Editorial: Gamma Knife radiosurgery and nonfunctioning pituitary adenomas
Bibliographic record
Abstract
The publication of Lee et al. is a useful and well-written addition to the literature.1 They analyze, based on a review of previous studies and their own experience, the advantages and disadvantages of Gamma Knife radiosurgery (GKRS) in the treatment of patients with clinically nonfunctioning pituitary adenomas. The results of GKRS are also compared with those produced by conventional resection. Clinically nonfunctioning pituitary adenomas represent the most frequent pituitary adenoma type among pituitary tumors. Medical treatment is not available, and pituitary tumor irradiation has several significant disadvantages. Thus, the question is, Gamma Knife surgery or conventional resection? The authors conclude that in older patients (older than 70 years) and in patients with other comorbidities in whom surgical intervention is contraindicated, initial GKRS is an acceptable alternative. Obviously, as the authors emphasize, an experienced team is needed to decide which treatment to use and to undertake the GKRS. One great disadvantage of GKRS is that the tumor is not investigated by pathologists. Morphological investigation is of crucial importance. Several diseases can mimic pituitary adenomas: for example, other primary intrasellar neoplasms, metastatic tumors, inflammatory diseases, and others. We have seen several metastatic carcinomas arising from the lung, colon, and other organs, which were mis diagnosed as pituitary adenomas! Another reason morphological investigation is important is that it allows one to draw conclusions regarding the growth potential of tumor cells. We can assess the Ki 67 nuclear labeling index, a valuable method of revealing the cell proliferation rate. Maybe in the future new drugs will be developed, which will permit medical therapy. Advances in molecular/genetic methods may provide an alternative treatment option as well. Obviously, more studies are needed to decide whether one should use GKRS and in which patients. (http://thejns.org/doi/abs/10.3171/2013.10.JNS132248) Disclosure
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.017 |
| Meta-epidemiology (narrow) | 0.005 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.005 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.004 | 0.001 |
| Research integrity | 0.013 | 0.017 |
| Insufficient payload (model declined to judge) | 0.006 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".