Foundations of Neuro-Oncology: A Multidisciplinary Approach

Barbaro, Marissa; Fine, Howard A.; Magge, Rajiv

doi:10.1016/j.wneu.2021.02.059

Cited by 5 publications

(12 citation statements)

References 47 publications

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“…Oncologic patients discussed in the multidisciplinary CNS TB are more likely to benefit from a pre- and postoperative staging and are more likely to receive the optimal adjuvant treatment 24,25 . Barbaro et al presented in their review the foundations of neuro-oncology and the need for multidisciplinary expertise in order to embrace the multiple disease aspects in CNS tumour-affected patients 13 . The authors highlighted the prerogatives and missions of a CNS TB: 1) Neuro-oncology, Neurosurgery, Radiation Oncology, Neuropathology, Neurology and Radiology are specialties necessary to compose the CNS TB.…”

Section: Discussionmentioning

confidence: 99%

“…One explanation could be paywall barriers to some of the prominent journals. Thus, breaking these barriers or facilitating AI access to the newest scientific information, could be one potential direction of future development as the new ongoing trials consist of a crucial part of a CNS TB discussion 13 . With deep learning, chatbots such as ChatGPT could have the potential to integrate the newest trial and bench science information into multidisciplinary decision-making and help TB direct patients to potential applicable clinical trials.…”

Section: Further Developmentsmentioning

confidence: 99%

“…Neurooncolgy has significantly evolved in parallel with new research advances 13 . For instance, treatment of high-grade gliomas has been extensively studied for the last 20 years to offer a longer survival rate for affected individuals 14,15 .…”

Section: Introductionmentioning

confidence: 99%

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ChatGPT in glioma patient adjuvant therapy decision making: ready to assume the role of a doctor in the tumour board?

Haemmerli

Sveikata

Nouri

et al. 2023

Preprint

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Introduction ChatGPT, a novel AI-based chatbot, sparked a lot of interest in the scientific community. Complex central CNS tumour cases require multidisciplinary expert recommendations that incorporate multimodal disease information. Thus, the potential of ChatGPT to integrate comprehensive treatment information may be of tremendous benefit for CNS tumour decision-making. We evaluated the ChatGPT recommendations for glioma management by a panel of CNS tumour experts. Methods We randomly selected 10 patients with primary CNS gliomas discussed at our institution's Tumour Board. Patients' clinical status, surgical, imaging, and immuno-pathology-related information was provided to ChatGPT and seven CNS tumour experts. The chatbot was asked to give the most likely diagnosis, the adjuvant treatment choice, and the regimen while considering the patient's functional status. The experts rated the AI-based recommendations from 0 (complete disagreement) to 10 (complete agreement). An intraclass correlation agreement (ICC) was used to measure the inter-rater agreement. Results Eight patients (80%) met the criteria for glioblastoma and two (20%) were low-grade gliomas. The experts rated the quality of ChatGPT recommendations as poor for diagnosis (median 3, IQR 1-7.8, ICC 0.9, 95% CI 0.7-1.0), good for treatment recommendation (7, IQR 6-8, ICC 0.8, 95% CI 0.4-0.9), good for therapy regimen (7, IQR 4-8, ICC 0.8, 95% CI 0.5-0.9), moderate for functional status consideration (6, IQR 1-7, ICC 0.7, 95% CI 0.3-0.9), and moderate for overall agreement with the recommendations (5, IQR 3-7, ICC 0.7, 95% CI 0.3-0.9). No differences were observed between the glioblastomas and low-grade glioma ratings. Conclusions ChatGPT performed poorly in classifying glioma types but was good for adjuvant treatment recommendations as evaluated by CNS Tumour Board experts. Even though the ChatGPT lacks the precision to replace expert opinion, it may become a promising tool to supplement experts, especially in low-resource settings.

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Section: Discussionmentioning

confidence: 99%

Section: Further Developmentsmentioning

confidence: 99%

See 1 more Smart Citation

ChatGPT in glioma patient adjuvant therapy decision making: ready to assume the role of a doctor in the tumour board?

Haemmerli

Sveikata

Nouri

et al. 2023

Preprint

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show abstract

“…Neuro-oncolgy has significantly evolved in parallel with new research advances 14. For instance, the treatment of high-grade gliomas has been extensively studied for the last 20 years to offer a longer survival rate for affected individuals 15 16.…”

Section: Introductionmentioning

confidence: 99%

ChatGPT in glioma adjuvant therapy decision making: ready to assume the role of a doctor in the tumour board?

Haemmerli

Sveikata

Nouri

et al. 2023

BMJ Health Care Inform

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ObjectiveTo evaluate ChatGPT‘s performance in brain glioma adjuvant therapy decision-making.MethodsWe randomly selected 10 patients with brain gliomas discussed at our institution’s central nervous system tumour board (CNS TB). Patients’ clinical status, surgical outcome, textual imaging information and immuno-pathology results were provided to ChatGPT V.3.5 and seven CNS tumour experts. The chatbot was asked to give the adjuvant treatment choice, and the regimen while considering the patient’s functional status. The experts rated the artificial intelligence-based recommendations from 0 (complete disagreement) to 10 (complete agreement). An intraclass correlation coefficient agreement (ICC) was used to measure the inter-rater agreement.ResultsEight patients (80%) met the criteria for glioblastoma and two (20%) were low-grade gliomas. The experts rated the quality of ChatGPT recommendations as poor for diagnosis (median 3, IQR 1–7.8, ICC 0.9, 95% CI 0.7 to 1.0), good for treatment recommendation (7, IQR 6–8, ICC 0.8, 95% CI 0.4 to 0.9), good for therapy regimen (7, IQR 4–8, ICC 0.8, 95% CI 0.5 to 0.9), moderate for functional status consideration (6, IQR 1–7, ICC 0.7, 95% CI 0.3 to 0.9) and moderate for overall agreement with the recommendations (5, IQR 3–7, ICC 0.7, 95% CI 0.3 to 0.9). No differences were observed between the glioblastomas and low-grade glioma ratings.ConclusionsChatGPT performed poorly in classifying glioma types but was good for adjuvant treatment recommendations as evaluated by CNS TB experts. Even though the ChatGPT lacks the precision to replace expert opinion, it may serve as a promising supplemental tool within a human-in-the-loop approach.

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“…Such mapping allows for better surgical planning, more accurate risk–benefit assessments, and a lower incidence of postoperative deficits [ 1 ]. Thus, functional neuro-oncology aims to study and preserve brain functions in order to ensure a better quality of life [ 2 ]. This is especially important for tumors involving eloquent circuits, for example, the cortical/subcortical networks that control the cognitive and motor functions underlying communicative abilities, which are considered indispensable for daily life.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Navigated Transcranial Magnetic Stimulation: New Insight for Brain Tumor-Related Language Mapping

Natalizi

Vecchio

Spalletta

et al. 2022

JPM

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Preoperative brain mapping methods are particularly important in modern neuro-oncology when a tumor affects eloquent language areas since damage to parts of the language circuits can cause significant impairments in daily life. This narrative review examines the literature regarding preoperative and intraoperative language mapping using repetitive navigated transcranial magnetic stimulation (rnTMS) with or without direct electrical stimulation (DES) in adult patients with tumors in eloquent language areas. The literature shows that rnTMS is accurate in detecting preexisting language disorders and positive intraoperative mapping regions. In terms of the region extent and clinical outcomes, rnTMS has been shown to be accurate in identifying positive sites to guide resection, reducing surgery duration and craniotomy size and thus improving clinical outcomes. Before incorporating rnTMS into the neurosurgical workflow, the refinement of protocols and a consensus within the neuro-oncology community are required.

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Foundations of Neuro-Oncology: A Multidisciplinary Approach

Cited by 5 publications

References 47 publications

ChatGPT in glioma patient adjuvant therapy decision making: ready to assume the role of a doctor in the tumour board?

ChatGPT in glioma patient adjuvant therapy decision making: ready to assume the role of a doctor in the tumour board?

ChatGPT in glioma adjuvant therapy decision making: ready to assume the role of a doctor in the tumour board?

Preoperative Navigated Transcranial Magnetic Stimulation: New Insight for Brain Tumor-Related Language Mapping

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