Application of an Artificial Intelligence Algorithm to Prognostically Stratify Grade II Gliomas

Cesselli, Daniela; Ius, Tamara; Isola, Miriam; Ben, Fabio Del; Col, Giacomo Da; Bulfoni, Michela; Turetta, Matteo; Pegolo, Enrico; Marzinotto, Stefania; Scott, Cathryn Anne; Mariuzzi, Laura; Loreto, Carla Di; Beltrami, Antonio Paolo; Škrap, Miran

doi:10.3390/cancers12010050

Cited by 15 publications

(22 citation statements)

References 45 publications

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“…Numerous studies have recently demonstrated that the maximal safe extent of tumoral resection (EOR) is the first-line treatment resulting in better survival [ 21 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ]. In the last decade, the qualitative and subjective descriptions of EOR as “gross total resection”, “near total resection”, and “subtotal resection”, are being replaced by precise and objective estimation based on the volume of residual tumor according to the following formula: “EOR = preoperative tumor volume − postoperative tumor volume/preoperative tumor volume” [ 21 , 66 ].…”

Section: Role Of Surgerymentioning

confidence: 99%

Clinical Management of Diffuse Low-Grade Gliomas

Lombardi

Barresi

Castellano

et al. 2020

Cancers

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Diffuse low-grade gliomas (LGG) represent a heterogeneous group of primary brain tumors arising from supporting glial cells and usually affecting young adults. Advances in the knowledge of molecular profile of these tumors, including mutations in the isocitrate dehydrogenase genes, or 1p/19q codeletion, and in neuroradiological techniques have contributed to the diagnosis, prognostic stratification, and follow-up of these tumors. Optimal post-operative management of LGG is still controversial, though radiation therapy and chemotherapy remain the optimal treatments after surgical resection in selected patients. In this review, we report the most important and recent research on clinical and molecular features, new neuroradiological techniques, the different therapeutic modalities, and new opportunities for personalized targeted therapy and supportive care.

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Section: Role Of Surgerymentioning

confidence: 99%

Clinical Management of Diffuse Low-Grade Gliomas

Lombardi

Barresi

Castellano

et al. 2020

Cancers

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“…All histological samples were reviewed according to the 2016 World Health Organization (WHO) classification 21 . Molecular markers were evaluated as previously described 22 .…”

Section: Methodsmentioning

confidence: 99%

Multimodal integrated approaches in low grade glioma surgery

Ius

Mazzucchi

Tomasino

et al. 2021

Sci Rep

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Surgical management of Diffuse Low-Grade Gliomas (DLGGs) has radically changed in the last 20 years. Awake surgery (AS) in combination with Direct Electrical Stimulation (DES) and real-time neuropsychological testing (RTNT) permits continuous intraoperative feedback, thus allowing to increase the extent of resection (EOR). The aim of this study was to evaluate the impact of the technological advancements and integration of multidisciplinary techniques on EOR. Two hundred and eighty-eight patients affected by DLGG were enrolled. Cases were stratified according to the surgical protocol that changed over time: 1. DES; 2. DES plus functional MRI/DTI images fused on a NeuroNavigation system; 3. Protocol 2 plus RTNT. Patients belonging to Protocol 1 had a median EOR of 83% (28–100), while those belonging to Protocol 2 and 3 had a median EOR of 88% (34–100) and 98% (50–100) respectively (p = 0.0001). New transient deficits with Protocol 1, 2 and 3 were noted in 38.96%, 34.31% and 31,08% of cases, and permanent deficits in 6.49%, 3.65% and 2.7% respectively. The average follow-up period was 6.8 years. OS was influenced by molecular class (p = 0.028), EOR (p = 0.018) and preoperative tumor growing pattern (p = 0.004). Multimodal surgical approach can provide a safer and wider removal of DLGG with potential subsequent benefits on OS. Further studies are necessary to corroborate our findings.

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“…All histological samples were reviewed according to the 2016 World Health Organization (WHO) classification ( 9 ). Molecular markers were evaluated as previously described ( 13 ).…”

Section: Methodsmentioning

confidence: 99%

Risk Assessment by Pre-surgical Tractography in Left Hemisphere Low-Grade Gliomas

et al. 2021

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Background: Tracking the white matter principal tracts is routinely typically included during the pre-surgery planning examinations and has revealed to limit functional resection of low-grade gliomas (LGGs) in eloquent areas.Objective: We examined the integrity of the Superior Longitudinal Fasciculus (SLF) and Inferior Fronto-Occipital Fasciculus (IFOF), both known to be part of the language-related network in patients with LGGs involving the temporo-insular cortex. In a comparative approach, we contrasted the main quantitative fiber tracking values in the tumoral (T) and healthy (H) hemispheres to test whether or not this ratio could discriminate amongst patients with different post-operative outcomes.Methods: Twenty-six patients with LGGs were included. We obtained quantitative fiber tracking values in the tumoral and healthy hemispheres and calculated the ratio (HIFOF–TIFOF)/HIFOF and the ratio (HSLF–TSLF)/HSLF on the number of streamlines. We analyzed how these values varied between patients with and without post-operative neurological outcomes and between patients with different post-operative Engel classes.Results: The ratio for both IFOF and SLF significantly differed between patient with and without post-operative neurological language deficits. No associations were found between white matter structural changes and post-operative seizure outcomes.Conclusions: Calculating the ratio on the number of streamlines and fractional anisotropy between the tumoral and the healthy hemispheres resulted to be a useful approach, which can prove to be useful during the pre-operative planning examination, as it gives a glimpse on the potential clinical outcomes in patients with LGGs involving the left temporo-insular cortex.

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Application of an Artificial Intelligence Algorithm to Prognostically Stratify Grade II Gliomas

Cited by 15 publications

References 45 publications

Clinical Management of Diffuse Low-Grade Gliomas

Clinical Management of Diffuse Low-Grade Gliomas

Multimodal integrated approaches in low grade glioma surgery

Risk Assessment by Pre-surgical Tractography in Left Hemisphere Low-Grade Gliomas

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