of patients died because of a postoperative complication in the perioperative period. The PCMIS improved in 3 patients (12.5%), remained stable in 1 (4.2%), and worsened in 20 (83.3%). There were 36 cases in the late group (2000–2009), and the mean duration of follow-up was 77.9 months. The mean EOR was 92.7%, and good long-term tumor control was obtained in 34 patients (94.4%). The PCMIS score improved in 23 patients (63.9%), remained stable in 5 (13.9%), and worsened in 8 (22.2%). CONCLUSIONS The combined transpetrosal approach has provided satisfactory functional improvements and excellent tumor control for patients with petroclival meningiomas. The PCMIS provides a specific tool for quantitative assessment of the patient's state.

scholarly journals The Bedel Score: Suggesting a New Scoring System to Avoid Negative Appendectomy

2021 ◽  
pp. 966-972
Author(s):  
Cihan Bedel ◽  
Mustafa Korkut ◽  
Fatih Selvi ◽  
Ökkes Zortuk
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Scoring Systems ◽  
Threshold Value ◽  
Negative Appendectomy ◽  
Histopathological Diagnosis ◽  
Alvarado Score ◽  
Study Population ◽  
The Mean ◽  
New Scoring

Introduction: Scoring systems are still valuable and valid for differential diagnosis of acute appendicitis (AA). Bedel Score is a new diagnostic tool with 7 parameters that can be easily applied. The aim of this study is to determine the diagnostic performance of the Bedel score in AA and compare it with the Alvarado score. Methods: Our study consisted of 95 patients as a prospective cohort who were admitted to our emergency department due to abdominal pain and were hospitalized with a preliminary diagnosis of AA. Bedel and Alvarado scores were calculated. The patients were categorized into two groups (positive and negative appendectomy) according to their histopathological diagnosis. Results: The study population consisted of 65 (68.4%) male and 30 (31.6%) female patients. The mean age of the patients was 34 (18-87) years. 81 (85.3%) of the patients had histopathologically confirmed AA. Median Alvarado score was significantly higher in patients with positive AA than those with negative AA (7 (range: 3-10) vs. 5 (range 3-7), p<0.001, respectively). Median Bedel score of positive AA patients were also significantly higher than those with negative AA (9 (range: 6-10) vs. 5 (range 2-8) p<0.001, respectively) In separating acute appendicitis from negative exploration, the threshold of the Alvarado score is 63% sensitivity for ?7, 85.7% specificity; The Bedel score had 80.2% sensitivity and 92.9% specificity for the threshold value ?7. Conclusion: Bedel score is fast, simple, easy to learn and apply, as well as an effective and practical scoring system with only 7 parameters. Keywords: Acute appendicitis, Alvarado score, New score, Negative appendectomy

scholarly journals Validation of a New Scoring System for the Detection of Early Forme of Keratoconus

2012 ◽  
Vol 1 (2) ◽  
pp. 100-108 ◽  
Author(s):  
Alain Saad
Keyword(s):  
At Risk ◽  
Scoring System ◽  
Refractive Surgery ◽  
Operating Characteristic ◽  
False Negative ◽  
Automated System ◽  
Roc Curve Analysis ◽  
The Mean ◽  
New Scoring ◽  
Tomography Data

ABSTRACT Purpose To evaluate the accuracy of a new objective method for the detection of ectasia susceptible eyes. Methods One hundred and eighty-three elevation and placido topographies were retrospectively evaluated by one experimented refractive surgeon and classified as ‘normal’ or ‘at risk for LASIK’. An objective automated system built on the combination of topography and tomography data in a discriminant function was also used to classify the corneas. The concordance between the objective and the subjective classification was evaluated and the usefulness of the objective scoring system was assessed by receiver operating characteristic (ROC) curve analysis. Results The mean age of the studied group was 37 ± 8 years old. One hundred and fifty-nine eyes were subjectively classified as ‘normal’ and 24 as ‘At risk for LASIK’. The scoring system correctly classified 153 eyes as ‘normal’ and 22 eyes as ‘at risk for LASIK’. Six eyes were wrongly detected as ‘at risk’ by the automated system (false-positive) and two eyes were wrongly classified as ‘normal’ (false-negative). The sensitivity and specificity of the automated system were 92 and 96% respectively. Conclusion An automated system built on the combination of topography and tomography parameters can help in creating a sensitive and specific artificial intelligence for the detection of corneas at risk for refractive surgery. How to cite this article Saad A, Gatinel D. Validation of a New Scoring System for the Detection of Early Forme of Keratoconus. Int J Kerat Ect Cor Dis 2012;1(2):100-108.

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