Brain & spine最新文献

{"title":"Current state and future perspectives of spinal navigation and robotics—an AO spine survey","authors":"Stefan Motov ,&nbsp;Vicki M. Butenschoen ,&nbsp;Philipp E. Krauss ,&nbsp;Anand Veeravagu ,&nbsp;Kelly H. Yoo ,&nbsp;Felix C. Stengel ,&nbsp;Nader Hejrati ,&nbsp;Martin N. Stienen","doi":"10.1016/j.bas.2024.104165","DOIUrl":"10.1016/j.bas.2024.104165","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of robotics in spine surgery has gained popularity. This study aims to assess the current state of robotics and raise awareness of its educational implications.</div></div><div><h3>Research question</h3><div>What are the current adoption trends and barriers to the implementation of robotic assistance in spine surgery?</div></div><div><h3>Material and methods</h3><div>An online questionnaire comprising 27 questions was distributed to AO spine members between October 25th and November 13th, 2023, using the SurveyMonkey platform (<span><span>https://www.surveymonkey.com</span><svg><path></path></svg></span>; SurveyMonkey Inc., San Mateo, CA, USA). Statistical analyses (descriptive statistics, Pearson Chi-Square tests) and generation of all graphs were performed using SPSS Version 29.0.1.0 (IBM SPSS Statistic).</div></div><div><h3>Results</h3><div>We received 424 responses from AO Spine members (response rate = 9.9 %). The participants were mostly board-certified orthopedic surgeons (46 %, n = 195) and neurosurgeons (32%, n = 136). While 49% (n = 208) of the participants reported occasional or frequent use of navigation assistance, only 18 % (n = 70) indicated the use of robotic assistance for spinal instrumentation. A significant difference based on the country's median income status (p &lt; 0.001) and the respondent's number of annual instrumentation procedures (p &lt; 0.001) has been observed. While 11 % (n = 47) of all surgeons use a spinal robot frequently, 36 % (n = 153) of the participants stated they don't need a robot from a current perspective. Most participants (77%, n = 301) concluded that high acquisition costs are the primary barrier for the implementation of robotics.</div></div><div><h3>Discussion and conclusion</h3><div>Although the hype for robotics in spine surgery increased recently, robotic systems remain non-standard equipment due to cost constraints and limited usability.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104165"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting the Endoscopic vs. Microscopic colloid cysts resection battle with emphasis on endoscope assisted technique","authors":"Ahmed Al Menabbawy ,&nbsp;Amr Elsamman ,&nbsp;Tamim Essawy ,&nbsp;Reem Elwy ,&nbsp;Sebastian Lehmann ,&nbsp;Loay Shoubash ,&nbsp;Ehab El Refaee ,&nbsp;Nasser M.F. El-Ghandour ,&nbsp;Mohamed Ramadan ,&nbsp;Ahmed Zohdi","doi":"10.1016/j.bas.2024.104181","DOIUrl":"10.1016/j.bas.2024.104181","url":null,"abstract":"<div><h3>Introduction</h3><div>Colloid cysts are challenging regarding their location. Surgical resection remains the therapeutic option of choice for symptomatic cysts. However, choosing the optimal surgical approach is still a subject of debate.</div></div><div><h3>Research question</h3><div>The aim of the study is to compare three surgical approaches; Pure endoscopic (PE), pure microscopic (PM) and endoscope assisted microsurgical (EA).</div></div><div><h3>Material and methods</h3><div>Retrospective data extraction from our database was done and we included patients who underwent surgical resection for colloid cysts since 2008. Patients were categorized into three groups based on the forementioned surgical techniques. Outcome measures assessed included extent of resection (EOR), morbidity using modified Rankin Scale (mRS), hospital stay duration (HSD), and complications.</div></div><div><h3>Results</h3><div>41 patients met our inclusion criteria and were divided as follows; PM 13 patients (31.7%), PE 19 patients (46.3%) and EA with 9 patients (22.0%). Mean age (SD) was 37.4 ± 12.2. Male: Female is 1:1.05 and average follow-up was 3.9 ± 2.8 years. Gross total resection(GTR) reached 92.3% (12/13) using PM, 78.9% (15/19) with PE and 100% (9/9) under EA. Morbidity was 15.4%, 10.5% and 0% respectively (mRS &gt;2). Hospital stay duration was significantly shorter in PE and EA (p = 0.012).</div></div><div><h3>Discussion and conclusion</h3><div>EA excision of colloid cysts is safe and effective. When compared to PE and PM approaches, it can combine the advantages of both tools utilizing the microscope and endoscope to achieve a safe, gross total resection while minimizing hospitalization duration. The choice of surgical approach, however, should be individualized based on the cyst's location, size, and the surgeon's expertise and preference.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104181"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical symptoms and surgical outcome of colloid cysts of the third ventricle: A multicenter retrospective study","authors":"V.M. Butenschoen ,&nbsp;N. Lange ,&nbsp;A. Quiring ,&nbsp;L. Mikhina ,&nbsp;J. Gempt ,&nbsp;M. Shah ,&nbsp;J. Beck ,&nbsp;P. Evangelou ,&nbsp;V. Rohde ,&nbsp;D. Jankovic ,&nbsp;F. Ringel ,&nbsp;I. Janssen ,&nbsp;K. Schaller ,&nbsp;C.F. Freyschlag ,&nbsp;C. Thomé ,&nbsp;S. Maurer ,&nbsp;M. Czabanka ,&nbsp;P. Leissa ,&nbsp;P. Vajkoczy ,&nbsp;B. Meyer","doi":"10.1016/j.bas.2025.104196","DOIUrl":"10.1016/j.bas.2025.104196","url":null,"abstract":"<div><h3>Introduction</h3><div>Colloid cysts of the third ventricle are benign brain lesions that may obstruct cerebrospinal fluid flow within the ventricular system and cause symptoms like headaches, deterioration of vision, and acute hydrocephalus.</div></div><div><h3>Research question</h3><div>What is the clinical outcome of surgical treatment of third ventricle colloid cysts, and what factors are influencing long-term complications?</div></div><div><h3>Material and methods</h3><div>In this multicenter retrospective cohort study performed between 2008 and 2023, we assessed the preoperative clinical status, the colloid cyst risk score, surgical techniques, and the clinical outcome of patients undergoing surgical cyst resection for incidental and symptomatic colloid cysts of the third ventricle. We specifically focused on long-term data such as shunt dependency and postoperative complications.</div></div><div><h3>Results</h3><div>In total, 190 patients were included. Most presented with headaches (75,3%), while 25% showed signs of acute and 36% signs of chronic hydrocephalus. In 23% of the patients, short-term memory was impaired. The surgical treatment presented a safe and definite treatment, with wound healing disorders (6.3%) and CSF leakage (4.7%) being the most frequently encountered complications. Only 5.3% showed a postoperative shunt dependency.</div></div><div><h3>Discussion and conclusion</h3><div>The surgical treatment of colloid cysts of the third ventricle represents a safe procedure. Acute hydrocephalus was observed more frequently than previously described, and shunt dependency after surgery was low. (211/250 words)</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104196"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome measures after anterior cervical decompression and fusion surgery –non-respondents do not bias the results: A Finnish spine register (FinSpine) study","authors":"N. Klimko ,&nbsp;N. Danner ,&nbsp;H. Salo ,&nbsp;A. Malmivaara ,&nbsp;V. Leinonen ,&nbsp;J. Huttunen","doi":"10.1016/j.bas.2024.104179","DOIUrl":"10.1016/j.bas.2024.104179","url":null,"abstract":"<div><h3>Introduction</h3><div>Comprehensive national spine registers are used in the Nordic countries. Register data is inherently incomplete, raising concerns about the derived results due to non-respondent bias. Few studies have addressed the effect of non-respondents on the integrity of patient-reported outcome data in national spine registers, suggesting that outcome measures after spine surgery may not differ between respondents and non-respondents.</div></div><div><h3>Research question</h3><div>Using the Finnish national spine register (FinSpine), we aimed to assess whether non-respondents would bias patient-reported outcomes at 12 months following anterior cervical decompression and fusion (ACDF) surgery.</div></div><div><h3>Material and methods</h3><div>FinSpine data from 5563 ACDF surgeries since 2016 were analyzed, supplemented with prescription records from the Finnish Social Insurance Institution and subcohort data from Kuopio University Hospital. Patients were grouped based on whether they completed post-operative outcome surveys. Outcomes were compared on neck and upper extremity pain, functional capacity, quality of life, sleep quality, return to work, regular use of pain medication, and opioid purchases 12 months after surgery.</div></div><div><h3>Results</h3><div>Out of 5563 ACDF patients, 1362 (24.5%) purchased opioids during the first post-operative year. There were no significant differences in the mean cumulative opioid purchases between respondents and non-respondents. In the subcohort (n = 60), all non-respondents (n = 29) were reached and interviewed. There were no differences between respondents and non-respondents in any outcome measures at 12 months.</div></div><div><h3>Discussion and conclusion</h3><div>Non-respondents do not bias the assessment of outcome measures following ACDF at 12 months, supporting the validity and reliability of national quality registers like FinSpine for clinical research.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104179"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors of thalamic and thalamopeduncular low-grade gliomas in children: A systematic review and recommendations for surgical management","authors":"Jana Táborská ,&nbsp;Adéla Bubeníková ,&nbsp;Petr Skalický ,&nbsp;Jakub Táborský ,&nbsp;David Horváth ,&nbsp;Michal Zápotocký ,&nbsp;Ondřej Bradáč ,&nbsp;Vladimír Beneš 3rd","doi":"10.1016/j.bas.2025.104183","DOIUrl":"10.1016/j.bas.2025.104183","url":null,"abstract":"<div><h3>Introduction</h3><div>Pediatric low-grade gliomas arising from the thalamus or thalamopeduncular junction are rare. Prognostic factors are thus seldom reported in the literature.</div></div><div><h3>Research question</h3><div>This systematic review aims to define the factors influencing the prognosis of pediatric patients with thalamic and thalamopeduncular low-grade gliomas.</div></div><div><h3>Material and methods</h3><div>An extensive literature search in adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed and included Web of Science, Scopus, and OVID interface (Medline and Embase). Original articles were selected if they provided data on 10 or more patients under 18 years old with separate or retrievable data for thalamic or thalamopeduncular low-grade gliomas, as well as at least one prognostic factor and its corresponding outcome. The risk of bias and applicability were assessed using The Quality Assessment of Prognostic Accuracy Studies criteria.</div></div><div><h3>Results</h3><div>The study selection process resulted in the inclusion of 14 articles out of the initial pool of 876 references. These 14 articles encompassed data from 446 patients. The prognostic factors reported were the extent of resection in ten studies, age and radiotherapy in four studies, bilateral involvement and molecular genetics in two studies, and sex and dissemination in one study each. Significant prognostic factors included the extent of resection, bilateral involvement, histology, and radiotherapy.</div></div><div><h3>Discussion and conclusion</h3><div>The reported factors considered significant for prognosis align with previously published data. The maximal safe resection, as a potentially curative modality for thalamic low-grade glioma, and the multidisciplinary approach to each patient should be a standard of care. Given the excellent long-term outlook of these patients, the extent of resection should not be pursued at the risk of neurological function since additional therapeutic possibilities are available today, such as molecular-targeted agents.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104183"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling neurocysticercosis: A call for heightened awareness and action","authors":"Inibehe Ime Okon ,&nbsp;Muhammad Danish Shafqat ,&nbsp;Muhammad Daniyal Shafqat ,&nbsp;Javeria Hussain ,&nbsp;Youssef Razouqi","doi":"10.1016/j.bas.2024.104174","DOIUrl":"10.1016/j.bas.2024.104174","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104174"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebrospinal fluid pressure dynamics as a biomechanical marker for quantification of spinal cord compression: Conceptual framework and systematic review of clinical trials","authors":"Najmeh Kheram ,&nbsp;Madeleine A. Bessen ,&nbsp;Claire F. Jones ,&nbsp;Benjamin M. Davies ,&nbsp;Mark Kotter ,&nbsp;Mazda Farshad ,&nbsp;Markus Hupp ,&nbsp;Daniel Nanz ,&nbsp;Patrick Freund ,&nbsp;Martin Schubert ,&nbsp;Vartan Kurtcuoglu ,&nbsp;Armin Curt ,&nbsp;Carl M. Zipser","doi":"10.1016/j.bas.2025.104211","DOIUrl":"10.1016/j.bas.2025.104211","url":null,"abstract":"<div><h3>Introduction</h3><div>In patients with acute spinal cord injury (SCI) and degenerative cervical myelopathy (DCM), spinal cord compression is considered a main contributor to spinal cord damage, associated with cerebrospinal fluid (CSF) space obstruction. CSF pressure (CSFP) dynamics are studied as a potential indirect biomechanical marker for spinal cord compression, and as a proxy to estimate spinal cord perfusion pressure (SCPP).</div></div><div><h3>Research question</h3><div>Evidence for safety and feasibility of CSFP dynamics in clinical trials as well as interrelations with neuroimaging and intraspinal pressure, and relation to preclinical CSFP models.</div></div><div><h3>Material and methods</h3><div>Systematic review. This review followed PRISMA guidelines, risk of bias assessment with ROBINS-I tool, PROSPERO registration (CRD42024545629).</div></div><div><h3>Results</h3><div>11 relevant papers were identified (n = 212 patients, n = 194 intraoperative, n = 18 bedside). Risk of bias for safety reporting was low-moderate. Intraoperative CSFP assessments were commonly performed in acute SCI. CSFP was assessed to calculate SCPP (7/11), to evaluate effects from surgical decompression (5/11) and for therapeutic CSF drainage (3/11). The adverse event rate associated with the intrathecal catheter was 8% (n = 15/194).</div></div><div><h3>Discussion and conclusion</h3><div>The preliminary safety and feasibility profile of CSFP assessments in spinal cord compression encourages clinical application. However, a deeper risk-benefit analysis is limited as the clinical value is not yet determined, given challenges of defining disease specific critical CSFP and SCPP thresholds. The interrelation between measures of CSFP and neuroimaging is yet to be proven. Targeted preclinical studies are essential to improve our understanding of complex CSFP-cord compression interrelations.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104211"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-specific titanium-reinforced calcium-phosphate (CaP: Ti) implants for revision cranioplasty","authors":"Paul Vincent Naser ,&nbsp;Friederike Zacharias ,&nbsp;Henrik Giese ,&nbsp;Sandro M. Krieg ,&nbsp;Andreas W. Unterberg ,&nbsp;Alexander Younsi","doi":"10.1016/j.bas.2025.104213","DOIUrl":"10.1016/j.bas.2025.104213","url":null,"abstract":"<div><h3>Introduction</h3><div>Cranioplasty is a common neurosurgical procedure, but infections can complicate it, necessitating revision surgery. Alloplastic patient-specific implants (PSI) are increasingly utilized, and different materials are available. This study evaluates the role of titanium-reinforced calcium-phosphate (CaP:Ti) implants in revision cranioplasty.</div></div><div><h3>Research question</h3><div>Assessing the efficacy and safety of CaP:Ti PSI in patients requiring revision cranioplasty following complications with previously failed cranioplasty attempts.</div></div><div><h3>Material and methods</h3><div>Retrospective analysis of 15 patients who underwent CaP:Ti PSI implantation for revision cranioplasty between 2016 and 2022 at a single neurosurgical department. Data on demographics, perioperative details, and outcomes were collected and assessed. Differences in distribution were assessed using Fisher's exact test, and groups were numerically compared using student's t-test. A p-value &lt;0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>In most patients, CP failure occurred early (38 days) following elective craniotomy for tumor and vascular procedures. The first revision cranioplasty was conducted in 12 cases using CaP:Ti PSI in 8 cases successfully requiring no further revision. Three cases implanted with other alloplastic materials required revision and received CaP:Ti PSI in the second (n = 2) or third (n = 1) CP attempt. The overall success rate for CaP:Ti PSI was 73.3% over more than two years of follow-up. success rate in revision cranioplasty. Surgical site complications, predominantly infections, were the main cause of CP failure. The average interval between implant removal and re-cranioplasty was 300 days. Prehabilitation using skin expanders and postoperative antibiotic use were strategies successfully utilized in this cohort.</div></div><div><h3>Discussion and conclusion</h3><div>Our findings suggest that CaP:Ti PSI implants hold promise in salvaging complicated cranioplasty in most cases despite challenges such as infection and implant failure. The use of techniques like skin expanders may contribute to better outcomes. However, further research is crucial to establish optimal timing and patient selection guidelines in revision cranioplasty using CaP:Ti implants, which could significantly impact future neurosurgical practices.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104213"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidural steroid injections in lumbar disc herniation- Evidence synthesis from 72 randomised controlled trials (RCTs) and a total of 7701 patients","authors":"Alexandros G. Brotis ,&nbsp;Theodosios Spiliotopoulos ,&nbsp;Adamantios Kalogeras ,&nbsp;Kostas N. Fountas ,&nbsp;Andreas K. Demetriades","doi":"10.1016/j.bas.2025.104216","DOIUrl":"10.1016/j.bas.2025.104216","url":null,"abstract":"<div><h3>Introduction</h3><div>The role of epidural steroid injection in treating sciatica still remains debatable.</div></div><div><h3>Research question</h3><div>To compare epidural steroid injection with other manipulations in terms of pain control, quality of life and other parameters (Q1), compare the various available ESI alternatives regarding the approach (Q2), compare ESI to analgesia (Q3), identify the ideal ESI protocol (Q4), compare different guiding techniques (Q5) and determine the role of ESI as e predictive factor for the outcome.</div></div><div><h3>Material and methods</h3><div>This systematic review searched three databases from inception to February 2024. Independent reviewers assessed and gathered the data and also the quality of evidence was critically appreciated.</div></div><div><h3>Results</h3><div>The systematic review included 72 randomized controlled trials 7701 patients. There was a big variation among the aim of the studies. ESI proved to surpass other conservative methods for treating sciatica, however it does not provide long-term results. US- guided as well asFL-guided ESI was proved to have superior results. On the other hand, the role of ESIs in predicting the requirement for surgery is understudied. Comparing the different approaches in ESI the TFESI proved mostly to have better results.Surgery still remains the method with the most instant results providing also long-term treatment.</div></div><div><h3>Discussion and conclusions</h3><div>ESI has superior results to other conservative treatment modalities for sciatica; However surgery seems to have more immediate effect and better long term outcome. Apart from different approaches, additional agents such as amitriptyline proved to have effect when administered additionally to ESI. More studies need to be conducted for ESI as a predictive factor for the outcome or need of surgery.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104216"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative assessment of tumor consistency and gross total resection in pituitary adenoma: Radiomic analysis of T2-weighted MRI and interpretation of contributing radiomic features","authors":"Martin Černý ,&nbsp;Vojtěch Sedlák ,&nbsp;Martin Májovský ,&nbsp;Petr Vacek ,&nbsp;Kateřina Sajfrídová ,&nbsp;Kíra R. Patai ,&nbsp;Alexia-Ştefana Mârza ,&nbsp;David Netuka","doi":"10.1016/j.bas.2025.104237","DOIUrl":"10.1016/j.bas.2025.104237","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative knowledge of tumor consistency and the likelihood of gross total resection (GTR) would greatly benefit planning of pituitary adenoma surgery, however, no reliable methods currently exist.</div></div><div><h3>Objectives</h3><div>To evaluate the utility of radiomic analysis of MRI for predicting tumor consistency and GTR. To explore the interpretability of contributing radiomic features.</div></div><div><h3>Methods</h3><div>Patients undergoing first endoscopic surgery for pituitary macroadenomas were included. Tumor consistency was assessed intraoperatively, GTR was assessed based on postoperative MRI. Radiomic features were extracted from axial T2-weighted MRI. Low-variability and highly intercorrelated features were removed. Random Forest Classifiers were optimized using 70 % of patient data and evaluated on the remaining 30 %. Relative feature importance was assessed using the Gini–Simpson index.</div></div><div><h3>Results</h3><div>542 patients were included. GTR was achieved in 325 (60.0 %) cases, firm tumors were encountered in 122 (22.5 %) cases. There was a significant correlation between GTR and tumor consistency (67.1 % vs. 35.2 %, p &lt; 0.001). 1688 radiomic variables were extracted, 442 were removed due to low variance and 699 due to high intercorrelation. The consistency prediction model achieved an accuracy of 81.6 % and utilized 32 features, GTR prediction model achieved 79.1 % accuracy using 73 features.</div></div><div><h3>Conclusions</h3><div>Radiomic analysis demonstrated significant potential for preoperative evaluation of pituitary adenomas. Texture and intensity-based features were the primary contributors to consistency prediction. However, the explanation of these features was insufficient. GTR prediction was predominantly driven by shape-related features. Our findings highlight the challenges of linking radiomic features to underlying tissue properties and emphasize the need for cautious interpretation.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104237"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}