Innovative Technologies in Neuro-oncology

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (25 March 2022) | Viewed by 20491

Special Issue Editors


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Guest Editor
Department of Neurosurgery, University of Tor Vergata, Rome, Italy
Interests: neuro-oncology; spine surgery; functional neurosurgery; vascular neurosurgery
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Guest Editor
Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy
Interests: neuro-oncology; brain tumors; MRgFUS; spine; minimally invasive surgery
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Guest Editor
Department of Neurosurgery, Trauma and Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
Interests: skull base surgery; mixed reality; spine trauma; neuro-oncology
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Guest Editor
Department of Biomedicine, Interventional Neuroradiology Unit, University of Rome Tor Vergata, Rome, Italy
Interests: neuro-oncology; brain tumors; neuroradiology; imaging; interventional neuroradiology; endovascular treatment

Special Issue Information

Dear Colleagues,

Emerging technologies are changing neuro-oncology. The aim of this research topic is to provide the most recent evidence in brain and spine oncology. Papers focusing on the following fields are welcome: pre- and post-operative imaging; histologic diagnosis including liquid biopsy and the most recent advancement in molecular and genetic tumor assessment; intraoperative applications of advanced technologies like intraoperative CT scan, intraoperative fluorecensces, augmented reality, exoscope, minimally invasive surgery, maximal safe resection; new advances in chemotherapy; and radiotherapy (proton beam, MRgFUS, gamma-knife, cyber knife). Articles types: Original articles, review.

Manuscripts submitted to this Special Issue should follow certain
requirements:

1. Manuscripts should present an important novelty of the content and high potential impact in the relevant field of research;
2. They should have a high standard of English (expression, grammar, and spelling);
3. There should be a proper design of the experiment, and methodology described detailed to guarantee the reproducibility of the study;
4. There should be a sample per analysis subgroup minimum of 10 participants. A smaller sample may be justified if it is a population that is excessively difficult to recruit more (e.g., a rare disease).
For small samples, i.e., <15 participants, the effect size should be used to show that the sample is sufficient to support the results. However, it is recommended to always include the effect sizes in the data report;
5. Manuscripts should include the reference of the approval by the ethical committee for experimental studies.

Prof. Dr. Maurizio Salvati
Dr. Rosario Maugeri
Dr. Giuseppe Emmanuele Umana
Dr. Valerio Da Ros
Guest Editors

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Keywords

  • brain and spine tumors
  • augmented reality
  • neuroradiology
  • radiotherapy
  • chemotherapy

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Published Papers (6 papers)

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Editorial

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3 pages, 191 KiB  
Editorial
Radiotherapy in Current Neuro-Oncology: There Is Still Much to Reveal
by Gianluca Ferini and Giuseppe Emmanuele Umana
Life 2021, 11(12), 1412; https://doi.org/10.3390/life11121412 - 16 Dec 2021
Cited by 4 | Viewed by 1910
Abstract
Radiation therapy (RT) has a pivotal role in the treatment of Central Nervous System (CNS) neoplasms and is routinely employed for both benign and malignant lesions [...] Full article
(This article belongs to the Special Issue Innovative Technologies in Neuro-oncology)

Research

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13 pages, 4012 KiB  
Article
Use of Mixed Reality in Neuro-Oncology: A Single Centre Experience
by Swati Jain, Yujia Gao, Tseng Tsai Yeo and Kee Yuan Ngiam
Life 2023, 13(2), 398; https://doi.org/10.3390/life13020398 - 31 Jan 2023
Cited by 5 | Viewed by 2112
Abstract
(1) Background: Intra-operative neuronavigation is currently an essential component to most neurosurgical operations. Recent progress in mixed reality (MR) technology has attempted to overcome the disadvantages of the neuronavigation systems. We present our experience using the HoloLens 2 in neuro-oncology for both intra- [...] Read more.
(1) Background: Intra-operative neuronavigation is currently an essential component to most neurosurgical operations. Recent progress in mixed reality (MR) technology has attempted to overcome the disadvantages of the neuronavigation systems. We present our experience using the HoloLens 2 in neuro-oncology for both intra- and extra-axial tumours. (2) Results: We describe our experience with three patients who underwent tumour resection. We evaluated surgeon experience, accuracy of superimposed 3D image in tumour localisation with standard neuronavigation both pre- and intra-operatively. Surgeon training and usage for HoloLens 2 was short and easy. The process of image overlay was relatively straightforward for the three cases. Registration in prone position with a conventional neuronavigation system is often difficult, which was easily overcome during use of HoloLens 2. (3) Conclusion: Although certain limitations were identified, the authors feel that this system is a feasible alternative device for intra-operative visualization of neurosurgical pathology. Further studies are being planned to assess its accuracy and suitability across various surgical disciplines. Full article
(This article belongs to the Special Issue Innovative Technologies in Neuro-oncology)
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14 pages, 3381 KiB  
Article
Skull Base Approaches for Tuberculum Sellae Meningiomas: Institutional Experience in a Series of 34 Patients
by Shamsul Alam, Gianluca Ferini, Nur Muhammad, Nazmin Ahmed, Abu Naim Mohammad Wakil, Kazi Mohammad Atiqul Islam, Mohammad Samsul Arifin, Abdullah Al Mahbub, Riad Habib, Mosiur Rahman Mojumder, Atul Vats and Bipin Chaurasia
Life 2022, 12(4), 492; https://doi.org/10.3390/life12040492 - 28 Mar 2022
Cited by 8 | Viewed by 4680
Abstract
(1) Background: The aim of the present study was to evaluate our institutional outcome in tuberculum sellae meningioma (TSM) patients treated microsurgically using multiple skull base approaches, including a transcranial approach and an extended endonasal transsphenoidal approach. (2) Materials and Methods: This is [...] Read more.
(1) Background: The aim of the present study was to evaluate our institutional outcome in tuberculum sellae meningioma (TSM) patients treated microsurgically using multiple skull base approaches, including a transcranial approach and an extended endonasal transsphenoidal approach. (2) Materials and Methods: This is a retrospective study that includes 34 patients with TSM. The study aimed to observe the efficacy of the different common approaches used by a single neurosurgeon. All the patients were evaluated preoperatively and during follow-up with campimetry, head CT scan, and post-contrast MRI. (3) Results: After a transcranial approach, visual acuity improved in 86.20%, was stable in 10.34%, and deteriorated in 3.45%. Through transsphenoidal surgery, vision improved in 80%, was static in 20%, and deteriorated in 0%. Transcranial approaches included pterional, mini-bifrontal basal, and supraciliary keyhole microscopic craniotomies. Gross total removal was performed in 58.82%, near total in 10.34%, and partial removal in 3.45%. The transcranial/supraciliary keyhole endoscopic-assisted approach showed a gross total removal rate of 80%, and near total in 20%. The transsphenoidal approach showed a gross total removal rate of 60%, near total in 20%, and partial removal in 20%. (4) Conclusion: Endoscopic-assisted keyhole supraciliary mini craniotomy for resection of tuberculum sellae meningioma offers low morbidity and good visual outcome. The endonasal route is preferred for the removal of TSM when they are small and midline placed. The major limitation of this approach is a narrow surgical corridor and the restriction on midline-placed lesions. Gross total removal was better achieved with mini-bifrontal basal and pterional craniotomies. Full article
(This article belongs to the Special Issue Innovative Technologies in Neuro-oncology)
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Review

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25 pages, 13885 KiB  
Review
Current Status of Neuromodulation-Induced Cortical Prehabilitation and Considerations for Treatment Pathways in Lower-Grade Glioma Surgery
by Ryan P. Hamer and Tseng Tsai Yeo
Life 2022, 12(4), 466; https://doi.org/10.3390/life12040466 - 22 Mar 2022
Cited by 12 | Viewed by 3903
Abstract
The infiltrative character of supratentorial lower grade glioma makes it possible for eloquent neural pathways to remain within tumoural tissue, which renders complete surgical resection challenging. Neuromodulation-Induced Cortical Prehabilitation (NICP) is intended to reduce the likelihood of premeditated neurologic sequelae that otherwise would [...] Read more.
The infiltrative character of supratentorial lower grade glioma makes it possible for eloquent neural pathways to remain within tumoural tissue, which renders complete surgical resection challenging. Neuromodulation-Induced Cortical Prehabilitation (NICP) is intended to reduce the likelihood of premeditated neurologic sequelae that otherwise would have resulted in extensive rehabilitation or permanent injury following surgery. This review aims to conceptualise current approaches involving Repetitive Transcranial Magnetic Stimulation (rTMS-NICP) and extraoperative Direct Cortical Stimulation (eDCS-NICP) for the purposes of inducing cortical reorganisation prior to surgery, with considerations derived from psychiatric, rehabilitative and electrophysiologic findings related to previous reports of prehabilitation. Despite the promise of reduced risk and incidence of neurologic injury in glioma surgery, the current data indicates a broad but compelling possibility of effective cortical prehabilitation relating to perisylvian cortex, though it remains an under-explored investigational tool. Preliminary findings may prove sufficient for the continued investigation of prehabilitation in small-volume lower-grade tumour or epilepsy patients. However, considering the very low number of peer-reviewed case reports, optimal stimulation parameters and duration of therapy necessary to catalyse functional reorganisation remain equivocal. The non-invasive nature and low risk profile of rTMS-NICP may permit larger sample sizes and control groups until such time that eDCS-NICP protocols can be further elucidated. Full article
(This article belongs to the Special Issue Innovative Technologies in Neuro-oncology)
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31 pages, 9430 KiB  
Review
Evaluating the Impact of Intraoperative MRI in Neuro-Oncology by Scientometric Analysis
by Harsh Deora, Gianluca Ferini, Kanwaljeet Garg, M. D. Krishna Narayanan and Giuseppe Emmanuele Umana
Life 2022, 12(2), 175; https://doi.org/10.3390/life12020175 - 25 Jan 2022
Cited by 5 | Viewed by 2791
Abstract
(1) Objective—Intraoperative Magnetic Resonance Imaging (IOMRI) guided surgery has revolutionized neurosurgery and has especially impacted the field of Neuro-Oncology, with randomized controlled trails demonstrating improved resection, fewer postoperative deficits and enhanced survival rates. Bibliometric analysis allows for analysing chronological trends and measuring the [...] Read more.
(1) Objective—Intraoperative Magnetic Resonance Imaging (IOMRI) guided surgery has revolutionized neurosurgery and has especially impacted the field of Neuro-Oncology, with randomized controlled trails demonstrating improved resection, fewer postoperative deficits and enhanced survival rates. Bibliometric analysis allows for analysing chronological trends and measuring the impact and directions of research in a particular field. To the authors’ knowledge, this is the first Bibliometric analysis conducted on IOMRI. (2) Methods—a title specific search of the Web of Science database was executed using the keywords ‘intraoperative MRI’, ‘intraoperative magnetic resonance imaging’, and “IOMRI’ on 23rd April 2021. Results—663 articles met the inclusion criteria and were included in the final analysis. In addition, the 100 most cited were analysed as well. Among these 100 articles, 76 were original research papers, while 14 others were review articles. Amongst all the authors, Ganslandt contributed the maximum number of articles, with USA being the largest single source of these articles, followed by Germany. Interestingly, a shift of trends from “Image guided surgery’ and ‘accuracy’ in the early 2000s to ‘extent of resection’, ‘impact’, and ‘survival’ in the later years was noted. (3) Conclusions—IOMRI has now become an integral part of neurosurgery, especially in neuro-oncology. Focus has now shifted from implementation to refinement of technique in the form of functional and oncological outcomes. Therefore, future research in this direction is imperative and will be of more impact that in any other sub-field related to IOMRI. Full article
(This article belongs to the Special Issue Innovative Technologies in Neuro-oncology)
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Other

13 pages, 3103 KiB  
Systematic Review
Primary Extracranial Meningiomas of the Head and Neck
by Giuseppe Emmanuele Umana, Gianluca Scalia, Atul Vats, Gianluca Pompili, Fabio Barone, Maurizio Passanisi, Francesca Graziano, Rosario Maugeri, Maria Grazia Tranchina, Sebastiano Cosentino, Massimo Ippolito, Santino Ottavio Tomasi, Giuseppe Raudino, Bipin Chaurasia, Domenico Gerardo Iacopino, Giovanni Federico Nicoletti, Salvatore Cicero, Lidia Strigari and Rosario Emanuele Perrotta
Life 2021, 11(9), 942; https://doi.org/10.3390/life11090942 - 9 Sep 2021
Cited by 21 | Viewed by 2771
Abstract
Meningiomas represent the most common benign histological tumor of the central nervous system. Usually, meningiomas are intracranial, showing a typical dural tail sign on brain MRI with Gadolinium, but occasionally they can infiltrate the skull or be sited extracranially. We present a systematic [...] Read more.
Meningiomas represent the most common benign histological tumor of the central nervous system. Usually, meningiomas are intracranial, showing a typical dural tail sign on brain MRI with Gadolinium, but occasionally they can infiltrate the skull or be sited extracranially. We present a systematic review of the literature on extracranial meningiomas of the head and neck, along with an emblematic case of primary extracranial meningioma (PEM), which provides further insights into PEM management. A literature search according to the PRISMA statement was conducted from 1979 to June 2021 using PubMed, Web of Science, Google Scholar, and Scopus databases, searching for relevant Mesh terms (primary extracranial meningioma) AND (head OR neck). Data for all patients were recorded when available, including age, sex, localization, histological grading, treatment, possible recurrence, and outcome. A total of 83 published studies were identified through PubMed, Google Scholar, and Scopus databases, together with additional references list searches from 1979 to date. A total of 49 papers were excluded, and 34 manuscripts were considered for this systematic review, including 213 patients. We also reported a case of a 45-year-old male with an extracranial neck psammomatous meningioma with sizes of 4 cm × 3 cm × 2 cm. Furthermore, whole-body 68Ga-DOTATOC PET/CT was performed, excluding tumor spread to other areas. Surgical resection of the tumor was accomplished, as well as skin flap reconstruction, obtaining radical removal and satisfying wound healing. PEMs could suggest an infiltrative and aggressive behavior, which has never found a histopathological correlation with a malignancy (low Ki-67, <5%). Whole-body 68Ga-DOTATOC PET/CT should be considered in the patient’s global assessment. Surgical removal is a resolutive treatment, and the examination of frozen sections can confirm the benignity of the lesion, reducing the extension of the removal of healthy tissue surrounding the tumor. Full article
(This article belongs to the Special Issue Innovative Technologies in Neuro-oncology)
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