Postoperative Speech Impairment and Surgical Approach to Posterior Fossa Tumours in Children: A Prospective European Multicentre Study

Grønbæk, Jonathan Kjær; Wibroe, Morten; Toescu, Sebastian; Frič, Radek; Möller, Luciana M.; Grillner, Pernilla; Gustavsson, Bengt; Mallucci, Conor; Aquilina, Kristian; Molinari, Emanuela; Hjort, Magnus Aasved; Westerholm-Ormio, Mia; Kiudelienė, Rosita; Mudra, K; Hauser, Péter; Baarsen, Kirsten van; Hoving, Eelco W.; Zipfel, Julian; Nysom, Karsten; Schmiegelow, Kjeld; Sehested, Astrid; Juhler, Marianne; Mathiasen, René

doi:10.2139/ssrn.3788120

Cited by 10 publications

(9 citation statements)

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“…We presume that skewness might reflect the tumor type that is related to CMS. Although surgical techniques have been improved, the CMS still develops after surgery 37,38 . Researchers believe CMS is related to tumoral invasiveness 37 .…”

Section: Discussionmentioning

confidence: 99%

“…Although surgical techniques have been improved, the CMS still develops after surgery. 37,38 Researchers believe CMS is related to tumoral invasiveness. 37 This study proposed that CMS is associated with tumoral radiomics characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…37,38 Researchers believe CMS is related to tumoral invasiveness. 37 This study proposed that CMS is associated with tumoral radiomics characteristics. Radiomics features could reflect the texture features and aggressiveness of tumors.…”

Section: Discussionmentioning

confidence: 99%

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Presurgical MRI‐Based Radiomics Models for Predicting Cerebellar Mutism Syndrome in Children With Posterior Fossa Tumors

Yang

et al. 2023

Magnetic Resonance Imaging

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BackgroundCurrent studies have indicated that tumoral morphologic features are associated with cerebellar mutism syndrome (CMS), but the radiomics application in CMS is scarce.PurposeTo develop a model for CMS discrimination based on multiparametric MRI radiomics in patients with posterior fossa tumors.Study TypeRetrospective.PopulationA total of 218 patients (males 132, females 86) with posterior fossa tumors, 169 of which were included in the MRI radiomics analysis. The MRI radiomics study cohort (169) was split into training (119) and testing (50) sets with a ratio of 7:3.Field/SequenceAll the MRI were acquired under 1.5/3.0 T scanners. T2‐weighted image (T2W), T1‐weighted (T1W), fluid attenuated inversion recovery (FLAIR), diffusion‐weighted imaging (DWI).AssessmentApparent diffusion coefficient (ADC) maps were generated from DWI. Each MRI dataset generated 1561 radiomics characteristics. Feature selection was performed with univariable logistic analysis, correlation analysis, and least absolute shrinkage and selection operator (LASSO) penalized logistic regression. Significant clinical features were selected with multivariable logistic analysis and used to constructed the clinical model. Radiomics models (based on T1W, T2W, FLAIR, DWI, ADC) were constructed with selected radiomics features. The mix model was based on the multiparametric MRI radiomics features.Statistical TestMultivariable logistic analysis was utilized during clinical features selection. Models' performance was evaluated using the area under the receiver operating characteristic (AUC) curve. Interobserver variability was assessed using Cohen's kappa. Significant threshold was set as P < 0.05.ResultsSex (aOR = 3.72), tumor location (aOR = 2.81), hydrocephalus (aOR = 2.14), and tumor texture (aOR = 5.08) were significant features in the multivariable analysis and were used to construct the clinical model (AUC = 0.79); totally, 33 radiomics features were selected to construct radiomics models (AUC = 0.63–0.93). Seven of the 33 radiomics features were selected for the mix model (AUC = 0.93).Data ConclusionMultiparametric MRI radiomics may be better at predicting CMS than single‐parameter MRI models and clinical model.Evidence Level4.Technical Efficacy2.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Presurgical MRI‐Based Radiomics Models for Predicting Cerebellar Mutism Syndrome in Children With Posterior Fossa Tumors

Yang

et al. 2023

Magnetic Resonance Imaging

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“…Among postoperative complications, speech alteration is the most common in surgery for License terms e2102023 DOI: 10.46900/apn.v5i3.2010 posterior fossa tumors. A recent multicenter study sought factors associated with the development of postoperative mutism or speech impairment in children undergoing resection of infratentorial tumors and found that the telelovelar access increased the risk (OR 1.7 95% CI 1.03-2.9), unlike the transvermian access (50). In addition, the duration of surgery, age, tumor location, and histology also affect this risk; in this regard, ependymomas showed no increased risk of postoperative mutism (50).…”

Section: Treatments and Outcomesmentioning

confidence: 99%

Posterior fossa ependymomas in children and adolescents - the state of the art

Da Costa,

Torres Soares,

Dastoli

et al. 2023

Arch Pediat Neurosurg

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Central nervous system tumors in pediatric patients represent the most frequent solid tumor type in this age group, especially ependymomas, which comprise 5% of childhood intracranial tumors, and occur mainly in the posterior fossa. The MEDLINE and ClinicalTrials databases were searched for studies on posterior fossa ependymomas, 64 studies met the search criteria. Symptoms include ataxia, vertigo, headache, vomiting, cranial nerve palsies, or papilledema, resulting from intracranial hypertension due to obstruction of CSF circulation. Imaging examination often reveals posterior fossa ependymomas in the fourth ventricle or cerebellopontine angle; they may extend through the foramina of Luschka, Magendie, and/or magnum. These tumors cause a significant mass effect, displacing rather than invading the hidbrain, and may involve vessels or cranial nerves, making surgical resection difficult. Various radiological features have been studied to distinguish between ependymomas and other histological types, as well as between ependymoma subtypes. The 2021 WHO classification of central nervous system tumors classifies ependymomas by location. Three types occur in the posterior fossa: subependymomas, PF-A, and PF-B. These are differentiated by the degree of DNA methylation and CpG islands, which can be assessed by immunohistochemical analysis with H3K27me3. The consensus on the treatment of posterior fossa ependymomas in children advocates the maximum possible surgical resection, followed by radiotherapy in patients >1 year. Chemotherapy remains controversial, with no survival gain. Recent studies suggest molecular subgroups as an independent prognostic factor in posterior fossa ependymomas. The therapeutic challenge of ependymomas requires new treatment options, based on new technologies and molecular discoveries.

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“…GTR, NTR, and STR are de ned as no residual tumor, less than 1.5 cm² residual tumor, and 1.5 cm² or more of residual tumor respectively(Thompson et al 2016a). Surgical approaches can be subdivided into ve aforementioned categories(Grønbaek et al 2021).…”

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confidence: 99%

Beijing Children’s Hospital guidelines on the design and conduction of the first standardized database for medulloblastoma

Yang

Huang

et al. 2023

Metab Brain Dis

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Medulloblastoma (MB) is one of the most common malignant childhood brain tumors (WHO grade IV).Its high degree of malignancy leads to an unsatisfactory prognosis, requiring more precise and personalized treatment in the near future. Multi-omics and arti cial intelligence have been playing a signi cant role in precise medical research, but their implementation needs a large amount of clinical information and biomaterials. For these reasons, it is urgent for current MB researchers to establish a large sample-size database of MB that contains complete clinical data and su cient biomaterials such as blood, cerebrospinal uid (CSF), cancer tissue, and urine. Unfortunately, there are few biobanks of pediatric central nervous system (CNS) tumors throughout the world for limited specimens, scarce funds, different standards collecting methods and et cl. Even though, China falls behind western countries in this area. The present research set up a standard work ow to construct the Beijing Children's Hospital Medulloblastoma (BCH-MB) biobank. Clinical data from children with MB and for collecting and storing biomaterials, along with regular follow-up has been collected and recorded in this database. In the future, the BCH-MB biobank could make it possible to validate the promising biomarkers already identi ed, discover unrevealed MB biomarkers, develop novel therapies, and establish personalized prognostic models for children with MB upon the support of its su cient data and biomaterials, laying the foundation for individualized therapies of children with MB.

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Postoperative Speech Impairment and Surgical Approach to Posterior Fossa Tumours in Children: A Prospective European Multicentre Study

Cited by 10 publications

References 0 publications

Presurgical MRI‐Based Radiomics Models for Predicting Cerebellar Mutism Syndrome in Children With Posterior Fossa Tumors

Presurgical MRI‐Based Radiomics Models for Predicting Cerebellar Mutism Syndrome in Children With Posterior Fossa Tumors

Posterior fossa ependymomas in children and adolescents - the state of the art

Beijing Children’s Hospital guidelines on the design and conduction of the first standardized database for medulloblastoma

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