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Πέμπτη 10 Νοεμβρίου 2022

Global survival trends for brain tumors, by histology: analysis

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Abstract
Background
Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology.
Methods
We analyzed individual data for adults (15–99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000–2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator.
Results
The study included 556,237 adults. In 2010–2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%–38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in s urvival occurred between 2000–2004 and 2005–2009. These improvements were more noticeable among adults diagnosed aged 40–70 years than among younger adults.
Conclusions
To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Posttraumatic Lingual Artery Pseudoaneurysm and Synchronous Multiple Pneumatosis in a Child

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This case report describes a lingual artery pseudoaneurysm in a child after a low-energy, blunt, neck trauma accompanied by subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumopericardium, pneumoperitoneum, and pneumorrhachis.
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Surveillance for Survivors of Locoregionally Advanced Head and Neck Cancer

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The evaluation and management of head and neck cancers is an area of intense research and data-driven recommendations. However, once a patient completes definitive treatment for a head and neck cancer, there is surprisingly little evidence to guide the surveillance and long-term management of these patients. Most guidelines, such as those of the National Comprehensive Cancer Network, are based primarily on expert opinion and take a one-size-fits-all approach to head and neck cancers. However, the long-term prognoses of head and neck cancers vary widely, depending on numerous factors, such as subsite, staging, human papillomavirus (HPV) status for oropharyngeal cancers, and other tumor and patient characteristics. Furthermore, surveillance visits represent a substantial use of clinical resources, time, and patient expense for many years after cancer treatment. Clearly, this is an area in need of evidence-based approaches to ensure optimal patient care.
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Assessment of Fat Fractions in the Tongue, Soft Palate, Pharyngeal Wall, and Parapharyngeal Fat Pad by the GOOSE and DIXON Methods

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imageObjective The 2-point DIXON method is widely used to assess fat fractions (FFs) in magnetic resonance images (MRIs) of the tongue, pharyngeal wall, and surrounding tissues in patients with obstructive sleep apnea (OSA). However, the method is semiquantitative and is susceptible to B0 field inhomogeneities and R2* confounding factors. Using the method, although several studies have shown that patients with OSA have increased fat deposition around the pharyngeal cavity, conflicting findings was also reported in 1 study. This discrepancy necessitates that we examine the FF estimation method used in the earlier studies and seek a more accurate method to measure FFs. Materials and Methods We examined the advantages of using the GOOSE (globally optimal surface estimation) method to replace the 2-point DIXON method for quantifying fat in the tongue and surrounding tissues on MRIs. We first used phantoms with known FFs (true FFs) to validate the GOOSE method and examine the errors in the DIXON method. Then, we compared the 2 methods in the tongue, soft palate, pharyngeal wall, and parapharyngeal fat pad of 63 healthy participants to further assess the errors caused by the DIXON method. Six participants were excluded from the comparison of the tongue FFs because of technical failures. Paired Student t tests were performed on FFs to detect significant differences between the 2 methods. All measures were obtained using 3 T Siemens MRI scanners. Results In the phantoms, the FFs measured by GOOSE agreed with the true FF, with only a 1.2% mean absolute error. However, the same measure by DIXON had a 10.5% mean absolute error. The FFs obtained by DIXON were significantly lower than those obtained by GOOSE (P
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Deep Learning-Enhanced Parallel Imaging and Simultaneous Multislice Acceleration Reconstruction in Knee MRI

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imageObjectives This study aimed to examine various combinations of parallel imaging (PI) and simultaneous multislice (SMS) acceleration imaging using deep learning (DL)-enhanced and conventional reconstruction. The study also aimed at comparing the diagnostic performance of the various combinations in internal knee derangement and provided a quantitative evaluation of image sharpness and noise using edge rise distance (ERD) and noise power (NP), respectively. Materials and Methods The data from adult patients who underwent knee magnetic resonance imaging using various DL-enhanced acquisitions between June 2021 and January 2022 were retrospectively analyzed. The participants underwent conventional 2-fold PI and DL protocols with 4- to 8-fold acceleration imaging (P2S2 [2-fold PI with 2-fold SMS], P3S2, and P4S2). Three readers evaluated the internal knee derangement and the overall image quality. The diagnostic performance was calculated using consensus reading as a standard reference, and we conducted comparative evaluations. We calculated the ERD and NP for quantitative evaluations of image sharpness and noise, respectively. Interreader and intermethod agreements were calculated using Fleiss κ. Results A total of 33 patients (mean age, 49 ± 19 years; 20 women) were included in this study. The diagnostic performance for internal knee derangement and the overall image quality were similar among the evaluated protocols. The NP values were significantly lower using the DL protocols than with conventional imaging (P 0.12). Interreader and intermethod agreements were moderate-to-excellent (κ = 0.574–0.838) and good-to-excellent (κ = 0.755–1.000), respectively. In addition, the mean acquisition time was reduced by 47% when using DL with P2S2, by 62% with P3S2, and by 71% with P4S2, compared with conventional P2 imaging (2 minutes and 55 seconds). Conclusions The combined use of DL-enhanced 8-fold acceleration imaging (4-fold PI with 2-fold SMS) showed comparable performance with conventional 2-fold PI for the evaluation of internal knee derangement, with a 71% reduction in acquisition time.
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