Abstract:
BACKGROUND:Gamma Knife radiosurgery (GKRS) inverse dose planning is currently far from competing effectively with the quality of dose planning developed by experienced experts. A new inverse planning (IP) method based on « efficient convex optimization algorithms » is proposed, providing high-quality dose plans in real time. MATERIALS AND METHODS:Eighty-six patients treated by GKRS for vestibular schwannomas (VS) were recruited. The treatment plans created by the first author, who has 27 years of experience and has developed and delivered more than 15,000 dose plans, served as reference. A first set of basic constraints determined by default led the IP for an initial real-time dose plan. Additional constraints were interactively proposed by the planner to take other parameters into account. A second optimized plan was then calculated by the IP. The primary endpoint was the Paddick Conformity Index (PCI). The statistical analysis was planned on a non-inferiority trial design. Coverage, selectivity, and gradient indexes, dose at the organ(s) at risk, and 12 Gy isodose line volume were compared. RESULTS:After a single run of the IP, the PCI was shown to be non-inferior to that of the "expert." For the expert and the IP, respectively, the median coverage index was 0.99 and 0.98, the median selectivity index 0.92 and 0.90, the median gradient index 2.95 and 2.84, the median dose at the modiolus of the cochlea 2.83 Gy and 2.86 Gy, the median number of shots 14.31 and 24.13, and the median beam-on time 46.20 min and 26.77 min. In a few specific cases, advanced tools of the IP were used to generate a second run by adding new constraints either globally (for higher selectivity) or locally, in order to increase or decrease these constraints focally. CONCLUSION:These preliminary results showed that this new IP method based on « efficient convex optimization algorithms », called IntuitivePlan®, provided high-quality dose plans in real time with excellent coverage, selectivity, and gradient indexes with optimized beam-on time. If the new IP evaluated here is able to compete in real time with the quality of the treatment plans of an expert with extensive radiosurgical experience, this could allow new planners/radiosurgeons with limited or no experience to immediately provide patients with high-quality GKRS for benign and malignant lesions.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Régis J,Hamdi H,Loundou A,Merly L,Castillo L,Balossier A,Spatola Gdoi
10.1007/s00701-020-04695-xsubject
Has Abstractpub_date
2021-01-05 00:00:00eissn
0001-6268issn
0942-0940pii
10.1007/s00701-020-04695-xpub_type
杂志文章abstract:PURPOSE:Malignant gliomas are highly infiltrative tumours with a fatal prognosis. F18-fluoroethyl-tyrosine (FET)-positron emission tomography (PET) often reveals a broader extension of these tumours compared with contrast-enhanced magnetic resonance imaging (MRI). Complete resection of the contrast-enhancing lesion is ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0462-7
更新日期:2009-11-01 00:00:00
abstract::BAK-C is a new autostabilizing interbody cage which is implanted during an anterior cervical procedure to provide stability to the motion segment and allow fusion to occur. Special instrumentation is provided with a bone collecting reamer. The system utilizes surgical site bone graft as the osteo-inductive material wi...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s007010050049
更新日期:1998-01-01 00:00:00
abstract::Regression of meningioma after haemorrhage and the cessation of hormone treatment is well reported. However, spontaneous regression is very rarely observed. Here, we report the spontaneous regression of a parafalcine meningioma in a 56-year-old woman with multiple sclerosis, who was referred to our department after an...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-3019-6
更新日期:2017-03-01 00:00:00
abstract:PURPOSE:Patients with oligodendrogliomas with allelic loss of chromosomal arm 1p and 19q have been shown, especially with anaplastic oligodendrogliomas, to have both a better initial and long-term response to chemotherapy as well as an improved overall survival. Effective treatment of patients with brain tumors require...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0743-1
更新日期:2010-11-01 00:00:00
abstract::A 28-year-old man with genetically confirmed hyperostosis corticalis generalisata (Van Buchem disease) suffered from headache and progressive cognitive and sensibility disorders. Bone formation of the skull was ongoing, leading to narrowing of the intracranial space and foramen magnum. A large bilateral frontoparietal...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2445-1
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Evolving of a single centre by means of different transsphenoidal approaches during the survey of methodological advances in pituitary surgery is presented. MATERIALS AND METHODS:Ninety-three consecutive patients with pituitary adenomas underwent transphenoidal pituitary operations at Gulhane Military Medic...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-0135-y
更新日期:2008-11-01 00:00:00
abstract::Cerebral primitive neuro-ectodermal tumour (PNET) occurring as a second primary malignancy in childhood is exceedingly rare. We present a 7-year-old boy who developed a proven supratentorial PNET five years after enucleation and radio-/chemotherapy for a sporadic, unilateral retinoblastoma with optic nerve invasion. T...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01420048
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Many high-grade glioma (HGG) patients have cognitive impairments, which impact daily functioning. Cognitive impairments can be caused by tumour-, treatment-, and patient-related factors. The effect of the tumour and of surgical resection on cognition is, however, not well known. We investigated tumour and su...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2115-8
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Lateral orbitotomy can be minimalized using contemporary endoscopy. METHODS:Anatomy of the temporal fossa/orbital wall junction is described. The attachment of the temporal fascia is cut off from the orbital rim through a 1.5 cm skin incision in the lateral orbital wrinkle. The temporal muscle is detached f...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2205-7
更新日期:2014-10-01 00:00:00
abstract::Bilateral chylothorax following anterior cervical spine surgery is very rare. This report documents the first case of chylothorax after anterior cervical spine surgery through a right-side surgical approach. Unidentified chyle leakage can easily remain unrecognized and, thus, is difficult to treat. For early diagnosis...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3294-x
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. Patients diagnosed with CSDH's are often planned for subacute surgery. This means that time from diagnostic CT scan until actual surgery might often be prolonged. There are no previous studies that highlight the effect of de...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-018-3620-y
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Peripheral nerve lesions usually are associated with neuropathic pain. In the present paper, we describe a simple scale to quantify pain after brachial plexus injuries and apply this scale to a series of patients to determine initial outcomes after reconstructive surgery. METHODS:Fifty-one patients with tra...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0709-3
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:For the treatment of medically refractory movement disorders such as Parkinson's disease, essential tremor and primary dystonia, deep brain stimulation (DBS) has become one of the main treatment options. The targets for implantation of the stimulation electrodes are various nuclei within the basal ganglia or...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010200065
更新日期:2002-05-01 00:00:00
abstract::A treatment protocol for a controlled open study in patients with subarachnoid haemorrhage (SAH) from cerebral aneurysms is presented, applying acute surgery and pharmacological prevention of symptomatic vasospasm: In patients clinically graded I-III (Hunt and Hess), operation is performed within 48 to 72 hours. After...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401814
更新日期:1983-01-01 00:00:00
abstract:BACKGROUND:Cerebral vasospasm following subarachnoid haemorrhage (SAH) remains one of the major factors contributing to poor overall patient outcome. Prostaglandin F2-alpha (PGF2a) induces vasoconstriction. After SAH, PGF2a leads to cerebral inflammation and enhanced vasoconstriction, resulting in cerebral vasospasm. L...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3419-2
更新日期:2018-02-01 00:00:00
abstract::The Spanish National Committee for Neurosurgery has recently approved a new training programme which will shortly replace the former programme, which dates from 1984. The object of this report was to evaluate training in neurosurgery in Spain under the extant programme as perceived by the residents themselves. Assessm...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-004-0459-1
更新日期:2005-04-01 00:00:00
abstract::A new atraumatic method for patency and blood flow control of microvascular anastomoses has been developed. Sounds proximal and distal to a suture line are separately detected by means of two specially modified miniature microphones built together as an auscultation unit and named a diplo-microphone. Transmission of t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02074518
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:The aim of this work was to retrospectively study the long-term reliability of the common consensus endocrinological criteria for the assessment of postoperative remission of acromegaly. PATIENTS AND METHODS:In 96 consecutive patients, surgical remission of acromegaly following transsphenoidal surgery was co...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0790-7
更新日期:2011-01-01 00:00:00
abstract::Incomplete cerebral ischaemia of 10 to 60 minutes duration was performed by reducing the perfusion pressure of completely isolated canine heads at brain temperatures of 37 and 32 degrees C. Complete cerebral ischaemia of the same duration was performed by complete stopping of the perfusion. The latency of recovery of ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02074501
更新日期:1982-01-01 00:00:00
abstract::Acute cerebrovascular congestion after a closed head injury is significantly related to intracranial hypertension. As an indirect method of cerebral blood flow measurement; transcranial doppler sonography (TCD) provides a rapid and noninvasive assessment of cerebral haemodynamics, including hyperaemic conditions. TCD ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01476289
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Intraoperative vessel visualization is highly desirable, especially when the target is related to or close to main vessels, such as in the skull base and vascular surgery. Contrast-enhanced ultrasound (CEUS) is an imaging technique that allows visualization of tissue perfusion and vascularization through the...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-015-2412-x
更新日期:2015-06-01 00:00:00
abstract::The accuracy of CAT in the diagnosis of infratentorial expanding lesions is analysed on the basis of 224 personal cases. The posterior fossa lesions are classified in four groups according to the reliability of CAT as the only pre-operative examination. The present indications for conventional neuroadiological procedu...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01811344
更新日期:1978-01-01 00:00:00
abstract:OBJECT:The authors analyzed the cases of 163 patients with syringomyelia to assess the appropriate surgical procedure. METHODS:Depending on the aetiological factors and treatment considerations the series was classified into three groups. Group I were cases where there was no definite demonstrable aetiological factor;...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050038
更新日期:2000-01-01 00:00:00
abstract::Fifty-one cases of posterior fossa haemangioblastoma have been seen in our department over a period of 23 years. Seven cases were associated with spinal cord lesions and one with a supratentorial lesion. There were 22 cases of Lindau's disease (43%). The onset was earlier and recurrences commoner than in isolated case...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02112026
更新日期:1993-01-01 00:00:00
abstract::A surgical carbon dioxide laser unit (laser) has been used since 1977 in twenty-five cases of various brain tumours, including ten meningiomas (four sphenoid ridge, two parasagittal, two falx, one olfactory, one posterior fossa), eleven gliomas (seven glioblastoma, four astrocytoma), two metastatic brain tumours, one ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02074786
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:In an increasingly complex and competitive professional environment, improving methods to educate neurosurgical residents is key to ensure high-quality patient care. Electronic (e)Learning resources promise interactive knowledge acquisition. We set out to give a comprehensive overview on available eLearning ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,meta分析
doi:10.1007/s00701-016-3042-7
更新日期:2017-02-01 00:00:00
abstract::Recent animal research has provided evidence that brain ischaemia is associated with a shift of energy related metabolites (lactate, adenosine, inosine, and hypoxanthine) and several transmitters from the intracellular to the extracellular fluid (ECF). These chemical changes of the ECF reflect the energy crisis of the...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405420
更新日期:1990-01-01 00:00:00
abstract::Hormonal disturbances caused by hypothalamic pathology can be treated effectively by target hormone replacement in the case of failure of glandotropic hormone secretion. Hyposomatotropism in children has to be substituted by parenteral administration of growth hormone. In addition gonadotropins respectively gonadotrop...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01406335
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Thoracic disc herniation (TDH) is a rare condition with severe neurological sequelae. Surgical management is still a matter of debate and challenging. METHOD:We present a modification of the transdural approach for TDH. The approach has been described in a stepwise fashion, analysing pre-, peri-, and postop...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04387-6
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:While large-to-giant pituitary adenomas (PAs) may be safely removed by experienced surgeons through a single route, the procedure is technically challenging. We present the outcome of a simultaneous combined transcranial and transsphenoidal approach and discuss its applications. METHODS:A retrospective revi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-1029-y
更新日期:2011-07-01 00:00:00