Enhancing Cardiorespiratory Fitness and Quality of Life in High-Grade Glioma through an Intensive Exercise Intervention during Chemotherapy: Proof of Concept.

Background: High-grade glioma (HGG) patients experience enormous disease burden both from tumor- and treatment-related symptoms. Exercise can improve physical fitness and quality of life (QoL); yet experience in neuro-oncology, especially with high-intensity exercise, remains limited. This study evaluated feasibility, safety, and efficacy of the intensive, structured 16-week strength and endurance program, "Active in Neuro-Oncology" (ActiNO) for HGG patients undergoing chemotherapy.

Impact of 5-ALA-induced PPIX accumulation on neural stem cell behavior.

5-aminolevulinic acid (5-ALA) is a widely recognized and effective tool for improving tumor resections during surgical interventions but may directly interact with cells in the tumor microenvironment. Nevertheless, there remains an ongoing debate regarding the impact of 5-ALA on neural stem cells (NSCs). This study aims to investigate the effects of 5-ALA on both NSCs and oligodendrocyte progenitor cells (OPCs).

Clinical Reasoning: Episodes of Uncontrollable Crying in a 52-Year-Old Man With a Sphenopetroclival Tumor.

A 52-year-old man presented with progressive gait disturbances. MRI demonstrated a large extra-axial tumor in the cerebellopontine angle compressing the brainstem and resulting in hydrocephalus. While taking the patient's history, episodes of uncontrollable crying with sudden onset occurred multiple times.

5-Aminolevulinic acid as an emerging radiosensitizer for radiodynamic therapy in solid tumors: a systematic review of available data and clinical potential.

Background: 5‑Aminolevulinic acid (5-ALA) is a keto-carbon amino acid frequently used in glioma surgery for fluorescence-guided resection. Additionally, cytotoxic properties of 5‑ALA can be induced via stimulation with laser light in photodynamic therapy (PDT). Preclinical in vitro and in vivo trials have also demonstrated this effect to be inducible by photon irradiation as used in radiation treatment.

Blood group O attributes to prolonged progression-free survival, overall survival, and 5-year survival in isocitrate dehydrogenase-wildtype glioblastoma patients with MGMT promoter methylation.

Background: Glioblastoma (GBM) remains incurable despite multimodal therapeutic approaches. Here, we assessed the relevance of ABO blood groups for progression-free survival (PFS), overall survival (OS), and long-term survival in a large cohort of isocitrate dehydrogenase (IDH)-wildtype (wt) GBM patients.

Methods: Consecutive GBM patients (2009-2020) at a large tertiary brain tumor center were included, and clinical data were retrospectively abstracted.

Synthetic O-(2-F-fluoroethyl)-l-tyrosine-positron emission tomography generation and hotspot prediction via preoperative MRI fusion of gliomas lacking radiographic high-grade characteristics.

Background: Limited amino acid availability for positron emission tomography (PET) imaging hinders therapeutic decision-making for gliomas without typical high-grade imaging features. To address this gap, we evaluated a generative artificial intelligence (AI) approach for creating synthetic O-(2-F-fluoroethyl)-l-tyrosine ([F]FET)-PET and predicting high [F]FET uptake from magnetic resonance imaging (MRI).

Methods: We trained a deep learning (DL)-based model to segment tumors in MRI, extracted radiomic features using the Python PyRadiomics package, and utilized  a Random Forest classifier to predict high [F]FET uptake.

Temporal Muscle Thickness as a Prognostic Marker in a Real-Life Cohort of Newly Diagnosed MGMT Promoter Methylated Glioblastoma: A Multicentric Imaging Analysis.

Introduction: Prior research has identified temporal muscle thickness (TMT) as a prognostic marker in glioblastoma. Nonetheless, implementation in daily clinical practice is complicated due to the heterogeneity of previous studies. We performed a multicentric analysis aiming to validate recently proposed sex-specific cutoff values using a homogeneous cohort of newly diagnosed MGMT promoter methylated glioblastoma patients; we included a balanced control cohort for comparison.

Assessment of 5-aminolevulinic acid-induced fluorescence using novel exoscopes and their feasibility in glioma surgery: technical note.

Objective: Filter specifications for visualizing 5-aminolevulinic acid (5-ALA) tumor fluorescence are incorporated in neurosurgical wide-field microscopes. Novel exoscopes offer modified visualization technologies that should be comparable to older systems to prevent over- or underresection. In this technical note, the authors compare the fluorescence visualization technologies of three exoscopes.

Radiation Treatment Planning After Minimum Metallic Instrumentation for Patients with Spinal Metastases: A Case Series.

: The utilization of non-metallic pedicle screws and rods has become a favored approach in the management of spinal tumors. An abundance of metal artifacts improves postoperative imaging and allows for precise radiation treatment planning. Under certain conditions, a vertebral body replacement (VBR) is necessary in addition to dorsal fixation.

Predictive modeling with linear machine learning can estimate glioblastoma survival in months based solely on MGMT-methylation status, age and sex.

Purpose: Machine Learning (ML) has become an essential tool for analyzing biomedical data, facilitating the prediction of treatment outcomes and patient survival. However, the effectiveness of ML models heavily relies on both the choice of algorithms and the quality of the input data. In this study, we aimed to develop a novel predictive model to estimate individual survival for patients diagnosed with glioblastoma (GBM), focusing on key variables such as O6-Methylguanine-DNA Methyltransferase (MGMT) methylation status, age, and sex.

The ATLAS/NOA-29 study protocol: a phase III randomized controlled trial of anterior temporal lobectomy versus gross-total resection in newly-diagnosed temporal lobe glioblastoma.

Background: The discovery of cellular tumor networks in glioblastoma, with routes of malignant communication extending far beyond the detectable tumor margins, has highlighted the potential of supramarginal resection strategies. Retrospective data suggest that these approaches may improve long-term disease control. However, their application is limited by the proximity of critical brain regions and vasculature, posing challenges for validation in randomized trials.

Sonodynamic therapy with a single neoadjuvant, diffuse delivery of low-intensity ultrasound with 5-ALA in treatment naïve glioblastoma results in tumor-specific cytotoxic edema and increased apoptosis.

Purpose: Sonodynamic therapy, which combines a tumor cell-selective sonosensitizer with ultrasound, is gaining attention as a promising new treatment approach for glioblastoma. The objective of this case study is to report on the first applications of 5-aminolevulinic acid (5-ALA) in combination with low-intensity, non-targeted ultrasound as neo-adjuvant treatment in therapy naïve glioblastoma.

Methods: Three patients with therapy naïve newly diagnosed glioblastoma were treated once before cytoreductive surgery with 5-ALA in combination with hemispheric, low-intensity, non-targeted ultrasound, assuming cell death to be triggered by non-ablative activation of 5-ALA-induced, tumor selective porphyrins.

Unveiling Molecular Dynamics of MeCp2, CDKL5 and BDNF in the Hippocampus of Individuals With Intractable Mesial Temporal Lobe Epilepsy.

Mutations occurring in the MeCp2, CDKL5 and BDNF genes have been linked to epileptogenesis in various epilepsy syndromes. This study employed bioinformatics analysis of transcriptomic data to examine the interrelationship among these genes in both epileptic and healthy individuals. Moreover, we assessed the expression of MeCp2, CDKL5 and BDNF at both mRNA and protein levels in human hippocampal tissues obtained from 22 patients undergoing epilepsy surgery for mesial temporal lobe epilepsy (MTLE) as well as from 25 autopsied specimens.

Multidisciplinary treatment is necessary in glioblastoma with extracerebral metastases.

Purpose: While glioblastoma is the most common malignant brain tumor in adults, extracerebral manifestations are very rare in this highly aggressive disease with poor prognosis.

Methods: We conducted a systematic literature review in the PubMed database and complemented the data by inclusion of a case treated in our clinic. In this context, we report on a 60-year-old woman with a right frontal glioblastoma, IDH wildtype, MGMT methylated.

Predicting intraoperative 5-ALA-induced tumor fluorescence via MRI and deep learning in gliomas with radiographic lower-grade characteristics.

Purpose: Lower-grade gliomas typically exhibit 5-aminolevulinic acid (5-ALA)-induced fluorescence in only 20-30% of cases, a rate that can be increased by doubling the administered dose of 5-ALA. Fluorescence can depict anaplastic foci, which can be precisely sampled to avoid undergrading. We aimed to analyze whether a deep learning model could predict intraoperative fluorescence based on preoperative magnetic resonance imaging (MRI).

Single-cell transcriptomics link gene expression signatures to clinicopathological features of gonadotroph and lactotroph PitNET.

Background: Pituitary neuroendocrine tumors (PitNET) are among the most common intracranial tumors. Despite a frequent benign course, aggressive behavior can occur. Tumor behavior is known to be under the influence of the tumor microenvironment (TME).

Machine and Deep Learning in Hyperspectral Fluorescence-Guided Brain Tumor Surgery.

Malignant glioma resection is often the first line of treatment in neuro-oncology. During glioma surgery, the discrimination of tumor's edges can be challenging at the infiltration zone, even by using surgical adjuncts such as fluorescence guidance (e.g.

Efficacy and Low Toxicity of Normo-Fractionated Re-Irradiation with Combined Chemotherapy for Recurrent Glioblastoma-An Analysis of Treatment Response and Failure.

Background: Glioblastoma is the most common malignant brain tumor in adults. Even after maximal safe resection and adjuvant chemoradiotherapy, patients normally relapse after a few years or even months. Standard treatment for recurrent glioblastoma is not yet defined, with re-resection, re-irradiation, and systemic therapy playing key roles.

Quality indicators in cranial neurosurgery: current insights and critical evaluation - a systematic review.

In recent decades, there has been increasing interest in measuring the quality of care across all medical fields, including neurosurgery. This interest aims not only to optimize care but also to reduce healthcare costs. For this purpose, different quality indicators (QIs) have been developed.