Article
Clinical Neurology
Cordelia Orillac, Walter Stummer, Daniel A. Orringer
Summary: The central goal in glioma surgery is to safely maximize extent of resection, especially in eloquent cortex, where the goal of maximal resection is balanced with neurological risk. New technologies such as fluorescence-guided surgery, intraoperative magnetic resonance imaging, and microscopic imaging methods have elevated the standards for maximal safe resection.
Review
Medicine, General & Internal
Alexander J. Schupper, Raymund L. Yong, Constantinos G. Hadjipanayis
Summary: Maximal safe resection is the standard of care for high-grade gliomas in neurosurgical treatment. Various advanced technologies, such as fluorescence-guided surgery, intraoperative imaging, neuromonitoring modalities, and microscopic imaging techniques, have been developed to improve intraoperative visualization of tumor tissue. These technologies aim to enhance the detection of tumor tissue beyond what conventional microsurgery allows, and future directions focus on improving intraoperative technologies.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Oncology
Andrea Carai, Alessandro De Benedictis, Tommaso Calloni, Nicola Onorini, Giovanni Paterno, Franco Randi, Giovanna Stefania Colafati, Angela Mastronuzzi, Carlo Efisio Marras
Summary: Surgical resection is crucial for pediatric central nervous system tumors, and intraoperative ultrasound shows high predictive value in assessing tumor residue compared to postoperative MRI. Analysis indicates tumor histology significantly impacts the presence of residual tumor, while variables like tumor location, patient positioning, age, and initial tumor volume do not significantly affect ioUS predictive ability.
FRONTIERS IN ONCOLOGY
(2021)
Article
Medicine, Research & Experimental
Zhenxing Sun, Dan Yuan, Yaxing Sun, Yi Guo, Guoqin Wang, Peihai Zhang, James Wang, Wei Shi, Guihuai Wang
Summary: This study demonstrates that the use of yellow fluorescence aids in identifying tumor margin and residual tumor tissue in intramedullary spinal cord ependymoma resection, improving the surgical resection rate. The 3-month follow-up clinical outcomes show good functional recovery in patients in the fluorescein group, with no residual tumor tissue or recurrence.
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH
(2022)
Article
Oncology
Fatih Incekara, Marion Smits, Linda Dirven, Eelke M. Bos, Rutger K. Balvers, Iain K. Haitsma, Joost W. Schouten, Arnaud J. P. E. Vincent
Summary: The study confirms that intraoperative B-mode ultrasound guided surgery leads to more frequent complete resection without harming patients, which helps to maximize the extent of glioblastoma resection.
FRONTIERS IN ONCOLOGY
(2021)
Article
Neurosciences
Benjamin Sass, Darko Zivkovic, Mirza Pojskic, Christopher Nimsky, Miriam H. A. Bopp
Summary: The results of this study demonstrate that navigated i3D ultrasound can accurately identify the boundaries of glioblastoma and positively influence the extent of resection during surgery.
FRONTIERS IN NEUROSCIENCE
(2022)
Article
Oncology
Victoria Becerra, Jose Hinojosa, Santiago Candela, Diego Culebras, Mariana Alamar, Georgina Armero, Gaston Echaniz, David Artes, Josep Munuera, Jordi Muchart
Summary: This study presents the experience of using 1.5-T high-field intraoperative magnetic resonance imaging (ioMRI) for pediatric neuro-oncological procedures. The study found that ioMRI identified residual tumors in 14% of cases and prompted further resection without any security incidents. The conclusion of the study is that ioMRI is a safe and reliable tool in pediatric neuro-oncology surgery, maximizing tumor resection without causing neurological deficits or complications.
FRONTIERS IN ONCOLOGY
(2023)
Article
Clinical Neurology
Timothy H. Ung, Stephanie Serva, Gregoire P. Chatain, Jens-Peter Witt, Michael Finn
Summary: Sodium fluorescein has shown potential in aiding the resection of spinal cord lesions, helping with localization and safe surgical treatment. Research has found that in some patients, fluorescence-guided microsurgery can facilitate lesion resection. Further exploration of fluorescein sodium applications in the resection of spinal cord lesions is needed.
NEUROSURGICAL REVIEW
(2022)
Review
Oncology
Othman Bin-Alamer, Hussam Abou-Al-Shaar, Zachary C. Gersey, Sakibul Huq, Justiss A. Kallos, David J. McCarthy, Jeffery R. Head, Edward Andrews, Xiaoran Zhang, Constantinos G. Hadjipanayis
Summary: Advancements in intraoperative visualization and imaging techniques have greatly improved the outcomes of brain tumor surgery. This review discusses the evolution and application of various imaging technologies, their benefits and challenges, and the potential future developments in the field, including artificial intelligence and virtual reality.
Article
Medicine, General & Internal
Jiro Akimoto, Shinjiro Fukami, Megumi Ichikawa, Kenta Nagai, Michihiro Kohno
Summary: The surgical eradication of malignant glioma cells is theoretically impossible, so reducing the number of remaining tumor cells around the BTI is crucial for satisfactory clinical outcomes. The effectiveness of fluorescence-guided resection for malignant glioma has been reported, and intraoperative rapid fluorescence cytology may help evaluate tumor cell presence in resection cavity walls for more complete resection.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Urology & Nephrology
Yue Che, Carolin Buddensieck, Peter Albers, Achim Lusch, Christian Winter, Robert Grosse Siemer, Andreas Hiester
Summary: The oncologic benefit of postchemotherapy residual tumor resection (RTR) in patients with germ cell tumors and elevated serum tumor markers (STMs) remains unclear. Analysis of the data showed that a preoperative serum level of AFP >= 30 mu g/l and viable cancer in the RTR specimens were significant predictors of relapse after first line chemotherapy. In addition, the prognosis of patients with elevated markers and surgery after second or later line therapy is poor regardless of the tumor marker levels.
JOURNAL OF UROLOGY
(2022)
Article
Clinical Neurology
Christoph Bettag, Katharina Schregel, Philip Langer, Carolina Thomas, Daniel Behme, Christine Stadelmann, Veit Rohde, Dorothee Mielke
Summary: The study found that combined microscopic and endoscopic fluorescence-guided resection significantly increases the extent of resection in GBM patients, allowing surgeons to achieve a supratotal resection beyond the borders of contrast enhancement in noneloquently located GBM.
NEUROSURGICAL FOCUS
(2021)
Review
Oncology
Tiffany A. Eatz, Daniel G. Eichberg, Victor M. Lu, Long Di, Ricardo J. Komotar, Michael E. Ivan
Summary: 5-aminolevulinic acid (5-ALA) has been shown to enhance the outcomes of high-grade glioma (HGG) surgery, including extent of resection and patient survival. However, its impact on postoperative neurological function remains inconclusive.
JOURNAL OF NEURO-ONCOLOGY
(2022)
Article
Oncology
J. -K. Kim, T. -Y. Jung, S. Jung, I. -Y. Kim, W. -Y. Jang, K-S. Moon, S. -K. Kim, J. -H. Kim, K. -H. Lee
Summary: This study explores the impact of 5-aminolevulinic acid (5-ALA) fluorescent signals on tumor cell infiltration in the resection cavity and ventricle wall post-brain tumor removal, highlighting that the presence of definitive infiltrating tumor cells significantly influences the prognosis of glioblastoma patients. Aggressive surgical removal of infiltrating tumor cells may improve patient outcomes.
CLINICAL & TRANSLATIONAL ONCOLOGY
(2021)
Article
Surgery
Jens Osterkamp, Rune Strandby, Nikolaj Nerup, Morten-Bo Svendsen, Lars-Bo Svendsen, Michael Achiam
Summary: This study investigated the use of intraoperative ICG lymphography in robot-assisted resection of GEJ cancer. The results showed that this technique could aid in LN detection without increasing surgical risk. However, none of the dissected LNs were found to be metastatic. Therefore, the potential improvement in oncological outcomes with NIR lymphography remains uncertain.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2023)
Article
Clinical Neurology
Alexander Rau, Suam Kim, Shan Yang, Marco Reisert, Elias Kellner, Ikram Eda Duman, Bram Stieltjes, Marc Hohenhaus, Juergen Beck, Horst Urbach, Karl Egger
Summary: The support vector machine algorithm can reliably detect the normal pressure hydrocephalus (NPH) pattern with a high accuracy that is comparable to human experts, with potential applications in the diagnosis of asymptomatic patients or neurodegenerative diseases.
CLINICAL NEURORADIOLOGY
(2021)
Article
Clinical Neurology
Sebastian Kuechlin, Christine Steiert, Yashar Naseri, Lutz Joachimsen, Markus Gruber, Michael Reich, Daniel Boehringer, Mark Metzger, Juergen Beck, Christian Scheiwe, Wolf A. Lagreze, Juergen Grauvogel
Summary: The study assessed predictors for visual outcome after standardized pterional orbital decompression for dysthyroid optic neuropathy in 40 patients. The results showed improvement in visual acuity and reduction in proptosis post-surgery, with low complication rates. Decompression surgery was highly effective at restoring and maintaining visual acuity in patients with dysthyroid optic neuropathy.
WORLD NEUROSURGERY
(2021)
Article
Biology
Maximilian Lenz, Pia Kruse, Amelie Eichler, Jakob Straehle, Juergen Beck, Thomas Deller, Andreas Vlachos
Summary: A defining feature of the brain is its ability for synaptic contacts to adapt structurally and functionally, with atRA being identified as a potent mediator of synaptic plasticity in the adult human cortex. The coordinated structural and functional changes in excitatory synapses observed in cortical slices were accompanied by ultrastructural remodeling of the spine apparatus organelle and required mRNA translation for these synaptic adaptations. The absence of these changes in synaptopodin-deficient mice suggests the importance of this organelle in the process.
Article
Critical Care Medicine
Christian Fung, Dieter Henrik Heiland, Raluca Reitmeir, Wolf-Dirk Niesen, Andreas Raabe, Jens Eyding, Oliver Schnell, Roland Roelz, Werner J. Z'Graggen, Juergen Beck
Summary: This study aimed to evaluate the feasibility of using contrast-enhanced ultrasound perfusion imaging (UPI) to detect cerebral hypoperfusion after aneurysmal subarachnoid hemorrhage (aSAH). The results showed that the left-right difference of time to peak (TTP) values is the most indicative result of cerebral hypoperfusion.
NEUROCRITICAL CARE
(2022)
Article
Clinical Neurology
Andreas Raabe, Jurgen Beck, Johannes Goldberg, Werner J. Z. Graggen, Mattia Branca, Serge Marbacher, Donato D'Alonzo, Javier Fandino, Martin N. Stienen, Marian C. Neidert, Jan-Karl Burkhardt, Luca Regli, Martin Hlavica, Martin Seule, Michel Roethlisberger, Raphael Guzman, Daniel Walter Zumofen, Rodolfo Maduri, Roy Thomas Daniel, Amir El Rahal, Marco Corniola, Philippe Bijlenga, Karl Schaller, Roland Roelz, Christian Scheiwe, Mukesch Shah, Dieter Henrik Heiland, Oliver Schnell, Christian Fung
Summary: This independent prospective multicenter study found that by modifying the WFNS grading system in aneurysmal subarachnoid hemorrhage patients, the specificity and positive predictive value were significantly improved, aiding in predicting poor outcomes. Therefore, a simple modification of adding positive signs of brain stem dysfunction to the WFNS classification should be considered.
Article
Biochemical Research Methods
James Rosado, Viet Duc Bui, Carola A. Haas, Jurgen Beck, Gillian Queisser, Andreas Vlachos
Summary: This study anatomically reconstructed human cortical spines and analyzed the influence of spine apparatus organelles on calcium dynamics. The findings suggest that spine apparatus organelles play a critical role in regulating calcium communication between spines and dendrites.
PLOS COMPUTATIONAL BIOLOGY
(2022)
Article
Biotechnology & Applied Microbiology
Christine Steiert, Luisa M. Kraus, Roland Roelz, Horst Urbach, Juergen Beck, Stephan Meckel, Juergen Grauvogel
Summary: In this study, cisternography followed by surgical repair was performed in 63 cases of skull base cerebrospinal fluid (CSF) leaks. The sensitivity of cisternography for localizing CSF leaks was found to be high. Iatrogenic leaks tended to have a more favorable surgical outcome, while traumatic leaks had a lower surgical success rate.
BIOMED RESEARCH INTERNATIONAL
(2022)
Article
Clinical Neurology
Levin Haeni, Christian Fung, Christopher Marvin Jesse, Christof Schild, Eike Immo Piechowiak, Tomas Dobrocky, Andreas Raabe, Juergen Beck
Summary: The aim of this study was to identify cerebrospinal fluid (CSF) biomarkers of infratentorial superficial siderosis (iSS) in patients with spontaneous intracranial hypotension (SIH). CSF ferritin level was found to be significantly elevated in patients with iSS as compared to those without, suggesting that measurement of CSF ferritin could help identify individuals at risk of developing iSS.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Health Care Sciences & Services
Christine Steiert, Johann Lambeck, Tanja Daniela Grauvogel, Juergen Beck, Juergen Grauvogel
Summary: This study evaluated the feasibility and methodology of using digital patient-reported outcome measures to assess health-related quality of life in skull base diseases. The results suggested that digital PROMs are suitable for assessing HRQoL in skull base patients, but the availability of medical personnel is essential for implementation and supervision.
Article
Clinical Neurology
Urs Wuertemberger, Daniel Erny, Alexander Rau, Jonas A. Hosp, Veysel Akguen, Marco Reisert, Valerij G. Kiselev, Jurgen Beck, Sonja Jankovic, Peter C. Reinacher, Marc Hohenhaus, Horst Urbach, Martin Diebold, Theo Demerath
Summary: The study successfully differentiated glioblastomas and brain metastases using advanced diffusion techniques and structural histopathology. Analysis of microstructural features in the contrast-enhancing tumor components served as imaging biomarkers for distinguishing these tumor entities.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2023)
Article
Clinical Neurology
Martin Hirsch, Juergen Beck, Armin Brandt, Georgia Papadopoulou, Kathrin Wagner, Horst Urbach, Andreas Schulze-Bonhage
Summary: This study aimed to determine if the growing evidence for epilepsy surgery as an early treatment option is reflected in the decrease of latencies between epilepsy onset and referral for presurgical evaluation. The results showed a significant reduction in the latencies between the periods 1999-2009 and 2010-2019, indicating that the trend towards early surgical intervention for epilepsy is increasing over time. However, the overall achievement of early diagnostic evaluation for epilepsy surgery options after established pharmacoresistance was still limited to a minority of patients.
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
(2023)
Review
Oncology
Christian D. Diehl, Frank A. Giordano, Anca-L. Grosu, Sebastian Ille, Klaus-Henning Kahl, Julia Onken, Stefan Rieken, Gustavo R. Sarria, Ehab Shiban, Arthur Wagner, Juergen Beck, Stefanie Brehmer, Oliver Ganslandt, Motaz Hamed, Bernhard Meyer, Marc Muenter, Andreas Raabe, Veit Rohde, Karl Schaller, Daniela Schilling, Matthias Schneider, Elena Sperk, Claudius Thome, Peter Vajkoczy, Hartmut Vatter, Stephanie E. Combs
Summary: Brain metastases are a growing concern in cancer patients and various treatment options are available. Small asymptomatic lesions are usually treated with focal stereotactic radiotherapy, while large or symptomatic metastases require surgical resection. Postsurgical radiotherapy has been proven effective in preventing local recurrence, and different techniques such as stereotactic radiosurgery and intraoperative radiotherapy have been introduced. This consensus paper summarizes the current local treatment strategies for resectable brain metastases.
Article
Clinical Neurology
T. Dobrocky, M. Rebsamen, C. Rummel, L. Haeni, P. Mordasini, A. Raabe, C. T. Ulrich, J. Gralla, E. I. Piechowiak, J. Beck
AMERICAN JOURNAL OF NEURORADIOLOGY
(2020)
