Radiographic Predictors of Occult Intracranial Involvement in Olfactory Neuroblastoma Patients
Bibliographic record
Abstract
Background: Traditional management of olfactory neuroblastoma (ONB) includes margin negative resection with removal of the cribriform plate, dura, and olfactory bulb, regardless of evidence of intracranial disease. The aim of this multi-institutional study was to examine clinical covariates associated with occult intracranial involvement to understand the application of elective skull base resection. Methods: Data from 9 North American academic centers (2005–2021) was retrospectively reviewed. Patient demographics, tumor staging, Hyam's grade and pathologic positivity of the dura, olfactory bulb/tract and brain were considered. Diagnostic imaging characterized risks factors for intracranial extension. Positive-predictive value (PPV) and negative-predictive value (NPV) were estimated. Hazard regression was performed for 24-month and 60-month overall survival (OS) and disease-free survival (DFS). Results: A total of 224 ONB patients were included. CT scans had the highest NPV for pathologic dura (88%) and olfactory bulb (88%) involvement. MRI had a NPV for dura and olfactory bulb involvement of 75 and 86%, respectively. Higher Hyam's grade was significantly associated with dural involvement (?2 = 12.04; p = 0.017). Subjects without any radiologically evident skull base involvement ( n = 66) had a rate of pathologic positivity of 12.1%. Within this subgroup, Hyam's grade was clinically significant for dural positivity (?2 = 3.50; p = 0.061) with 28.6% involvement in high-grade tumors. Neither clinical nor pathologic positivity of intracranial structures were associated with worse OS or DFS. Conclusions: The prevalence of occult dural and olfactory bulb involvement was 12.1%. Both CT and MRI had reasonably good NPV for involvement of dura and olfactory bulb. Higher Hyam's grade was associated with dural involvement. Patients with low-grade tumors not involving the skull base may be suitable for avoiding skull base resection, however further investigation is warranted. Publication History Article published online: 01 February 2023 © 2023. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".