bluuebunny/crossref_metadata_2025_split huggingface dataset:
STMO-21 The Outcome of tumor resection followed by photodynamic therapy for recurrent glioblastoma
Authors: Kobayashi Tatsuya , Nitta Masayuki , Shimizu Kazuhide , Saito Taiichi , Maruyama Takashi , Komori Takashi , Muragaki Yoshihiro , Kawamata Takakazu 
Published: December 2021

Abstract
Recurrent glioblastoma remains a clinical problem with no standard treatment and quite a few effective treatment options. We evaluated the efficacy of photodynamic therapy (PDT) using talaporfin sodium (TS) as a treatment for recurrent glioblastoma in a retrospective analysis of 70 patients who underwent PDT with surgery (PDT group) between 2014 and 2018, and 38 patients who underwent surgery alone (control group) during the same period. The median overall survival (OS) of the PDT and control groups were 16.03 and 12.75 months, respectively (P=0.0311). The median progression-free survival (PFS) of these two groups were 5.67 and 2.2 months, respectively (P=0.00428). Univariate and multivariate analyses showed PDT with surgery and preoperative Karnofsky Performance Scale as significant independent prognostic factors for both PFS and OS.On the other hand, IDH mutation and previous pathology before recurrence were not significant prognostic factors in this study. In the PDT group, there was no significant difference in PFS and OS between patients with GBM from the previous pathology before recurrence and those with malignant transformation to GBM from lower-grade glioma. Furthermore, there was also no significant difference in TS accumulation in the tumor between these two groups. These results suggest that additional PDT treatment for recurrent glioblastoma can have potential survival benefits and that its efficacy is independent of the pathology before recurrence or IDH status.
NI-8 Molecular diagnostic prediction combining T2-FLAIR mismatch sign, calcification, and methionine PET in grade II and III gliomas
Authors: Ebiko Yusuke , Tamura Kaoru , Hara Shoko , Inaji Motoki , Tanaka Yoji , Nariai Tadashi , Ishii Kenji , Maehara Taketoshi 
Published: December 2021

Abstract
Background: The 2016 WHO Classification classified grade II and III gliomas into three molecular subtypes depending on the presence of IDH mutation and 1p/19q codeletion. We combined T2-FLAIR mismatch sign, tumor calcification, and methionine PET uptake to examine whether molecular diagnosis could be predicted.
Methods: 53 grade II and III glioma patients with preoperative MRI, CT, and MET-PET who underwent surgical resection or biopsy during 2000–2019 were included in this study. Out of the 53 cases, astrocytic tumors (A group: IDH-mutant, 1p19q non-codeleted) were 17, oligodendroglial tumors (O group: IDH-mutant, 1p19q codeleted) were 15, and IDH wild tumors (W group) were 21. MR and CT scans were evaluated by 3 independent reviewers to assess presence/absence of T2-FLAIR mismatch sign and calcification in the tumor, respectively. The tumor-to-normal (T/N) ratio of methionine uptake was calculated by dividing the maximum standardized uptake value (SUV) for the tumor by the mean SUV of the normal brain.
Results: Out of the 53 cases, T2-FLAIR mismatch sign was present in 6 cases in group A and 9 cases in group W (p=0.008). Calcification in tumor was present in 2 cases in group A, 7 cases in group O, and 3 cases in group W (p=0.046). In the T2-FLAIR mismatch-positive cases, assuming MET-PET T/N&gt;1.401 was group W and &lt;1.401 was group A, sensitivity was 100% and specificity was 67%. In the T2-FLAIR mismatch-negative and calcification-positive cases, assuming those group O, the diagnostic predictive value was 70%. In the T2-FLAIR mismatch-negative and calcification-negative cases, assuming MET-PET T/N&gt;2.349 was group W and &lt;2.349 was group A or O, sensitivity was 60% and specificity was 94%.
Conclusions: Combined diagnostic prediction of T2-FLAIR mismatch, calcification, and MET-PET T/N may be useful for preoperative molecular diagnosis of grade II and III gliomas.
NI-16 Verification of APT image and relationship with T2/FLAIR mismatch sign in WHO2016 brain tumor pathology classification
Authors: Shirota Masami , Nitta Masayuki , Saito Taiichi , Tsuduki Syunsuke , Fukui Atsushi , Ikuta Souko , Yoshida Ayako , Muragaki Yoshihiro , Kawamata Takakazu 
Published: December 2021

Abstract
Introduction: Amide Proton Transfer Imaging(APT)is an MRI imaging method that images the increased concentration of amide groups in tumors and is expected to be clinically applied to the diagnostic imaging of gliomas.On the other hand,T2/FLAIR mismatch sign(T2/FLms)has been proposed as an MRI finding specific to astrocytoma with IDH gene mutation.This time,in the WHO2016 Brain Tumor Pathological Classification,we report the verification of the pathological gene classification of APT and the retrospective verification based on the pathological diagnosis results of whether there is a relationship between APT and T2/FLms. Method: We examined 88 cases of preoperative glioma (Grade:G2/3/4)in which APT/T2/FLAIR was imaged.resultIt showed a high value in high malignancy and a significant difference was observed.In the verification of genetic classification, the measured APT values were 1.91 ±0.71 for oligodendroglioma(16 cases),2.58±0.17 for astrocytoma(2 cases),2.40±0.90 for anaplastic oligodendroglioma(12 cases),Anaplastic astrocytoma(20 cases)2.63±0.42,The oligodendroglioma system showed lower values than the astrocytoma system.For anaplastic astrocytoma IDH mutant and glioblastoma IDH mutant,APT measurement values were measured after evaluating the presence or absence of T2/FL ms. APT measured values are anaplastic astrocytoma IDH mutant T2/FL ms present(7 cases) 2.63±0.38,T2/FL ms not (5 cases) 2.76±0.37, glioblastoma IDH mutant T2/FL ms present(5 cases)2.67±0.50, no T2/FL ms(3 cases)3.48±0.27,suggesting low APT measured values with T2/FL ms,respectively.ConclusionIn the verification of genetic classification, the oligodendroglioma system shows a lower value than the astrocytoma system,and it is considered that it can be one of the options such as treatment policy.Regarding the relationship between T2/FL ms and APT,it was suggested that the APT measured value with T2/FL ms tended to be low,but since it wasreported that the sensitivity of T2/FL ms was 30%,it was verified by accumulating cases.is required.
NQPC-7 Rehabilitation program toward reinstatement support based on network construction among related departments for the patients after treatment of brain disease including brain tumor
Authors: Ideguchi Makoto , Matsutani Masao , Sato Akira , Muraya Shoichi , Takahashi Toshiko , Omata Akiko 
Published: December 2021

Abstract
Introduction: We have conducted a rehabilitation program to support a return to work for patients with brain disease since 2019. The program focuses on independence in the home environment; physical ability for desk work, commuting and conversation; and concentration and executive ability in the office. The “Promotion of Health and Employment Support” document of the Ministry of Health, Labour and Welfare has been used to update the program since May 2021. Here, we report the status of this program.Methods: Patients desiring employment reinstatement attended the program. A doctor first gave an overview. Social workers then used the QLQ-C30/BN-20 questionnaire to assess mental and physical health, a therapist evaluated physical and higher cognitive function, and nurses advised on work-life balance and mental state. This information was used to develop suitable rehabilitation for each patient. The employment situation was surveyed after discharge. Results: The program included 77 patients (55 men, 22 women, mean age 54) from January 2019 to July 2021, after treatment for stroke (n=55), brain tumor (n=14), and traumatic brain injury or other conditions (n=8). FIM (94.2) and MMSE (26.3) at admission indicated that almost all patients were independent in ADL. A return to work was achieved by 25 (83%) of the 30 patients that could be investigated, including all 4 with brain tumors. The period until reinstatement was &lt;1 month in 16 cases, but &gt;1 month in 3 with brain tumors. The program was found useful by 26 patients (86%). Employment reinstatement was not achieved due to company reasons and family circumstances. Only 4 patients were interviewed by an industrial physician. Conclusion: The physical and cognitive functions of patients wishing for employment reinstatement were relatively well maintained. Cooperation with the company, information sharing with an industrial physician, and adjustment to the home environment were also important for reinstatement.
ML-13 Primary central nervous system malignant lymphoma in a patient with rheumatoid arthritis receiving tocilizumab
Authors: Ohno Masasuke , Kuramitsu Syunichiro , Ito Syohei , Kimata Masayuki , Asai Takumi , Suzaki Noriyuki , Kajita Yasukazu , Takahashi Tastuo 
Published: December 2021

Abstract
Background: Although the risk of developing malignant lymphoma is higher in patients with rheumatoid arthritis (RA) than in the general population, the occurrence of primary central nervous system lymphoma (PCNSL) in patients with RA is extremely rare. In recent years, there has been concern that biological disease-modifying antirheumatic drugs (DMRADs), which are widely administered to patients with RA, may increase the risk of developing cancer. We report the first case of PCNSL in a patient with RA who was treated with the biological DMRADs, tocilizumab. Case description: A 70-year-old man, who was diagnosed with RA in 2010 was treated with low-dose methotrexate from 2010 to 2015. He was started on tocilizumab in 2012. In 2018, he suffered from gait disturbance and was diagnosed with lumbar spinal stenosis. He underwent L2/3 posterior fusion surgery, but his paraplegia gradually deteriorated. Two months after the surgery, a head Gd-MRI showed multiple contrast-enhanced lesions in the basal ganglia and brain stem. A stereotactic brain biopsy was performed and DLBCL was diagnosed, and finally PCNSL was diagnosed because of no neoplastic lesions in other organs. He was treated with 5 courses of MTX 3.5g/m2 with rituximab and has been in remission for 23 months. He has maintained an independent life with residual paraplegia, but his ADLs gradually worsened. He was restarted on tocilizumab with a diagnosis of worsening RA. Conclusion: Low-dose methotrexate and biological DMRADs including tocilizumab, have been concerned to increase the risk of cancer in patients with RA, but there is no solid evidence. Since it has been a short time since the use of biological DMRADs, further accumulation of cases and careful follow-up are necessary.
ML-18 High-dose chemotherapy supported by autologous stem cell transplant in relapsed and refractory primary CNS lymphoma
Authors: Nagane Motoo , Sasaki Nobuyoshi , Saito Kuniaki , Kobayashi Keiichi , Onoda Ryo , Seiya Yosuke , Yamagishi Yuki , Nakatomi Hirofumi , Ohnishi Hiroaki , Takayama Nobuyuki , Shiokawa Yoshiaki 
Published: December 2021

Abstract
While whole brain radiation therapy (WBRT) has been performed as consolidation therapy in primary central nervous system lymphoma (PCNSL), high-dose chemotherapy supported by autologous stem cell transplant (HDC/ASCT) is widely investigated today as an alternative treatment strategy, given the high risk for radiation-induced neurotoxicity in WBRT. Various conditioning regimens have been investigated in phase II trials, which report non-inferiority of HDC/ASCT in efficacy and preservation of neurocognitive function in comparison with WBRT. Besides its promising efficacy, treatment-related deaths are reported in 11% in patients treated by a conditioning regimen using thiotepa, busulfan and cyclophosphamide (TBC), which raises a concern for safety. Among several conditioning regimens, analysis using registry data of Japan Society for Hematopoietic Cell Transplantation has revealed that the use of conditioning regimens containing thiotepa was a positive factor for longer PFS. According to the result of a phase I trial in Japan which investigated HDC/ASCT using thiotepa and busulfan (BuTT), thiotepa was approved by the pharmaceuticals and medical devices agency (PMDA) on March 2020. In comparison with the TBC regimen, cyclophosphamide is omitted, and the dose of thiotepa is lower (250 mg/m2, 3 days in TBC; 5 mg/kg, 2 days in BuTT) in BuTT, therefore BuTT could be less toxic in comparison with TBC, and no treatment-related deaths were observed in the phase I study in Japan. Further investigation on the efficacy and safety of BuTT in actual clinical practice is warranted. We have constituted a multi-disciplinary team in our institution in order to perform HDC/ASCT using BuTT in relapsed/refractory PCNSL. Treatment indications are as follows; 65 years old or younger, previously treated by rituximab, methotrexate, procarbazine and vincristine (R-MPV), good organ function and neurological status. Future directions along with preliminary treatment results will be discussed at the meeting.
MET-3 A Case of Intrapituitary Adenoma Metastasis from Advanced gastric cancer
Authors: Fujita Shohei , Kawanishi Yu , Fukuda Hitoshi , Fukui Naoki , Ueba Tetsuya 
Published: December 2021

Abstract
Metastasis from extracranial tumor into a pituitary adenoma is a rare case. We report a case of metastasis from gastric cancer to a giant pituitary tumor. A 65-year-old man had been drinking more water and had an increased frequency of urine in 10 years. From that time, the patient was gradually aware of the pain in his left eye. In 20XX the patient had a sudden severe headache and pain of his eyes and visited an ophthalmologist. The patient was referred to our institution with general malaise and nausea, vomiting. A cerebral MRI disclosed Extensive neoplastic lesions from the base of the skull to the nasal cavity. The left eye had esotropia and abduction disorder. Laboratory test demonstrated hyponatremia (Na 126mEq/L) and decreased in plasma osmolality (273mOsm/kg), D-dimer, fibrinogen and CA19-9 were high level. One week after admission, the patient’s symptom was getting worse. The patient underwent FDG PET/CT, which showed FDG avid in the gastric wall and clivus tumor. The lesion was suspected gastric cancer and performed Esophagogastroduodenoscopy. The biopsy-based pathology was showed cubic and round cells with high NC ratio and signet-ring cells containing mucin. And clivus tumor was biopsied at an otolaryngologist because part of the tumor was exposed from the nasal cavity. The biopsy-based pathology was showed a small amount of adenocarcinoma cells which is surrounded by pituitary adenoma. The patient was diagnosed as intrapituitary adenoma metastasis from advanced gastric cancer and has been started radiation therapy. But the level of consciousness dropped sharply, so radiation therapy had become difficult to continue. The patient transferred to palliative care ward and died 3 months after his first visit. In this case, diagnosis and treatment were difficult due to the that the image was a finding a malignant tumor and the rapid progression of symptoms.
COT-7 Online supports for opening of the tumor treating field
Authors: Sadahiro Hirokazu , Sugimoto Kazutaka , Nomura Sadahiro , Ishihara Hideyuki 
Published: December 2021

Abstract
Background: EF-14 trial showed the efficacy of tumor treating fields (TTF), and TTF was approved as a standard therapy for glioblastoma in Japan. In TTF opening, Device Support Specialist (DSS) explains how to use it for the patient and the family. Because there is no DSS in Yamaguchi prefecture, DSS has to come to our hospital across other prefectures. On the other hand, COVID-19 is still spreading and it is sometimes tough to move from a big city to countryside. Here, we would present the experiences of TTF opening with online DSS support. Method: From June 2020, Zoom was used for 4 patients, and from June 2021, iPad/Face-Time was used for one patient. TTF was introduced via online DSS support with direct support from our nurse in our out clinic. After that, initial times of TTF change were performed via online DSS support in patient’s home. Two patients who used Zoom had trouble to connect to internet, however finally completed with relative helps.Conclusion: Online medicine should be absolutely spreading in country sides. Now, we change from Zoom to iPad, because the old patients in country sides were hard to use internet utility. We should make efforts to provide patients more brief methods of online support.
COT-12 Clinical feature of end-stage glioblastomas
Authors: Saito Norihiko , Hirai Nozomi , Kushida Naoki , Sato Sho , Hiramoto Yu , Fujita Satoshi , Nakayama Haruo , Hayashi Morito , Ito Keisuke , Iwabuchi Satoshi 
Published: December 2021

Abstract
Glioblastoma is the most common and most aggressive primary brain tumor. Even with optimal treatment, tumors repeatedly recur and grow, eventually invading the entire brain. Few studies have evaluated the pathogenesis and pathophysiology of terminal glioblastoma. In this study, we describe the pathological characteristics of 26 glioblastoma cases (including 18 autopsy cases) that were analyzed from initial treatment to confirmation of death at our hospital. The mean age of the 26 patients was 60.7 years, and mean overall survival was 16.7 months. The interval of clinical symptoms from coma to death was 36.2 days, and the interval from onset of respiratory depression to death was 12 days. Steroids and antiepileptic drugs were often continued after completion of active treatment. Psychiatric symptoms and central fever were observed in patients with intrathecal dissemination, and disease progression was rapid in these patients. These patients presented with a variety of symptoms, including psychiatric symptoms, headache, neck pain, and central fever. In addition, a case of diffuse infiltration from the brain parenchyma to the periventricular area in a patient treated with bevacizumab suggested a possible change in the form of recurrence. In the terminal stage of glioblastoma, hypoxemia due to disturbance of the respiratory center results in progression from impaired consciousness to death. Because convulsive seizures are rare when patients are close to death, continuation of antiepileptic drugs may not be necessary. Although many patients develop local recurrences, new treatments may change the mode of recurrence or alter tumor cell characteristics. The number of patients receiving home care and end-of-life care has recently been increasing because of medical improvements, such as home care. Further study of the pathophysiology of glioblastoma may yield better end-of-life care.
COT-16 Development of automatic lesion extraction application using artificial intelligence for the purpose of simplifying tumor volume measurement of meningioma
Authors: Hirayama Ryuichi , Iwata Takamitsu , Yamada Shuhei , Kuroda Hideki , Nakagawa Tomoyoshi , Kijima Noriyuki , Okita Yoshiko , Kagawa Naoki , Kishima Haruhiko 
Published: December 2021

Abstract
BACKGROUND: With the widespread use of MRI equipment and brain scans, opportunities to perform follow-up examinations for meningiomas have increased. On the other hand, an objective evaluation index for meningiomas characterized by slow changes on imaging has not been established. To establish a volume-based evaluation index for meningoceles, we are developing an application for automatic lesion extraction using artificial intelligence as a highly reproducible tumor volume measurement technique that enables large volume image data processing. METHODS: In this study, 195 patients with meningioma who underwent contrast-enhanced MRI imaging at Osaka University Hospital were included. The images were manually extracted by three neurosurgeons and used as supervised data. deeplabV3 was used as the learning network. All the supervised data were randomly divided into training (80%) and testing (20%) data, and the application was constructed by deep learning and validation with 5-fold cross-validation. The matching rate of the area of the region automatically extracted by the device against the test data and the mean square error rate of the calculated tumor volume were used as indices of the product measurement performance. RESULTS: The matching rate using the automatic extraction application for the correct data(Dice index) was 91.5% on average. The mean squared error rate of the tumor volume calculated from these extracted regions was 8.84%. CONCLUSION: We consider that this application using artificial intelligence has a certain degree of validity in terms of the accuracy of extracted lesions. In the future, it is necessary not only to improve the performance of the equipment but also to clarify the clinical significance of the new imaging biomarkers based on tumor volume that can be obtained from these lesion extraction techniques.
COT-28 Questionnaire Survey Regarding Working Condition of the Members Belongs to the Japan Society for Neuro-Oncology (JSNO) by the Gender Equality and Diversity Committee of the JSNO, 2021
Authors: Fujiamaki Takamitsu , Tamura Kaoru , Abe Tatsuya , Nakada Mitsutoshi , Higuchi Akiko , Watanabe Yuko , Nagane Motoo 
Published: December 2021

Abstract
Gender Equality and Diversity Committee (“Women and Diversity in Neuro-oncology - WING”) of the Japan Society for Neuro-oncology (JSNO) was established in November 2020 with the aim of supporting and providing better opportunities for diverse members including women in JSNO. In order to achieve this goal, the JSNO and WING planned to conduct a questionnaire survey of all members in the fall of 2021 to investigate the actual situation of members. The targets of this study were clinicians, basic researchers, nurses and allied health professionals including medical social workers. The survey is conducted after obtaining the approval of the Ethics Committee and Academic Committee of the JSNO. Method: As of September 26, this questionnaire is currently underway online and anonymously. The questionnaire includes questions on work environment, home environment (including childcare and nursing care) for understanding work-life balance, existence of problems related to career development, support measures considered necessary, and expectations for WING. Results: As the results of the questionnaire were not available at the time of writing this abstract. However at the presentation we will present the statistical analysis of the survey. Various comparisons of the questionnaire items common to those of the Japan Neurosurgical Society and the Japan Pediatric Society, which were conducted several years before this survey. Conclusion: Respect for diversity is increasingly important in the field of neuro-oncology. Surveys are important for the future success of our diverse community, and we believe that this survey will be an important milestone.