ArticleActa neurochirurgica2023
When is a staging scan required for newly diagnosed brain lesions on CT? A multivariate logistic regression analysis.
Article in Acta neurochirurgica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 citing papers in PubMed, 1 citations in OpenAlex.
- Article
- Perioperative management of patients with glioblastoma copresenting with pheochromocytoma: illustrative case.Journal of neurosurgery. Case lessons · 2024Article
- Additional imaging for newly diagnosed brain lesions suspected to be brain tumors.Acta neurochirurgica · 2023Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFor patients with a new lesion on CT head (CTH) suspected to be a brain tumor, a staging chest, abdomen, and pelvis CT (CTCAP) is only warranted if a metastatic lesion is suspected. Unnecessary CTCAPs are often performed too early in a patient's journey due to poor patient selection. We sought to create a protocol to guide the selection of patients for CTCAPs based on their CTH findings.
methodsPatients with suspected new brain tumors discussed at the neuro-oncology MDT at a tertiary neurosurgical center were reviewed. Patient demographics and CTH features were collected. For protocol creation, data was collected from July to December 2020, and predictor variables were identified using multivariate logistic regression. Candidate protocols were assessed in a protocol testing stage using similar data collected from January to June 2021. Sensitivity, specificity, and area under the curve (AUC) were computed for each protocol.
resultsVariables from the protocol creation stage (222 patients) were assessed in the protocol testing stage (216 patients). The most sensitive variables predicting metastatic disease were a previous history of cancer, multiple lesions, lesion < 4 cm, and infratentorial location. A protocol recommending a CTCAP based on the presence of one of these features has a sensitivity of 99.1% (AUC 0.704).
conclusionsUnnecessary CTCAPs are reduced if performed only if a patient has one of the four identified predictor variables.
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