Hippocampal sparing approach in fractionated stereotactic brain <scp>VMAT</scp> radio therapy: A retrospective feasibility analysis

Falco, M.D.; Giancaterino, S.; D’Andrea, M.; Lorenzo, R. Giménez De; Trignani, Marianna; Caravatta, L.; Carlo, C. Di; Biase, S. Di; Allajbej, A.; Genovesi, Domenico

doi:10.1002/acm2.12216

Cited by 5 publications

(2 citation statements)

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“…The proposed doses refer to conventional radiotherapy in which the fractional dose oscillates between 2 and 3 Gy. The problem arises in the case of hypofractionated RT and in particular stereotactic RT, although there are newer reports of "protective" doses in the hippocampus region in such cases [59,60].…”

Section: Clinical Situations In Which Hippocampal Protection Should Bmentioning

confidence: 99%

Benefits and difficulties during brain radiotherapy planning with hippocampus sparing

2019

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Radiotherapy (RT) is frequently used in the treatment of primary and secondary brain tumours, as well as in prophylactic cranial irradiation (PCI). The hippocampus plays a key function in the process of remembering, relaying information from short-term to long-term memory as consolidation, and spatial orientation. Sparing the hippocampus during brain radiotherapy aims to prevent hippocampal-dependent cognitive function deterioration.This procedure requires a good knowledge of the brain's radiological anatomy and use of modern radiotherapy techniques.This article presents the validity of hippocampus sparing during brain radiotherapy, the potential benefits of using this procedure, available clinical premises regarding patient qualification, and technical difficulties in the brain's RT planning with hippocampus avoidance.

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Section: Clinical Situations In Which Hippocampal Protection Should Bmentioning

confidence: 99%

Benefits and difficulties during brain radiotherapy planning with hippocampus sparing

2019

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“…However, many challenges still limit the precise implementation of hippocampus‐sparing WBRT. During WBRT, cranial irradiation may induce hippocampal neural stem‐cell injury 6 . Studies have shown the correlation between memory loss or cognitive impairment and hippocampal injury 7–9 .…”

Section: Introductionmentioning

confidence: 99%

Automatic segmentation of hippocampus in hippocampal sparing whole brain radiotherapy: A multitask edge‐aware learning

Qiu

Yang

et al. 2021

Medical Physics

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This study aimed to improve the accuracy of the hippocampus segmentation through multitask edge-aware learning. Method: We developed a multitask framework for computerized hippocampus segmentation. We used three-dimensional (3D) U-net as our backbone model with two training objectives: (a) to minimize the difference between the targeted binary mask and the model prediction; and (b) to optimize an auxiliary edge-prediction task which is designed to guide the model detection of the weak boundary of the hippocampus in model optimization. To balance the multiple task objectives, we proposed an improved gradient normalization by adaptively adjusting the weight of losses from different tasks. A total of 247 T1-weighted MRIs including 131 without contrast and 116 with contrast were collected from 247 patients to train and validate the proposed method. Segmentation was quantitatively evaluated with the dice coefficient (Dice), Hausdorff distance (HD), and average Hausdorff distance (AVD). The 3D U-net was used for baseline comparison. We used a Wilcoxon signed-rank test to compare repeated measurements (Dice, HD, and AVD) by different segmentations. Results: Through fivefold cross-validation, our multitask edge-aware learning achieved Dice of 0.8483 AE 0.0036, HD of 7.5706 AE 1.2330 mm, and AVD of 0.1522 AE 0.0165 mm, respectively. Conversely, the baseline results were 0.8340 AE 0.0072, 10.4631 AE 2.3736 mm, and 0.1884 AE 0.0286 mm, respectively. With a Wilcoxon signed-rank test, we found that the differences between our method and the baseline were statistically significant (P < 0.05). Conclusion:Our results demonstrated the efficiency of multitask edge-aware learning in hippocampus segmentation for hippocampal sparing whole-brain radiotherapy. The proposed framework may also be useful for other low-contrast small organ segmentations on medical imaging modalities.

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The Effects of Brain Tumours upon Medical Decision-Making Capacity

et al. 2019

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Purpose of Review Informed consent is the integral part of good medical practice in patients with brain tumours. Capacity to consent may be affected by the brain disorder or its treatment. We intend to draw upon the current neuro-oncology literature to discuss the influence intracranial tumours have upon patients’ capacity to consent to treatment and research. Recent Findings We performed a systematic review of studies of capacity to consent for treatment or research in patients with intracranial tumours. The search retrieved 1597 papers of which 8 were considered eligible for review. Summary Although there are obvious inherent limitations to solely assessing cognition, most research consistently demonstrated increased risk of incapacity in brain tumour patients with cognitive impairment. Specific items in cognitive screening batteries, for example Semantic Verbal Fluency Test (SVFT), Hopkins Verbal Learning Test (HVLT-Recall), and Trail Making Test A/B (TMT), are simple, easily applied tests that may act as significant red flags to identify patients at increased risk of incapacity and who subsequently will require additional cognitive/psychiatric evaluation or more formal tests for capacity to consent for treatment or research.

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Hippocampal sparing approach in fractionated stereotactic brain VMAT radio therapy: A retrospective feasibility analysis

Cited by 5 publications

References 32 publications

Benefits and difficulties during brain radiotherapy planning with hippocampus sparing

Benefits and difficulties during brain radiotherapy planning with hippocampus sparing

Automatic segmentation of hippocampus in hippocampal sparing whole brain radiotherapy: A multitask edge‐aware learning

The Effects of Brain Tumours upon Medical Decision-Making Capacity

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