Publications by authors named "Wan Yuo Guo"

The chapter explores the extensive integration of artificial intelligence (AI) in healthcare systems, with a specific focus on its application in stereotactic radiosurgery. The rapid evolution of AI technology has led to promising developments in this field, particularly through the utilization of machine learning and deep learning models. The diverse implementation of AI algorithms was developed from various aspects of radiosurgery, including the successful detection of spontaneous tumors and the automated delineation or segmentation of lesions.

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This research examined the distinctions in brain network characteristics among individuals with Alzheimer's disease (AD), mild cognitive impairment (MCI), and a control group. Magnetic resonance imaging (MRI) and mini-mental state examination (MMSE) data were retrieved from the Alzheimer's Disease Neuroimaging Initiative (ANDI) database, comprising 40 subjects in each group. Correlation maps for evaluating brain network connectivity were generated using fractal dimension (FD) analysis, a method capable of quantifying morphological changes in cortical and cerebral regions.

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Background And Objectives: Treatment selection for brain arteriovenous malformations (BAVMs) is complicated by BAVM size, location, and hemodynamics. Quantitative digital subtraction angiography is used to quantify the hemodynamic impact of BAVMs on cerebral circulation. This study investigated the association between cerebral circulation time and the complete obliteration (CO) rate of BAVMs after stereotactic radiosurgery (SRS).

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Article Synopsis
  • The study aimed to determine if the morphology (compact vs. diffuse) of brain arteriovenous malformations (bAVMs) influences the rate of hemorrhagic events in patients undergoing Stereotactic Radiosurgery (SRS).
  • It analyzed 262 adult patients with unruptured bAVMs, revealing that hemorrhagic events occurred in 5.0% of patients, with a higher risk associated with larger and diffuse bAVMs.
  • Findings suggest that compact and smaller bAVMs, along with a higher prescribed treatment dose, are linked to lower hemorrhage risks, which could inform clinical decision-making regarding SRS treatment plans.
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Article Synopsis
  • This study reviewed clinical cases of expanding cysts and hematomas that occurred after gamma knife surgery (GKS) for treating arteriovenous malformations (AVMs) over a 30-year period.
  • Out of 1072 AVM patients treated, 18 exhibited these complications, with an average onset of 8.6 years post-GKS; 72.2% of the affected patients required surgical intervention.
  • The research suggests that both complications may stem from similar mechanisms of radiation-induced damage to surrounding blood vessels, leading to inflammation and tissue changes.
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Objective: The goal of this study was to assess the safety and efficacy of single-session Gamma Knife radiosurgery (GKRS) for orbital cavernous hemangiomas (OCHs).

Methods: Patients who presented with an OCH between September 1999 and May 2022 and were treated with single-session GKRS were included in this single-center cohort study.

Results: There were 23 patients (7 males and 16 females) in this study.

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Purpose: To examine the differential effects of SRS and TKI on EGFR-mutated NSCLC patients with brain metastases (BMs) and outcomes following continuation of the same TKI agent in case of new BMs.

Methods: This study included 608 NSCLC patients (2,274 BMs) while meta-analyses included 1,651 NSCLC patients (> 3,944 BMs). Overall survival (OS) and intracranial progression free survival (iPFS) were estimated using Kaplan-Meier methods.

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Purpose: Given the availability of TKIs with high central nervous system efficacy, the question arises as to whether upfront SRS provides additional clinical benefits. The goal of this study was to characterize the clinical outcomes of SRS as salvage therapy for TKI-uncontrolled BMs.

Methods: This retrospective study included EGFR-mutant NSCLC patients presenting BMs at the time of primary tumor diagnosis.

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Background: Deep learning-based segmentation algorithms usually required large or multi-institute data sets to improve the performance and ability of generalization. However, protecting patient privacy is a key concern in the multi-institutional studies when conventional centralized learning (CL) is used.

Purpose: To explores the feasibility of a proposed lesion delineation for stereotactic radiosurgery (SRS) scheme for federated learning (FL), which can solve decentralization and privacy protection concerns.

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Background And Objectives: The pathophysiology of vestibular schwannoma (VS) pseudoprogression after Gamma Knife radiosurgery (GKRS) remains unclear. Radiological features in pretreatment magnetic resonance images may help predict VS pseudoprogression. This study used VS radiological features quantified using an automated segmentation algorithm to predict pseudoprogression after GKRS treatment.

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Background: The hemorrhage risk of unruptured and untreated cerebral arteriovenous malformations (AVMs) has been shown to be higher for female patients than male patients in their child bearing ages. Although it has been neurosurgical practice to advise female patients in their childbearing ages to postpone pregnancy until proven AVM obliteration, there is no literature consensus regarding this potential hemorrhage risk increase.

Objective: To accurately quantify the risk increase for AVM hemorrhage during pregnancy.

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The early prediction of overall survival (OS) in patients with lung cancer brain metastases (BMs) after Gamma Knife radiosurgery (GKRS) can facilitate patient management and outcome improvement. However, the disease progression is influenced by multiple factors, such as patient characteristics and treatment strategies, and hence satisfactory performance of OS prediction remains challenging. Accordingly, we proposed a deep learning approach based on comprehensive predictors, including clinical, imaging, and genetic information, to accomplish reliable and personalized OS prediction in patients with BMs after receiving GKRS.

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Objective: Stereotactic radiosurgery (SRS) is an effective treatment for brain metastases (BMs) in patients with non-small cell lung cancer (NSCLC). However, factors associated with the development of post-SRS leptomeningeal metastasis (LM) remain unclear. The authors analyzed the incidence and risk factors of LM development in patients with NSCLC and BMs after SRS and examined the survival outcomes and prognostic factors after LM development.

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(1) Background: Surgical resection for the removal of brain metastases often fails to prevent tumor recurrence within the surgical cavity; hence, researchers are divided as to the benefits of radiation treatment following surgical resection. This retrospective study assessed the effects of post-operative stereotactic radiosurgery (SRS) on local tumor control and overall survival. (2) Methods: This study examined the demographics, original tumor characteristics, and surgical outcomes of 97 patients who underwent Gamma Knife Radiosurgery (GKRS) treatment (103 brain metastases).

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Background: Rapid evolution of artificial intelligence (AI) prompted its wide application in healthcare systems. Stereotactic radiosurgery served as a good candidate for AI model development and achieved encouraging result in recent years. This article aimed at demonstrating current AI application in radiosurgery.

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Purpose: Metastases extending to the pituitary gland and cavernous sinus are extremely rare; however, advances in neuroimaging have increased the reported incidence. Stereotactic radiosurgery (SRS) affords the precise delivery of focused radiation to minimize adverse radiation effects. This study assessed the efficacy and safety of SRS in the treatment of pituitary and cavernous sinus metastases.

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Background And Objective: GKRS is an effective treatment for smaller intracranial tumors with a high control rate and low risk of complications. Target delineation in medical MR images is essential in the planning of GKRS and follow-up. A deep learning-based algorithm can effectively segment the targets from medical images and has been widely explored.

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Objective: To investigate the association between the magnetic resonance imaging (MRI) signal characteristics of skull base chordoma and radiosurgical outcomes.

Methods: Twenty-four patients with skull base chordomas treated with Gamma Knife radiosurgery (GKRS) after previous surgical resection were retrospectively (2001-2021) examined. Pre-GKRS MRIs were analyzed for R (tumor-to-brainstem signal intensity ratio on T2-weighted imaging), R (tumor-to-brainstem signal intensity ratio on contrast-enhanced T1-weighted imaging), and mean apparent diffusion coefficient (ADC).

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Article Synopsis
  • Whole brain radiation therapy (WBRT) increases the risk of leukoencephalopathy compared to stereotactic radiosurgery (SRS) alone for treating brain metastases.
  • The study analyzed data from 993 patients and found that factors like older age and larger tumor volume are linked to higher leukoencephalopathy incidence.
  • SRS is deemed safe for oligo-brain metastases, as combining it with WBRT does not significantly raise the risk of leukoencephalopathy.
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Purpose: In this study we report our 30-year experience in stereotactic radiosurgery (SRS) treatment of lung squamous cell carcinoma (LUSC) brain metastases (BMs). It will serve to provide detailed longitudinal outcomes and predictors of efficacy in treating LUSC-BMs with SRS.

Method: We retrospectively reviewed 51 patients and 109 tumors treated with SRS at our center between 1993 and 2022.

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Background: Knowledge about the natural course of brain arteriovenous malformations (AVMs) have increased during the past 20 years, as has the number of AVMs treated, especially larger ones. It is thus timely to again analyze the risk for hemorrhage after Gamma Knife Surgery (GKS).

Objective: To confirm or contradict conclusions drawn 20 years ago regarding factors that affect the risk for post-GKS hemorrhage.

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Objective: Tyrosine kinase inhibitors (TKIs) is the first-line treatment for EGFR-positive non-small cell lung cancer (NSCLC); however, its applicability to patients with wild-type NSCLC remains an issue of contention. This study compared the effects of gamma knife radiosurgery (GKRS) alone versus combining GKRS and TKIs in treating two genetic forms of NSCLC.

Methods: This retrospective study examined 479 NSCLC patients with 1982 brain metastases who underwent GKRS and for whom imaging follow-up data or death records were available.

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Objective: To explore the impact of outflow patency on radiosurgical outcomes of lateral sinus dural arteriovenous fistulas (DAVFs).

Methods: We retrospectively examined 83 lateral sinus DAVFs treated with Gamma Knife radiosurgery (GKRS) between 1995 and 2020. Two neuroradiologists blinded to the therapeutic outcomes served as imaging evaluators on pre-GKRS digital subtraction angiography and magnetic resonance images.

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Purpose: To investigate sinovenous outflow restriction (SOR) in lateral sinus dural arteriovenous fistulas (LSDAVFs) after Gamma Knife radiosurgery (GKRS) and its association with complete obliteration.

Methods: We retrospectively (1995-2019) enrolled 39 patients with LSDAVFs who had undergone GKRS alone and evaluated their angiography and magnetic resonance imaging (MRI) before and after GKRS. The LS conduits ipsilateral and contralateral to the DAVFs were scored using a 5-point scoring system, with scores ranging from 0 (total occlusion) to 4 (fully patent).

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