The Experts below are selected from a list of 180 Experts worldwide ranked by ideXlab platform
Hugues Duffau - One of the best experts on this subject based on the ideXlab platform.
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Analysis of Legal, Cultural, and Socioeconomic Parameters in Low-Grade Glioma Management: Variability Across Countries and Implications for Awake Surgery
World Neurosurgery, 2018Co-Authors: Clarissa Vanacôr, Hugues DuffauAbstract:Low-grade glioma (LGG) usually occurs in young patients who enjoy an active family, social, and professional life. Because awake surgery for patients with LGG has resulted in significant improvement in both functional and oncological outcomes and because the surgery per se is not very expensive, it is currently performed in many countries worldwide. Nonetheless, in addition to the necessity of tailoring the surgical strategy to the patient (e.g., neurological and cognitive status) and tumor (e.g., Brain Location and volume) characteristics, the legal, cultural, and socioeconomic parameters could also play a key role in the therapeutic strategy. These include clear information to the patient and relatives during the first meeting, the adapted selection of tasks for awake mapping, and active collaboration of the patient throughout the resection and during the early postoperative rehabilitation. In the present study, our goal was to analyze these socioenvironmental aspects, which have been neglected for many decades, in LGG management, with a special emphasis on epilepsy and the awake procedure. These criteria are relevant with respect to the diagnosis, surgery, functional remediation, and long-term follow-up for patients who now benefit from a longer life expectancy. However, although such factors are essential to resume an active life, including returning to work, they vary greatly across countries. Therefore, they should be considered more systematically to allow for greater reproducibility of results of awake surgery worldwide.
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resection probability maps for quality assessment of glioma surgery without Brain Location bias
PLOS ONE, 2013Co-Authors: Philip C De Witt Hamer, Eef J Hendriks, Emmanuel Mandonnet, Frederik Barkhof, Aeilko H Zwinderman, Hugues DuffauAbstract:Background Intraoperative Brain stimulation mapping reduces permanent postoperative deficits and extends tumor removal in resective surgery for glioma patients. Successful functional mapping is assumed to depend on the surgical team's expertise. In this study, glioma resection results are quantified and compared using a novel approach, so-called resection probability maps (RPM), exemplified by a surgical team comparison, here with long and short experience in mapping. Methods Adult patients with glioma were included by two centers with two and fifteen years of mapping experience. Resective surgery was targeted at non-enhanced MRI extension and was limited by functional boundaries. Neurological outcome was compared. To compare resection results, we applied RPMs to quantify and compare the resection probability throughout the Brain at 1 mm resolution. Considerations for spatial dependence and multiple comparisons were taken into account. Results The senior surgical team contributed 56, and the junior team 52 patients. The patient cohorts were comparable in age, preoperative tumor volume, lateralization, and lobe localization. Neurological outcome was similar between teams. The resection probability on the RPMs was very similar, with none (0%) of 703,967 voxels in left-sided tumors being differentially resected, and 124 (0.02%) of 644,153 voxels in right-sided tumors. Conclusion RPMs provide a quantitative volumetric method to compare resection results, which we present as standard for quality assessment of resective glioma surgery because Brain Location bias is avoided. Stimulation mapping is a robust surgical technique, because the neurological outcome and functional-based resection results using stimulation mapping are independent of surgical experience, supporting wider implementation.
Philip C De Witt Hamer - One of the best experts on this subject based on the ideXlab platform.
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NI-34Brain LocationS INVOLVED IN COGNITIVE ALTERATIONS AFTER RESECTIVE Brain SURGERY IDENTIFIED BY RESECTION PROBABILITY MAPS
Neuro-Oncology, 2014Co-Authors: Eef J Hendriks, Frederik Barkhof, Esther J. J. Habets, Martin Klein, W. Peter Vandertop, Martin J.b. Taphoorn, Philip C De Witt HamerAbstract:INTRODUCTION: Cognition is at risk in patients with Brain tumors. Cognitive alterations, improvement or decline, may result from Brain tumor surgery, as well as from other factors such as direct tumor effects, radiotherapy, chemotherapy, anti-epileptic drugs, and steroids. In this study, cognitive alterations after Brain tumor surgery are quantified and correlated with Brain Location using resection probability maps, which is a new approach. METHODS: Adult patients were included, who had (1) a Brain tumor, (2) resective surgery between 2006 and 2011, (3) baseline and postoperative (9-12 months) neuropsychological assessment in seven cognitive domains, and (4) pre- and postoperative MRI available. Resective surgery was performed with intraoperative stimulation mapping until functional boundaries were met. Resection probability maps quantify the likelihood of resection throughout the Brain in 3D at 1 mm resolution in standard Brain space. We compared resection probability maps of patients with and without cognitive alterations. Considerations for spatial dependence and multiple comparisons were taken into account. PRELIMINARY RESULTS: Seventy-four patients were so far included. The cognitive domains with most frequent and most extensive alterations after surgery were attentional function and working memory capacity. Results on the correlation between these cognitive changes and Brain Location are pending, but will be available in October 2014. CONCLUSION: Brain Locations involved in cognitive improvement as well as decline in relation to resective surgery can be identified using resection probability maps. Brain tumors which are located in regions to be identified are associated with alterations in attention and verbal working memory.
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resection probability maps for quality assessment of glioma surgery without Brain Location bias
PLOS ONE, 2013Co-Authors: Philip C De Witt Hamer, Eef J Hendriks, Emmanuel Mandonnet, Frederik Barkhof, Aeilko H Zwinderman, Hugues DuffauAbstract:Background Intraoperative Brain stimulation mapping reduces permanent postoperative deficits and extends tumor removal in resective surgery for glioma patients. Successful functional mapping is assumed to depend on the surgical team's expertise. In this study, glioma resection results are quantified and compared using a novel approach, so-called resection probability maps (RPM), exemplified by a surgical team comparison, here with long and short experience in mapping. Methods Adult patients with glioma were included by two centers with two and fifteen years of mapping experience. Resective surgery was targeted at non-enhanced MRI extension and was limited by functional boundaries. Neurological outcome was compared. To compare resection results, we applied RPMs to quantify and compare the resection probability throughout the Brain at 1 mm resolution. Considerations for spatial dependence and multiple comparisons were taken into account. Results The senior surgical team contributed 56, and the junior team 52 patients. The patient cohorts were comparable in age, preoperative tumor volume, lateralization, and lobe localization. Neurological outcome was similar between teams. The resection probability on the RPMs was very similar, with none (0%) of 703,967 voxels in left-sided tumors being differentially resected, and 124 (0.02%) of 644,153 voxels in right-sided tumors. Conclusion RPMs provide a quantitative volumetric method to compare resection results, which we present as standard for quality assessment of resective glioma surgery because Brain Location bias is avoided. Stimulation mapping is a robust surgical technique, because the neurological outcome and functional-based resection results using stimulation mapping are independent of surgical experience, supporting wider implementation.
Frederik Barkhof - One of the best experts on this subject based on the ideXlab platform.
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Probability Maps of Glioblastoma Indicate Variation in Surgical Decisions Between 10 Surgical Teams
Neurosurgery, 2018Co-Authors: Dmj Müller, Frederik Barkhof, Pierre Robe, W. Van Der Brink, Hilko Ardon, B. Idema, Fred Kloet, William P. Vandertop, Lorenzo Bello, Georg WidhalmAbstract:INTRODUCTION The aim of glioblastoma surgery is to maximize the extent of resection, while preserving functional integrity. Standards are lacking for surgical decision-making and consequently surgical strategies may differ between neurosurgical teams. In this study, we quantitated and compared surgical decision-making throughout the Brain between neurosurgical teams for patients with a glioblastoma using probability maps. METHODS All adults with first-time glioblastoma surgery in 2012-2013 from 10 tertiary referral centers for neurooncological care were included in this study. For each patient, pre- and postoperative tumor were manually segmented on MRI and aligned to standard Brain space. Resection probability maps and biopsy probability maps were constructed in 1 mm resolution for each team's cohort. Brain regions with differential biopsy and resection results between teams were identified. RESULTS The study cohort consisted of 931 patients of whom 293 received a biopsy and 638 a resection. Biopsy probability maps demonstrated differences between teams in biopsy rate per Brain Location, such as for the left precuneus and superior parietal lobule, indicating variation in biopsy decisions. Resection probability maps demonstrated differences between teams in residual tumor rate per Brain Location, such as for the left saggital striatum and neighboring posterior corpus callosum, indicating variation in resection decisions. CONCLUSION Biopsy and resection probability maps indicate treatment variation between teams for patients with a glioblastoma. This conveys useful objective arguments for quality of care discussions between surgical teams for these patients.
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NI-34Brain LocationS INVOLVED IN COGNITIVE ALTERATIONS AFTER RESECTIVE Brain SURGERY IDENTIFIED BY RESECTION PROBABILITY MAPS
Neuro-Oncology, 2014Co-Authors: Eef J Hendriks, Frederik Barkhof, Esther J. J. Habets, Martin Klein, W. Peter Vandertop, Martin J.b. Taphoorn, Philip C De Witt HamerAbstract:INTRODUCTION: Cognition is at risk in patients with Brain tumors. Cognitive alterations, improvement or decline, may result from Brain tumor surgery, as well as from other factors such as direct tumor effects, radiotherapy, chemotherapy, anti-epileptic drugs, and steroids. In this study, cognitive alterations after Brain tumor surgery are quantified and correlated with Brain Location using resection probability maps, which is a new approach. METHODS: Adult patients were included, who had (1) a Brain tumor, (2) resective surgery between 2006 and 2011, (3) baseline and postoperative (9-12 months) neuropsychological assessment in seven cognitive domains, and (4) pre- and postoperative MRI available. Resective surgery was performed with intraoperative stimulation mapping until functional boundaries were met. Resection probability maps quantify the likelihood of resection throughout the Brain in 3D at 1 mm resolution in standard Brain space. We compared resection probability maps of patients with and without cognitive alterations. Considerations for spatial dependence and multiple comparisons were taken into account. PRELIMINARY RESULTS: Seventy-four patients were so far included. The cognitive domains with most frequent and most extensive alterations after surgery were attentional function and working memory capacity. Results on the correlation between these cognitive changes and Brain Location are pending, but will be available in October 2014. CONCLUSION: Brain Locations involved in cognitive improvement as well as decline in relation to resective surgery can be identified using resection probability maps. Brain tumors which are located in regions to be identified are associated with alterations in attention and verbal working memory.
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resection probability maps for quality assessment of glioma surgery without Brain Location bias
PLOS ONE, 2013Co-Authors: Philip C De Witt Hamer, Eef J Hendriks, Emmanuel Mandonnet, Frederik Barkhof, Aeilko H Zwinderman, Hugues DuffauAbstract:Background Intraoperative Brain stimulation mapping reduces permanent postoperative deficits and extends tumor removal in resective surgery for glioma patients. Successful functional mapping is assumed to depend on the surgical team's expertise. In this study, glioma resection results are quantified and compared using a novel approach, so-called resection probability maps (RPM), exemplified by a surgical team comparison, here with long and short experience in mapping. Methods Adult patients with glioma were included by two centers with two and fifteen years of mapping experience. Resective surgery was targeted at non-enhanced MRI extension and was limited by functional boundaries. Neurological outcome was compared. To compare resection results, we applied RPMs to quantify and compare the resection probability throughout the Brain at 1 mm resolution. Considerations for spatial dependence and multiple comparisons were taken into account. Results The senior surgical team contributed 56, and the junior team 52 patients. The patient cohorts were comparable in age, preoperative tumor volume, lateralization, and lobe localization. Neurological outcome was similar between teams. The resection probability on the RPMs was very similar, with none (0%) of 703,967 voxels in left-sided tumors being differentially resected, and 124 (0.02%) of 644,153 voxels in right-sided tumors. Conclusion RPMs provide a quantitative volumetric method to compare resection results, which we present as standard for quality assessment of resective glioma surgery because Brain Location bias is avoided. Stimulation mapping is a robust surgical technique, because the neurological outcome and functional-based resection results using stimulation mapping are independent of surgical experience, supporting wider implementation.
Eef J Hendriks - One of the best experts on this subject based on the ideXlab platform.
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NI-34Brain LocationS INVOLVED IN COGNITIVE ALTERATIONS AFTER RESECTIVE Brain SURGERY IDENTIFIED BY RESECTION PROBABILITY MAPS
Neuro-Oncology, 2014Co-Authors: Eef J Hendriks, Frederik Barkhof, Esther J. J. Habets, Martin Klein, W. Peter Vandertop, Martin J.b. Taphoorn, Philip C De Witt HamerAbstract:INTRODUCTION: Cognition is at risk in patients with Brain tumors. Cognitive alterations, improvement or decline, may result from Brain tumor surgery, as well as from other factors such as direct tumor effects, radiotherapy, chemotherapy, anti-epileptic drugs, and steroids. In this study, cognitive alterations after Brain tumor surgery are quantified and correlated with Brain Location using resection probability maps, which is a new approach. METHODS: Adult patients were included, who had (1) a Brain tumor, (2) resective surgery between 2006 and 2011, (3) baseline and postoperative (9-12 months) neuropsychological assessment in seven cognitive domains, and (4) pre- and postoperative MRI available. Resective surgery was performed with intraoperative stimulation mapping until functional boundaries were met. Resection probability maps quantify the likelihood of resection throughout the Brain in 3D at 1 mm resolution in standard Brain space. We compared resection probability maps of patients with and without cognitive alterations. Considerations for spatial dependence and multiple comparisons were taken into account. PRELIMINARY RESULTS: Seventy-four patients were so far included. The cognitive domains with most frequent and most extensive alterations after surgery were attentional function and working memory capacity. Results on the correlation between these cognitive changes and Brain Location are pending, but will be available in October 2014. CONCLUSION: Brain Locations involved in cognitive improvement as well as decline in relation to resective surgery can be identified using resection probability maps. Brain tumors which are located in regions to be identified are associated with alterations in attention and verbal working memory.
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resection probability maps for quality assessment of glioma surgery without Brain Location bias
PLOS ONE, 2013Co-Authors: Philip C De Witt Hamer, Eef J Hendriks, Emmanuel Mandonnet, Frederik Barkhof, Aeilko H Zwinderman, Hugues DuffauAbstract:Background Intraoperative Brain stimulation mapping reduces permanent postoperative deficits and extends tumor removal in resective surgery for glioma patients. Successful functional mapping is assumed to depend on the surgical team's expertise. In this study, glioma resection results are quantified and compared using a novel approach, so-called resection probability maps (RPM), exemplified by a surgical team comparison, here with long and short experience in mapping. Methods Adult patients with glioma were included by two centers with two and fifteen years of mapping experience. Resective surgery was targeted at non-enhanced MRI extension and was limited by functional boundaries. Neurological outcome was compared. To compare resection results, we applied RPMs to quantify and compare the resection probability throughout the Brain at 1 mm resolution. Considerations for spatial dependence and multiple comparisons were taken into account. Results The senior surgical team contributed 56, and the junior team 52 patients. The patient cohorts were comparable in age, preoperative tumor volume, lateralization, and lobe localization. Neurological outcome was similar between teams. The resection probability on the RPMs was very similar, with none (0%) of 703,967 voxels in left-sided tumors being differentially resected, and 124 (0.02%) of 644,153 voxels in right-sided tumors. Conclusion RPMs provide a quantitative volumetric method to compare resection results, which we present as standard for quality assessment of resective glioma surgery because Brain Location bias is avoided. Stimulation mapping is a robust surgical technique, because the neurological outcome and functional-based resection results using stimulation mapping are independent of surgical experience, supporting wider implementation.
Sarileena Himanen - One of the best experts on this subject based on the ideXlab platform.
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development and comparison of four sleep spindle detection methods
Artificial Intelligence in Medicine, 2007Co-Authors: Eero Huupponen, Alpo Varri, J Hasan, German Gomezherrero, Antti Saastamoinen, Sarileena HimanenAbstract:Objective: The objective of the present work was to develop and compare methods for automatic detection of bilateral sleep spindles. Methods and materials: All-night sleep electroencephalographic (EEG) recordings of 12 healthy subjects with a median age of 40 years were studied. The data contained 6043 visually scored bilateral spindles occurring in frontopolar or central Brain Location. In the present work a new sigma index for spindle detection was developed, based on the fast Fourier transform (FFT) spectrum, aiming at approximating our previous fuzzy spindle detector. The sigma index was complemented with spindle amplitude analysis, based on finite impulse response (FIR) filtering, to form of a combination detector of bilateral spindles. In this combination detector, the spindle amplitude distribution of each recording was estimated and used to tune two different amplitude thresholds. This combination detector was compared to bilaterally extracted sigma indexes and fuzzy detections, which aim to be independent of absolute spindle amplitudes. As a fourth method a fixed spindle amplitude detector was included. Results: The combination detector provided the best overall performance; in S2 sleep a 70% true positive rate was reached with a specificity of 98.6%, and a false-positive rate of 32%. The bilateral sigma indexes provided the second best results, followed by fuzzy detector, while the fixed amplitude detector provided the poorest results so that in S2 sleep a 70% true positive rate was reached with a specificity of 97.7% and false-positive rate of 46%. The spindle amplitude distributions automatically determined for each recording by the combination detector were compared to amplitudes of visually scored spindles and they proved to correspond well. Inter-hemispheric amplitude variation of visually scored bilateral spindles is also presented. Conclusion: Flexibility is beneficial in the detection of bilateral spindles. The present work advances automated spindle detection and increases the knowledge of bilateral sleep spindle characteristics.