Recurrent glioblastoma in national guidelines on the diagnosis and treatment of gliomas: A matter of European practice variation.

Introduction: The optimal treatment for recurrent glioblastoma patients remains not well-defined in international guidelines. On top of that, the availability of national guidelines is uncharted.

Research Question: This study aimed to investigate the availability of national guidelines on the diagnosis and treatment of adult glioma throughout Europe, specifically focusing on recurrent glioblastoma.

Deep learning on CT scans to predict checkpoint inhibitor treatment outcomes in advanced melanoma.

Immune checkpoint inhibitor (ICI) treatment has proven successful for advanced melanoma, but is associated with potentially severe toxicity and high costs. Accurate biomarkers for response are lacking. The present work is the first to investigate the value of deep learning on CT imaging of metastatic lesions for predicting ICI treatment outcomes in advanced melanoma.

The influence of cardiac substructure dose on survival in a large lung cancer stereotactic radiotherapy cohort using a robust personalized contour analysis.

Background/purpose: Radiation-induced cardiac toxicity in lung cancer patients has received increased attention since RTOG 0617. However, large cohort studies with accurate cardiac substructure (CS) contours are lacking, limiting our understanding of the potential influence of individual CSs. Here, we analyse the correlation between CS dose and overall survival (OS) while accounting for deep learning (DL) contouring uncertainty, uncertainty and different modelling approaches.

Validation of SynthSeg segmentation performance on CT using paired MRI from radiotherapy patients.

Introduction: Manual segmentation of medical images is labor intensive and especially challenging for images with poor contrast or resolution. The presence of disease exacerbates this further, increasing the need for an automated solution. To this extent, SynthSeg is a robust deep learning model designed for automatic brain segmentation across various contrasts and resolutions.

Auto-contouring of cardiac substructures for Stereotactic arrhythmia radioablation (STAR): A STOPSTORM.eu consortium study.

Background/purpose: High doses to healthy cardiac substructures (CS) in stereotactic arrhythmia radioablation (STAR) raise concerns regarding potential treatment-induced cardio-toxicity. However, CS contours are not routinely created, hindering the understanding of the CS dose-effect relationships. To address this issue, the alignment of CS contouring was initiated within the STOPSTORM consortium.

Radiation Therapy for Meningiomas - Where Do We Stand and What's on the Horizon?

Radiation therapy, including conventionally fractionated external beam radiation therapy, stereotactic radiosurgery, and fractionated stereotactic radiation therapy, is a cornerstone in the interdisciplinary management of meningiomas. Recent advances in radiation oncology and also in other fields, such as neuropathology and imaging, have various implications for meningioma radiation therapy. This review aims to summarize current and anticipated developments, as well as active clinical trials related to the use of radiation therapy for meningiomas.

Results from a phase I study of 4--[131I]iodo-phenylalanine ([I]IPA) with external radiation therapy in patients with recurrent glioblastoma (IPAX-1).

Background: Glioblastoma (GBM), the most common malignant brain tumor, is associated with devastating outcomes. IPAX-1 was a multicenter, open-label, single-arm phase I study to evaluate carrier-added 4--[I]iodo-phenylalanine ([I]IPA) plus external radiation therapy (XRT) in recurrent GBM.

Methods: A total of 10 adults with recurrent GBM who had received first-line debulking surgery plus radio-chemotherapy, were randomized to a single-dose regimen (1f; I-IPA 2 GBq before XRT); a fractionated parallel dose regimen (3f-p; 3 I-IPA 670 MBq fractions, in parallel with second-line XRT), or a fractionated sequential dose regimen (3f-s; 3 I-IPA 670 MBq fractions before and after XRT).

Refining Treatment Planning in STereotactic Arrhythmia Radioablation: Benchmark Results and Consensus Statement From the STOPSTORM.eu Consortium.

Purpose: STereotactic Arrhythmia Radioablation (STAR) showed promising results in patients with refractory ventricular tachycardia. However, clinical data are scarce and heterogeneous. The STOPSTORM.

Stereotactic arrhythmia radioablation (STAR)-A systematic review and meta-analysis of prospective trials on behalf of the STOPSTORM.eu consortium.

Stereotactic arrhythmia radioablation (STAR) is a noninvasive treatment of refractory ventricular tachycardia (VT). In this study, we aimed to systematically review prospective trials on STAR and pool harmonized outcome measures in a meta-analysis. After registration in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023439666), we searched OVID Medline, OVID Embase, Web of Science Core Collection, the Cochrane Central Register of Controlled Trials, and Google Scholar on November 9, 2023, to identify reports describing results of prospective trials evaluating STAR for VT.

Individualized trajectories in postradiotherapy neurocognitive functioning of patients with brain metastases.

Background: The increasing incidence of brain metastases (BMs) and improved survival rates underscore the necessity to investigate the effects of treatments on individuals. The aim of this study was to evaluate the individual trajectories of subjective and objective cognitive performance after radiotherapy in patients with BMs.

Methods: The study population consisted of adult patients with BMs referred for radiotherapy.

The Differentiation between Progressive Disease and Treatment-Induced Effects with Perfusion-Weighted Arterial Spin-Labeling in High-Grade Gliomas.

Background And Purpose: Treatment-induced effects are difficult to differentiate from progressive disease in radiologically progressing diffuse gliomas after treatment. This retrospective, single-center cohort study investigated the diagnostic value of arterial spin-labeling perfusion in differentiating progressive disease from treatment-induced effects in irradiated patients with a high-grade glioma.

Materials And Methods: Adults with a high-grade glioma diagnosed between January 1, 2012, and December 31, 2018, with a new or increasing contrast-enhancing lesion after radiotherapy with or without chemotherapy and arterial spin-labeling were consecutively included.

From algorithms to action: improving patient care requires causality.

In cancer research there is much interest in building and validating outcome prediction models to support treatment decisions. However, because most outcome prediction models are developed and validated without regard to the causal aspects of treatment decision making, many published outcome prediction models may cause harm when used for decision making, despite being found accurate in validation studies. Guidelines on prediction model validation and the checklist for risk model endorsement by the American Joint Committee on Cancer do not protect against prediction models that are accurate during development and validation but harmful when used for decision making.

Patient vulnerability in stereotactic arrhythmia radioablation (STAR): a preliminary ethical appraisal from the STOPSTORM.eu consortium.

This preliminary ethical appraisal from the STOPSTORM.eu consortium is meant to raise critical points that clinicians administering stereotactic arrhythmia radioablation should consider to meet the highest standards in medical ethics and thus promote quality of life of patients recruited for radiotherapy treatments at a stage in which they experience a significant degree of vulnerability.

Stereotactic Body and Conventional Radiotherapy for Painful Bone Metastases: A Systematic Review and Meta-Analysis.

Importance: Conventional external beam radiotherapy (cEBRT) and stereotactic body radiotherapy (SBRT) are commonly used treatment options for relieving metastatic bone pain. The effectiveness of SBRT compared with cEBRT in pain relief has been a subject of debate, and conflicting results have been reported.

Objective: To compare the effectiveness associated with SBRT vs cEBRT for relieving metastatic bone pain.

A prediction model for response to immune checkpoint inhibition in advanced melanoma.

Predicting who will benefit from treatment with immune checkpoint inhibition (ICI) in patients with advanced melanoma is challenging. We developed a multivariable prediction model for response to ICI, using routinely available clinical data including primary melanoma characteristics. We used a population-based cohort of 3525 patients with advanced cutaneous melanoma treated with anti-PD-1-based therapy.

Refining critical structure contouring in STereotactic Arrhythmia Radioablation (STAR): Benchmark results and consensus guidelines from the STOPSTORM.eu consortium.

Background And Purpose: In patients with recurrent ventricular tachycardia (VT), STereotactic Arrhythmia Radioablation (STAR) shows promising results. The STOPSTORM.eu consortium was established to investigate and harmonise STAR treatment in Europe.

Interobserver variability in target definition for stereotactic arrhythmia radioablation.

Background: Stereotactic arrhythmia radioablation (STAR) is a potential new therapy for patients with refractory ventricular tachycardia (VT). The arrhythmogenic substrate (target) is synthesized from clinical and electro-anatomical information. This study was designed to evaluate the baseline interobserver variability in target delineation for STAR.

Different profiles of neurocognitive functioning in patients with brain metastases prior to brain radiotherapy.

Objective: Patients with brain metastases (BrMs) are a heterogeneous population, with almost 50% experiencing cognitive impairment before brain radiotherapy. Defining pre-radiotherapy cognitive profiles will aid in understanding of the cognitive vulnerabilities and offer valuable insight and guidance for tailoring interventions.

Methods: The study population consisted of 58 adult patients with BrMs referred for radiotherapy.

Evaluating Physiological MRI Parameters in Patients with Brain Metastases Undergoing Stereotactic Radiosurgery-A Preliminary Analysis and Case Report.

Brain metastases occur in ten to thirty percent of the adult cancer population. Treatment consists of different (palliative) options, including stereotactic radiosurgery (SRS). Sensitive MRI biomarkers are needed to better understand radiotherapy-related effects on cerebral physiology and the subsequent effects on neurocognitive functioning.

A Framework for Assessing the Effect of Cardiac and Respiratory Motion for Stereotactic Arrhythmia Radioablation Using a Digital Phantom With a 17-Segment Model: A STOPSTORM.eu Consortium Study.

Purpose: The optimal motion management strategy for patients receiving stereotactic arrhythmia radioablation (STAR) for the treatment of ventricular tachycardia (VT) is not fully known. We developed a framework using a digital phantom to simulate cardiorespiratory motion in combination with different motion management strategies to gain insight into the effect of cardiorespiratory motion on STAR.

Methods And Materials: The 4-dimensional (4D) extended cardiac-torso (XCAT) phantom was expanded with the 17-segment left ventricular (LV) model, which allowed placement of STAR targets in standardized ventricular regions.

Stereotactic Arrhythmia Radioablation (STAR): Assessment of cardiac and respiratory heart motion in ventricular tachycardia patients - A STOPSTORM.eu consortium review.

Aim: To identify the optimal STereotactic Arrhythmia Radioablation (STAR) strategy for individual patients, cardiorespiratory motion of the target volume in combination with different treatment methodologies needs to be evaluated. However, an authoritative overview of the amount of cardiorespiratory motion in ventricular tachycardia (VT) patients is missing.

Methods: In this STOPSTORM consortium study, we performed a literature review to gain insight into cardiorespiratory motion of target volumes for STAR.

Designing clinical trials based on modern imaging and metastasis-directed treatments in patients with oligometastatic breast cancer: a consensus recommendation from the EORTC Imaging and Breast Cancer Groups.

Breast cancer remains the most common cause of cancer death among women. Despite its considerable histological and molecular heterogeneity, those characteristics are not distinguished in most definitions of oligometastatic disease and clinical trials of oligometastatic breast cancer. After an exhaustive review of the literature covering all aspects of oligometastatic breast cancer, 35 experts from the European Organisation for Research and Treatment of Cancer Imaging and Breast Cancer Groups elaborated a Delphi questionnaire aimed at offering consensus recommendations, including oligometastatic breast cancer definition, optimal diagnostic pathways, and clinical trials required to evaluate the effect of diagnostic imaging strategies and metastasis-directed therapies.

Accelerated respiratory-resolved 4D-MRI with separable spatio-temporal neural networks.

Background: Respiratory-resolved four-dimensional magnetic resonance imaging (4D-MRI) provides essential motion information for accurate radiation treatments of mobile tumors. However, obtaining high-quality 4D-MRI suffers from long acquisition and reconstruction times.

Purpose: To develop a deep learning architecture to quickly acquire and reconstruct high-quality 4D-MRI, enabling accurate motion quantification for MRI-guided radiotherapy (MRIgRT).

Exploring contrast generalisation in deep learning-based brain MRI-to-CT synthesis.

Background: Synthetic computed tomography (sCT) has been proposed and increasingly clinically adopted to enable magnetic resonance imaging (MRI)-based radiotherapy. Deep learning (DL) has recently demonstrated the ability to generate accurate sCT from fixed MRI acquisitions. However, MRI protocols may change over time or differ between centres resulting in low-quality sCT due to poor model generalisation.