P10.18 The impact of clinical functional MRI on surgical decision making in low grade glioma - a survey of Canadian neurosurgeons
Notice bibliographique
Résumé
BACKGROUND: The goal of brain tumour resection is maximal removal of unhealthy tissue with minimal disruption of neurological function. For tumours in eloquent cortical regions, the balance between maximal tumour resection and preservation of functional tissue is exceedingly delicate. The tools available to surgeons to determine patients’ functional anatomy tend to be invasive. Functional magnetic resonance imaging (fMRI) is a non-invasive, and increasingly popular tool for functional mapping in neurosurgical patients. However, no widely used guidelines for the use of fMRI in neurosurgical patients currently exist. In this study, we are conducting a survey of Canadian neurosurgeons to elucidate how they use fMRI, and how it impacts their approach to patients with intracranial low grade glioma (LGG). METHODS: A 15-25 minute survey was created using an online survey tool. It has been distributed to neurosurgery staff and trainees at the London Health Sciences Centre (LHSC) through email, and in the future will be distributed to members of the Canadian Neurosurgical Society (CNS). The survey consists of two sections - background, and case-based decision making. In the background section, respondents are asked questions related to their practice, typical approach to LGG, and use of fMRI. In the case-based section, five cases of patients with LGG who underwent preoperative fMRI are presented. Initially structural MRI and clinical details of each case are provided, and respondents are asked about their preferred management, confidence in their preferred treatment, and predicted risk of surgical complications. Subsequently, respondents are also presented with fMRI details of each case, and asked an identical series of questions. Results: We collected 6 surveys of 24 distributed to neurosurgery staff and trainees at LHSC. On average, respondents stated they order preoperative fMRI for 9% of brain tumour patients. 67% of respondents stated they are comfortable ordering and interpreting fMRI for brain tumour patients, 17% stated they are not comfortable, and 17% stated they are neither comfortable nor uncomfortable. No respondents expressed a preference for early surgical intervention for LGG patients, 50% prefer watchful waiting, and 50% expressed no preference. In the case-based section, fMRI data did not tend to affect respondents’ preferred treatment, confidence in their treatment, or their predicted risk of surgical complications. We expect to collect 59-147 completed national surveys, based on a predicted 20-50% response rate of 293 CNS members. Conclusions: We expect this study to elucidate how Canadian neurosurgeons use fMRI in practice, and if fMRI allows them to recommend more aggressive surgical treatment for LGG patients with greater confidence.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».