Abstract

PURPOSE: The aim of glioblastoma surgery is to maximize the extent of resection while preserving functional integrity, which depends on the location within the brain. A standard to compare these decisions is lacking. We present a volumetric voxel-wise method for direct comparison between two multidisciplinary teams of glioblastoma surgery decisions throughout the brain.

METHODS: Adults undergoing first-time glioblastoma surgery from 2012 to 2013 performed by two neuro-oncologic teams were included. Patients had had a diagnostic biopsy or resection. Preoperative tumors and postoperative residues were segmented on magnetic resonance imaging in three dimensions and registered to standard brain space. Voxel-wise probability maps of tumor location, biopsy, and resection were constructed for each team to compare patient referral bias, indication variation, and treatment variation. To evaluate the quality of care, subgroups of differentially resected brain regions were analyzed for survival and functional outcome.

RESULTS: One team included 101 patients, and the other included 174; 91 tumors were biopsied, and 181 were resected. Patient characteristics were largely comparable between teams. Distributions of tumor locations were dissimilar, suggesting referral bias. Distributions of biopsies were similar, suggesting absence of indication variation. Differentially resected regions were identified in the anterior limb of the right internal capsule and the right caudate nucleus, indicating treatment variation. Patients with (n = 12) and without (n = 6) surgical removal in these regions had similar overall survival and similar permanent neurologic deficits.

CONCLUSION: Probability maps of tumor location, biopsy, and resection provide additional information that can inform surgical decision making across multidisciplinary teams for patients with glioblastoma.

Original languageEnglish
Pages (from-to)1-12
Number of pages12
JournalJCO clinical cancer informatics
Issue number3
DOIs
Publication statusPublished - Jan 2019

Cite this

@article{4cb6a99964b242d0af0ddc245b18dd1a,
title = "Comparing Glioblastoma Surgery Decisions Between Teams Using Brain Maps of Tumor Locations, Biopsies, and Resections",
abstract = "PURPOSE: The aim of glioblastoma surgery is to maximize the extent of resection while preserving functional integrity, which depends on the location within the brain. A standard to compare these decisions is lacking. We present a volumetric voxel-wise method for direct comparison between two multidisciplinary teams of glioblastoma surgery decisions throughout the brain.METHODS: Adults undergoing first-time glioblastoma surgery from 2012 to 2013 performed by two neuro-oncologic teams were included. Patients had had a diagnostic biopsy or resection. Preoperative tumors and postoperative residues were segmented on magnetic resonance imaging in three dimensions and registered to standard brain space. Voxel-wise probability maps of tumor location, biopsy, and resection were constructed for each team to compare patient referral bias, indication variation, and treatment variation. To evaluate the quality of care, subgroups of differentially resected brain regions were analyzed for survival and functional outcome.RESULTS: One team included 101 patients, and the other included 174; 91 tumors were biopsied, and 181 were resected. Patient characteristics were largely comparable between teams. Distributions of tumor locations were dissimilar, suggesting referral bias. Distributions of biopsies were similar, suggesting absence of indication variation. Differentially resected regions were identified in the anterior limb of the right internal capsule and the right caudate nucleus, indicating treatment variation. Patients with (n = 12) and without (n = 6) surgical removal in these regions had similar overall survival and similar permanent neurologic deficits.CONCLUSION: Probability maps of tumor location, biopsy, and resection provide additional information that can inform surgical decision making across multidisciplinary teams for patients with glioblastoma.",
author = "M{\"u}ller, {Domenique M J} and Robe, {Pierre A J T} and Eijgelaar, {Roelant S} and Witte, {Marnix G} and Martin Visser and {de Munck}, {Jan C} and Broekman, {Marieke L D} and Tatjana Seute and Jeroen Hendrikse and Noske, {David P} and Vandertop, {William P} and Frederik Barkhof and Kouwenhoven, {Mathilde C M} and Emmanuel Mandonnet and Berger, {Mitchel S} and {De Witt Hamer}, {Philip C}",
year = "2019",
month = "1",
doi = "10.1200/CCI.18.00089",
language = "English",
pages = "1--12",
journal = "JCO clinical cancer informatics",
issn = "2473-4276",
publisher = "American Society of Clinical Oncology",
number = "3",

}

Comparing Glioblastoma Surgery Decisions Between Teams Using Brain Maps of Tumor Locations, Biopsies, and Resections. / Müller, Domenique M J; Robe, Pierre A J T; Eijgelaar, Roelant S; Witte, Marnix G; Visser, Martin; de Munck, Jan C; Broekman, Marieke L D; Seute, Tatjana; Hendrikse, Jeroen; Noske, David P; Vandertop, William P; Barkhof, Frederik; Kouwenhoven, Mathilde C M; Mandonnet, Emmanuel; Berger, Mitchel S; De Witt Hamer, Philip C.

In: JCO clinical cancer informatics, No. 3, 01.2019, p. 1-12.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Comparing Glioblastoma Surgery Decisions Between Teams Using Brain Maps of Tumor Locations, Biopsies, and Resections

AU - Müller, Domenique M J

AU - Robe, Pierre A J T

AU - Eijgelaar, Roelant S

AU - Witte, Marnix G

AU - Visser, Martin

AU - de Munck, Jan C

AU - Broekman, Marieke L D

AU - Seute, Tatjana

AU - Hendrikse, Jeroen

AU - Noske, David P

AU - Vandertop, William P

AU - Barkhof, Frederik

AU - Kouwenhoven, Mathilde C M

AU - Mandonnet, Emmanuel

AU - Berger, Mitchel S

AU - De Witt Hamer, Philip C

PY - 2019/1

Y1 - 2019/1

N2 - PURPOSE: The aim of glioblastoma surgery is to maximize the extent of resection while preserving functional integrity, which depends on the location within the brain. A standard to compare these decisions is lacking. We present a volumetric voxel-wise method for direct comparison between two multidisciplinary teams of glioblastoma surgery decisions throughout the brain.METHODS: Adults undergoing first-time glioblastoma surgery from 2012 to 2013 performed by two neuro-oncologic teams were included. Patients had had a diagnostic biopsy or resection. Preoperative tumors and postoperative residues were segmented on magnetic resonance imaging in three dimensions and registered to standard brain space. Voxel-wise probability maps of tumor location, biopsy, and resection were constructed for each team to compare patient referral bias, indication variation, and treatment variation. To evaluate the quality of care, subgroups of differentially resected brain regions were analyzed for survival and functional outcome.RESULTS: One team included 101 patients, and the other included 174; 91 tumors were biopsied, and 181 were resected. Patient characteristics were largely comparable between teams. Distributions of tumor locations were dissimilar, suggesting referral bias. Distributions of biopsies were similar, suggesting absence of indication variation. Differentially resected regions were identified in the anterior limb of the right internal capsule and the right caudate nucleus, indicating treatment variation. Patients with (n = 12) and without (n = 6) surgical removal in these regions had similar overall survival and similar permanent neurologic deficits.CONCLUSION: Probability maps of tumor location, biopsy, and resection provide additional information that can inform surgical decision making across multidisciplinary teams for patients with glioblastoma.

AB - PURPOSE: The aim of glioblastoma surgery is to maximize the extent of resection while preserving functional integrity, which depends on the location within the brain. A standard to compare these decisions is lacking. We present a volumetric voxel-wise method for direct comparison between two multidisciplinary teams of glioblastoma surgery decisions throughout the brain.METHODS: Adults undergoing first-time glioblastoma surgery from 2012 to 2013 performed by two neuro-oncologic teams were included. Patients had had a diagnostic biopsy or resection. Preoperative tumors and postoperative residues were segmented on magnetic resonance imaging in three dimensions and registered to standard brain space. Voxel-wise probability maps of tumor location, biopsy, and resection were constructed for each team to compare patient referral bias, indication variation, and treatment variation. To evaluate the quality of care, subgroups of differentially resected brain regions were analyzed for survival and functional outcome.RESULTS: One team included 101 patients, and the other included 174; 91 tumors were biopsied, and 181 were resected. Patient characteristics were largely comparable between teams. Distributions of tumor locations were dissimilar, suggesting referral bias. Distributions of biopsies were similar, suggesting absence of indication variation. Differentially resected regions were identified in the anterior limb of the right internal capsule and the right caudate nucleus, indicating treatment variation. Patients with (n = 12) and without (n = 6) surgical removal in these regions had similar overall survival and similar permanent neurologic deficits.CONCLUSION: Probability maps of tumor location, biopsy, and resection provide additional information that can inform surgical decision making across multidisciplinary teams for patients with glioblastoma.

UR - http://www.mendeley.com/research/comparing-glioblastoma-surgery-decisions-between-teams-using-brain-maps-tumor-locations-biopsies-res

U2 - 10.1200/CCI.18.00089

DO - 10.1200/CCI.18.00089

M3 - Article

SP - 1

EP - 12

JO - JCO clinical cancer informatics

JF - JCO clinical cancer informatics

SN - 2473-4276

IS - 3

ER -