Evidence map›Paper›PMID 38550377›Full record

ArticleAdvances in radiation oncology2024

Image Guided Intraoperative Radiation Therapy After Surgical Resection of Brain Metastases: A First In-Human Feasibility Report.

Molina Grimmer, Gustavo R Sarria, Motaz Hamed, Mohammed Banat, Fabian Kugel, Hector Lorenzana, Davide Scafa, Mümtaz Köksal, Julian P Layer, Cas Dejonckheere and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Advances in radiation oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.7field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 2 institutions in 1 country.

Molina GrimmerDepartment of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany.
Gustavo R SarriaDepartment of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany.
Motaz HamedDepartment of Neurosurgery, University Hospital Bonn, University of Bonn, Bonn, Germany.
Mohammed BanatDepartment of Neurosurgery, University Hospital Bonn, University of Bonn, Bonn, Germany.
Fabian KugelDepartment of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany.
Hector LorenzanaDepartment of Neurosurgery, University Hospital Bonn, University of Bonn, Bonn, Germany.
Davide ScafaDepartment of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany.
Mümtaz KöksalDepartment of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany.
Julian P LayerDepartment of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany.
Cas DejonckheereDepartment of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany.
Martin FiebichTechnische Hochschule Mittelhessen, Gießen, Germany.
Frederic Carsten SchmeelDepartment of Neuroradiology, University Hospital Bonn, University of Bonn, Bonn, Germany.
Ana KowarkDepartment of Neurosurgical Anesthesia, University Hospital Bonn, University of Bonn, Bonn, Germany.
Hartmut VatterDepartment of Neurosurgery, University Hospital Bonn, University of Bonn, Bonn, Germany.
Leonard Christopher SchmeelDepartment of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany.
Stephan GarbeDepartment of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany.
University of Bonn · DETechnische Hochschule Mittelhessen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: A correct placement of the applicator during intraoperative radiation therapy for brain metastasis is of paramount importance, to deliver a precise and safe treatment. The applicator-to-surface contact assessment cannot be performed under direct observation because the applicator itself limits the visual range. No image guided verification is currently performed intracranially. We hypothesize that image guided intraoperative radiation therapy would assure a more precise delivery in the target area. We describe our workflow in a first in-human experience. Methods and Materials: Phantom-based measurements were performed to reach the best cone beam computed tomography imaging quality possible. Once defined, a clinical feasibility study was initiated. An in-room cone beam computed tomography device is used to acquire intraoperative images after placing the applicator. Repositioning the applicator is thereafter discussed with the surgeon, according to the imaging outcomes, if required. Results: An optimal image quality was achieved with 120-kV voltage, 20-mA current, and a tube current time product of 150 mAs. An additional 0.51 mSv patient exposure was calculated for the entire procedure. The wide dynamic range (-600 HU to +600 HU) of cone beam computed tomography and a 27 HU mean computed tomography values difference between brain tissue and spherical applicator allows distinguishing both structures. In this first in-human experience, the applicator was repositioned after evidencing air gaps, assuring full applicator-to-surface contact. Conclusions: This first in-human procedure confirmed the feasibility of kilovoltage image guided intraoperative radiation therapy in a neurosurgical setting. A prospective study has been initiated and will provide further dosimetric details.

Identifiers

PMID38550377
PMCPMC10965430
OpenAlexW4392734383

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.