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1. Beyond the WHO classification of meningioma: using molecular diagnostics to guide management

Author

Abigail Clynch, George E Richardson, Mohammad A Mustafa, Conor S Gillespie, Nitika Rathi, Ali Bakhsh, Rasheed Zakaria, Abdurrahman I Islim, Christopher P Millward, and Michael D Jenkinson

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Meningioma are the most common primary brain tumour. Classically, meningioma are phenotypically grouped using the World Health Organisation (WHO) classification system. However, it is now understood that the WHO approach overfits tumours into three grades, resulting in similarly graded tumours displaying phenotypically distinct behaviour. There is a growing body of research investigating the molecular biology of these tumours, including genomic, transcriptomic, metabolomic, proteomic, and methylomic profiling. Such advancements in molecular profiling of meningioma are providing greater accuracy in prognostication of tumours. Furthermore, a clearer understanding of tumour molecular biology highlights potential targets for pharmacotherapies. Currently, the routine application of in-depth tumour molecular analysis is limited, however as it becomes more widely available it will likely result in improved patient care. This review seeks to explore the important developments in meningioma molecular biology, discussed in the context of their clinical importance.

Published
2023
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3. Imaging Timing After Surgery for Glioblastoma (INTERVAL GB): A multi-centre, UK and Ireland retrospective cohort study

Author

Emily Rose Bligh, Conor Gillespie, Michael T.C. Poon, Georgios Solomou, Melissa Gough, Abdurrahman I. Islim, Christopher P. Millward, Ola Rominiyi, Rasheed Zakaria, Stephen J. Price, Colin Watts, Sophie Camp, Thomas C. Booth, Gerard Thompson, Samantha J. Mills, Adam Waldman, Paul Brennan, and Michael D. Jenkinson

Subjects
Neurology. Diseases of the nervous system, RC346-429
Published
2023
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4. Definition and surgical timing in cauda equina syndrome-An updated systematic review.

Author

Mohammad A Mustafa, George E Richardson, Conor S Gillespie, Abdurrahman I Islim, Martin Wilby, Simon Clark, and Nisaharan Srikandarajah

Subjects
Medicine, Science
Abstract

Study designSystematic review.ObjectivesTo conduct a systematic review identifying existing definitions of cauda equina syndrome (CES) and time to surgery in the literature for patients with CES.MethodsA systematic review was conducted in accordance with the PRISMA statement. Ovid Medline, Embase, CINAHL Plus, and trial registries were searched from October 1st, 2016, to 30th December 2022, and combined with articles identified from a previous systematic review by the same authors (studies published 1990-2016).ResultsA total of 110 studies (52,008 patients) were included. Of these only 16 (14.5%) used established definitions in defining CES, including Fraser criteria (n = 6), British Association of Spine Surgeons (BASS) (n = 5), Gleave and MacFarlane (n = 2), and other (n = 3). Most reported symptoms were urinary dysfunction (n = 44, 40%%), altered sensation in the perianal region (n = 28, 25.5%) and bowel dysfunction (n = 20, 18.2%). Sixty-eight (61.8%) studies included details on time to surgery. There was an increase in percentage of studies defining CES published in the last 5 years compared to ones from 1990-2016 (58.6% vs 77.5.%, P = .045).ConclusionsDespite Fraser recommendations, substantial heterogeneity exists in reporting of CES definitions, and a start point for time to surgery, with most authors using self-defined criteria. A consensus is required to define CES and time to surgery, to allow consistency in reporting and study analysis.

Published
2023
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5. Non-Equilibrium Aspects of Fission Dynamics within the Time Dependent Density Functional Theory

Author

Bulgac, A., Kafker, M., Abdurrahman, I., and Stetcu, I.

Subjects
Nuclear Theory
Abstract

In this report we will cover in some details only our preliminary results for the induced fission of odd-mass and odd-odd nuclei within a time-dependent density functional (TDDFT) extended to superfluid systems. In the talk we have covered three topics; i) Scission neutrons, ii) Induced fission of odd-mass and odd-odd nuclei, and iii) Nontrivial aspects of fission dynamics, which we discuss here briefly., Comment: 5 pages, 1 figure (3 subfigures), invited talk given at The 7th International Workshop on Compound Nuclear Reactions and Related Topics (CNR2024), Vienna, Austria, 8-12 July, 2024

Published
2024

6. Imaging timing after glioblastoma surgery (INTERVAL-GB): protocol for a UK and Ireland, multicentre retrospective cohort study

Author

Oliver Burton, Julie Woodfield, Daniel Richardson, Giles Critchley, Angelos Kolias, Thomas Santarius, Lewis Thorne, Peter Whitfield, Ola Rominiyi, Bharti Kewlani, Harsh Bhatt, Ahmed Ahmed, Michael O’Sullivan, Rasheed Zakaria, Michael D Jenkinson, Gerard Thompson, Paul M Brennan, Rory Piper, Seong Hoon Lee, Neil Barua, Engelbert Mthunzi, Sara Venturini, Daniel M Fountain, Najma Ahmed, Stephen J Price, Colin Watts, Michael T C Poon, Stuart Smith, Anand Pandit, Ryan K Mathew, Soham Bandyopadhyay, Rosa Sun, Setthasorn Zhi Yang Ooi, Victoria Wykes, William Bolton, Abdullah Egiz, Samantha J Mills, Babar Vaqas, Natalie Simon, Puneet Plaha, Georgios Solomou, Aswin Chari, Grainne McKenna, Melissa Gough, Simon Lammy, Sophie T Williams, Isabelle Williams, Andrew J Martin, Sam Hodgson, Robert Spencer, Adam Waldman, Armin Nazari, Joshua Erhabor, Omar Salim, Saad Moughal, Chinedu Brian Egu, Abdurrahman I Islim, Christopher P Millward, Suhaib Abualsaud, Michael Amoo, Neeraj Kalra, Agbolahan Sofela, Thomas C Booth, George E Richardson, Conor S Gillespie, Orla Mantle, Abigail Clynch, Jay J Park, Emily R Bligh, Avani Shanbhag, Moritz Steinruecke, Alvaro Yanez Touzet, Hannah Redpath, Gideon Adegboyega, Prithvi Bahu, Rosaline de Koning, Tomas Ferreira, Dana Hutton, Jashan Selvakumar, Tiffany TS Ye, Ashvin Kuri, Robin Borchert, Bea Duric, Elena Roman, Kristy Kehoe, Jeremy Cheong, Lauren Harris, Mohammad A Mustafa, Hidayatul Abdullmalek, Chinelo Afulukwe, Abdelsalam Nedal Al-Sousi, Yahia Al-Tamimi, Ajitesh Anand, Peter Bodkin, Ion Boiangiu, Abbey Boyle, Christiaan Bredell, Talhah Chaudri, Ana Cios, Iona Cleer, David Coope, Ian Coulter, Harriet Davis, Paolo Jose De Luna, Nayan Dey, Justyna O Ekert, Jinendra Ekanayake, Anna Elso, Tom Flannery, Kwan Wai Fung, Rahul Ganguly, Sanay Goyal, Emily Hardman, Theodore Hirst, Kelvin Sunn Hoah, Kismet Hossain-Ibrahim, Lena Mary Houlihan, Sami Squali Houssaini, Sadid Hoque, Mahnoor Javed, Siddarth Kannan, Efthymia Maria Kapasouri, Andrew Keenlyside, Prerna Khanna, Kunalika Sathish Kumar, Eunkyung Lee, Robert Magouirk, Riccardo Masina, Adele Mazzoleni, Patrick McAleavey, Daniel McSweeney, Trinh Ton Nu Ngoc, Shiva A Nischal, Jonathan Pesic-Smith, Peter Peterson, Isaac Phang, Shyam Pujara, Marwa Mohammed Elrasheed Saad, Shinjan Sangal, Veekshith Shetty, Irtiza Syed, Jesvin Tom Sunny, Anca-Mihaela Vasilica, Daniel O’Flaherty, Arslan Khaliq Raja, Daniele Ramsay, Renitha Reddi, Dorina Roy, Jeremiah Samkutty, Edward Jerome St George, Preethi Subramanian, Vaibhav Sundaresan, Kieron Sweeney, Boon Hoe Tan, Nicole Turnbull, Yuewei Tao, Rebecca Tweedie, Anastasia Tzatzidou, Kathrin Whitehouse, Jack Wildman, Karl Williams, Kelvin Sunn Yap, Mahir Yousuff, Asaad Zulfiqar, Sophie Camp, and Setthasorn ZY Ooi

Subjects
Medicine
Abstract

Introduction Glioblastoma is the most common malignant primary brain tumour with a median overall survival of 12–15 months (range 6–17 months), even with maximal treatment involving debulking neurosurgery and adjuvant concomitant chemoradiotherapy. The use of postoperative imaging to detect progression is of high importance to clinicians and patients, but currently, the optimal follow-up schedule is yet to be defined. It is also unclear how adhering to National Institute for Health and Care Excellence (NICE) guidelines—which are based on general consensus rather than evidence—affects patient outcomes such as progression-free and overall survival. The primary aim of this study is to assess MRI monitoring practice after surgery for glioblastoma, and to evaluate its association with patient outcomes.Methods and analysis ImagiNg Timing aftER surgery for glioblastoma: an eVALuation of practice in Great Britain and Ireland is a retrospective multicentre study that will include 450 patients with an operated glioblastoma, treated with any adjuvant therapy regimen in the UK and Ireland. Adult patients ≥18 years diagnosed with glioblastoma and undergoing surgery between 1 August 2018 and 1 February 2019 will be included. Clinical and radiological scanning data will be collected until the date of death or date of last known follow-up. Anonymised data will be uploaded to an online Castor database. Adherence to NICE guidelines and the effect of being concordant with NICE guidelines will be identified using descriptive statistics and Kaplan-Meier survival analysis.Ethics and dissemination Each participating centre is required to gain local institutional approval for data collection and sharing. Formal ethical approval is not required since this is a service evaluation. Results of the study will be reported through peer-reviewed presentations and articles, and will be disseminated to participating centres, patients and the public.

Published
2022
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7. External validation and recalibration of an incidental meningioma prognostic model – IMPACT: protocol for an international multicentre retrospective cohort study

Author

Julie Woodfield, Boris Krischek, Giles Critchley, Damian Holliman, Angelos Kolias, Thomas Santarius, Ola Rominiyi, Michael McDermott, Michael D Jenkinson, Jörg-Christian Tonn, Mohsen Javadpour, Andrea Saladino, Tiit Illimar Mathiesen, Rory Piper, Michael Vogelbaum, Chaya Brodie, Sara Venturini, Daniel M Fountain, Roland Goldbrunner, Elliot Tilling, Felix Sahm, Priscilla Brastianos, Rory J Piper, Antonio Santoro, Sylvia Kurz, Pierfrancesco Lapolla, Andrea Mingoli, Jennifer Brown, Debraj Mukherjee, Simon Walling, Andrew Morokoff, Patrick Wen, Ghazaleh Tabatabai, Jill Barnholtz-Sloan, Ryan K Mathew, Alexander Smedley, Helen Shih, William Taylor, Minh Nguyen, Bryony Ford, Samantha J Mills, Tamara Ali, Ruwanthi Kolamunnage-Dona, Josephine Jung, Muhammed Elhadi, Erminia Albanese, Aswin Chari, David Rowland, Melissa Gough, Michael Cearns, Simon Lammy, Yasir Chowdhury, Christian Mawrin, Mahmoud Saleh, Jens Schittenhelm, Farshad Nassiri, Raymond Huang, Pietro Familiari, Manfred Westphal, Warren Selman, Daniel Brown, Nathan McSorley, Oliver Hanemann, Richard Pullicino, Francesco Gaillard, Mirjam Renovanz, Chris Barrett, Christine Jungk, Aaron Cohen-Gadol, Javier Martín-Alonso, Gelareh Zadeh, Hytham Hamid, Abdurrahman I Islim, Christopher P Millward, Shaveta Mehta, Usama Ali, Shelli Diane Koszdin, Theo Georgious, Andrew R Brodbelt, Mohamed Abdelsadg, Suhaib Abualsaud, Amro Abuleil, Kevin Agyemang, Hanan Akbari, Likhith Alakandy, Clarissa Alfonso, Arousa Ali, Michael Amoo, Mohamed A. R. Arbab, Mutiu Asha, Kareem Austin, Khaled Badran, Jarnail Bal, Parameswaran Bhattathiri, Paul M. Brennan, Andrew R. Brodbelt, Ferran Brugada-Bellsolà, Placido Bruzzaniti, Annabel Butcher, Rory S. Cairns, Michael Canty, Sachiv Chakravarti, Rebecca Chave-Cox, Anna Craig-McQuade, Peter Crossley, Elizabeth Culpin, Alessia D'Amico, Bassam Dabbous, Pedro David Delgado-López, Mohamed Draz, Katharine J. Drummond, Rusiru T. Ekanayaka, Ibrahim Elmaadawi, Omar Elmandouh, Mazin Elsharif, Daisy Evans, Andreas Fahlström, Fleur L. Fisher, Daniel M. Fountain, Keiko Fox, Chloé Gelder, Shamayitri Ghosh, Aimee Goel, Athanasios Grivas, Andrew Gvozdanovic, Allan Hall, Liv Hartrick, Samih Hassan, Jack Henry, Abdurrahman I. Islim, Asgeir S. Jakola, Michael D. Jenkinson, Sanjeeva Jeyaretna, Adrian Jimenez, Andranik Kahramanian, Neeraj Kalra, David O. Kamson, Oliver Kennion, Adham M. Khalafallah, Sarah Kingdon, Howra Ktayen, Aditaya Kumar, Jun Yi Lau, Jing Xian Lee, Ryan Leyden, Patricia Littlechild, Sophie Liu, Darmanin Lora-Kay, Vivia Lung, Stephen T. Magill, Hani J. Marcus, Fawaz E. Marhoom, Ryan K. Mathew, Calan Mathieson, Tobias Mederer, Torstien R. Meling, Samantha J. Mills, Christopher P. Millward, Mujtaba Mohammad, Amir H. Zamanipoor Najafabadi, Olivia Näslund, Imran Noorani, Gildas Patet, Omar N. Pathmanaban, Andrea Perera, Amit Persad, See Yung Phang, Rory J. Piper, Jonathan Pollock, Benjamin Price, Martin Proescholdt, James Robins, Bobby Sachdev, Fozia Saeed, Ieva Sataite, Antony Kevin Scafa, Verena Schadewaldt, Syed Wajahat Shah, Mustafa El Sheikh, Zenab Sher, Bente Sandvei Skeie, Agbolahan Sofela, Jerome St George, Torbjørn Strømsnes, Nigel Suttner, Philip Theodosopoulos, Manjul Tripathi, Ismail Ughratdar, James Ulrich, Adithya Varma, Anil Varma, Maria Velicu, Esther Wu, Jacob Young, Giuseppa Zancana, Catherine Zhang, Karolyn Au, Felix Behling, Linda Bi, Nicholas Butowski, Ana Castro, Marta Couce, Francesco Dimeco, Katherine J. Drummond, Ian Dunn, Craig Erker, Michelle Felicella, Eva Galanis, Norbert Galldiks, Caterina Giannini, Christel Herold-Mende, Luke Hnenny, Craig Horbinski, Gerhard Jungwirth, Timothy Kaufmann, Daniel Lachance, Christian Lafougere, Katrin Lamszus, Serge Makarenko, Tathiana Malta, Jennifer Moliterno-Gunel, HK Ng, Houtan Noushmehr, Arie Perry, Laila Poisson, Bianco Pollo, Aditya Ragunathan, David Raleigh, Franz Ricklefs, Antonio Santacroce, Christian Schichor, Nils Schimdt, Andrew Sloan, Matija Snuderl, Jim Snyder, Erik Sulman, Suganth Suppiah, Marcos Tatagiba, Marco Timmer, Andreas Von Deimling, Tobias Walbert, Justin Z. Wang, Stephen Yip, Gabriel Zada, Viktor Zherebitskiy, and Michael T.C. Poon

Subjects
Medicine
Published
2022
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8. Development of ‘Core Outcome Sets’ for Meningioma in Clinical Studies (The COSMIC Project): protocol for two systematic literature reviews, eDelphi surveys and online consensus meetings

Author

James Snyder, Nisaharan Srikandarajah, Boris Krischek, Matthias Preusser, Michael Weller, Timothy J Kaufmann, Thomas Santarius, Carole Turner, Michael D Cusimano, Paula R Williamson, Michael McDermott, Michael D Jenkinson, Justin Wang, Mohsen Javadpour, Andrea Saladino, Anthony G Marson, David James, Chaya Brodie, Daniel M Fountain, Roland Goldbrunner, Felix Sahm, Sylvia Kurz, Colin Watts, Julian Spears, Amir H Zamanipoor Najafabadi, Simon Walling, Andrew Morokoff, Ghazaleh Tabatabai, Helen Shih, Linda Dirven, Puneet Plaha, Helen Bulbeck, David Schultz, Christian Mawrin, Jens Schittenhelm, Farshad Nassiri, Martin J B Taphoorn, Manfred Westphal, Warren Selman, C Oliver Hanemann, Patrick Y Wen, Mirjam Renovanz, Evanthia Galanis, Alireza Mansouri, Priscilla K Brastianos, Christine Jungk, Heather Barrington, Aaron Cohen-Gadol, Gelareh Zadeh, Abdurrahman I Islim, Christopher P Millward, Theo Georgious, Andrew R Brodbelt, Karolyn Au, Felix Behling, Nicholas Butowski, Ana Castro, Marta Couce, Francesco Dimeco, Craig Erker, Michelle Felicella, Norbert Galldiks, Caterina Giannini, Christel Herold-Mende, Luke Hnenny, Craig Horbinski, Gerhard Jungwirth, Daniel Lachance, Christian Lafougere, Katrin Lamszus, Serge Makarenko, Tathiana Malta, Jennifer Moliterno-Gunel, Houtan Noushmehr, Arie Perry, Aditya Ragunathan, David Raleigh, Franz Ricklefs, Antonio Santacroce, Christian Schichor, Andrew Sloan, Matija Snuderl, Erik Sulman, Suganth Suppiah, Marcos Tatagiba, Marco Timmer, Andreas Von Deimling, Tobias Walbert, Stephen Yip, Gabriel Zada, Viktor Zherebitskiy, Derek Tsang, Kenneth Aldape, Terri S Armstrong, Sabrina Bell, Anna Crofton, Paul L Grundy, Sumirat M Keshwara, Shelli D Koszdin, Michael W McDermott, Torstein R Meling, Kathy Oliver, Jill Barnhartz-Sloan, Wenya Linda Bi, Carlos Carlotti, Katharine Drummond, Ian F Dunn, Brent Griffith, Rintaro Hashizume, Raymond Y Huang, Ian Lee, Jeff C Liu, Yasin Mamatjan, David Munoz, Ho-Keung Ng, Farhad Pirouzmand, Laila M Poisson, Bianca Pollo, Nils O Schmidt, Daniela Tirapelli, Joerg C Tonn, Michael A Vogelbaum, and Adriana M Workewych

Subjects
Medicine
Abstract

Introduction Meningioma is the most common primary intracranial tumour in adults. The majority are non-malignant, but a proportion behave more aggressively. Incidental/minimally symptomatic meningioma are often managed by serial imaging. Symptomatic meningioma, those that threaten neurovascular structures, or demonstrate radiological growth, are usually resected as first-line management strategy. For patients in poor clinical condition, or with inoperable, residual or recurrent disease, radiotherapy is often used as primary or adjuvant treatment. Effective pharmacotherapy treatments do not currently exist. There is heterogeneity in the outcomes measured and reported in meningioma clinical studies. Two ‘Core Outcome Sets’ (COS) will be developed: (COSMIC: Intervention) for use in meningioma clinical effectiveness trials and (COSMIC: Observation) for use in clinical studies of incidental/untreated meningioma.Methods and analysis Two systematic literature reviews and trial registry searches will identify outcomes measured and reported in published and ongoing (1) meningioma clinical effectiveness trials, and (2) clinical studies of incidental/untreated meningioma. Outcomes include those that are clinician reported, patient reported, caregiver reported and based on objective tests (eg, neurocognitive tests), as well as measures of progression and survival. Outcomes will be deduplicated and categorised to generate two long lists. The two long lists will be prioritised through two, two-round, international, modified eDelphi surveys including patients with meningioma, healthcare professionals, researchers and those in caring/supporting roles. The two final COS will be ratified through two 1-day online consensus meetings, with representation from all stakeholder groups.Ethics and dissemination Institutional review board (University of Liverpool) approval was obtained for the conduct of this study. Participant eConsent will be obtained prior to participation in the eDelphi surveys and consensus meetings. The two systematic literature reviews and two final COS will be published and freely available.Trial registration number COMET study ID 1508

Published
2022
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9. Quantum turbulence, superfluidity, non-Markovian dynamics, and wave function thermalization

Author

Bulgac, A., Kafker, M., Abdurrahman, I., and Wlazlowski, G.

Subjects
Condensed Matter - Quantum Gases, Nuclear Theory
Abstract

While quantum turbulence has been addressed both experimentally (predominantly for superfluid $^4$He and $^3$He) and theoretically, the dynamics of various ensembles of quantized vortices was followed in time only until the vortices decay into phonons. How this ``thermalization'' is achieved is still an unaddressed and thus an unelucidated question. The Unitary Fermi Gas (UFG) is a unique quantum system, which has no classical counterpart and of relevance to neutron stars, cold atoms, condensed matter and nuclear many-body systems. The non-Markovian evolution of an isolated UFG is put in evidence and its entire non-equilibrium evolution can be studied theoretically within a unified theoretical framework. The initial lattice of quantum vortices and anti-vortices evolves through a couple of vortex tangles and excitation of Kelvin waves, where vortices cross and reconnect, until very slowly thermalization sets in., Comment: 8 pages, 6 figures, online supplemental material, published version

Published
2024
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10. Opportunities and challenges for the development of “core outcome sets” in neuro-oncology

Author

Millward, Christopher P, Armstrong, Terri S, Barrington, Heather, Brodbelt, Andrew R, Bulbeck, Helen, Byrne, Anthony, Dirven, Linda, Gamble, Carrol, Grundy, Paul L, Islim, Abdurrahman I, Javadpour, Mohsen, Keshwara, Sumirat M, Krishna, Sandhya T, Mallucci, Conor L, Marson, Anthony G, McDermott, Michael W, Meling, Torstein R, Oliver, Kathy, Pizer, Barry, Plaha, Puneet, Preusser, Matthias, Santarius, Thomas, Srikandarajah, Nisaharan, Taphoorn, Martin JB, Watts, Colin, Weller, Michael, Williamson, Paula R, Zadeh, Gelareh, Najafabadi, Amir H Zamanipoor, and Jenkinson, Michael D

Subjects
Clinical Trials and Supportive Activities, Rare Diseases, Neurosciences, Clinical Research, Cancer, Brain Disorders, Brain Cancer, Evaluation of treatments and therapeutic interventions, 6.9 Resources and infrastructure (treatment evaluation), Generic health relevance, Adult, Child, Consensus, Delphi Technique, Humans, Meningeal Neoplasms, Meningioma, Research Design, Treatment Outcome, clinical trial, core outcome set, effectiveness, glioma, meningioma, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

Core Outcome Sets (COS) define minimum outcomes to be measured and reported in clinical effectiveness trials for a particular health condition/health area. Despite recognition as critical to clinical research design for other health areas, none have been developed for neuro-oncology. COS development projects should carefully consider: scope (how the COS should be used), stakeholders involved in development (including patients as both research partners and participants), and consensus methodologies used (typically a Delphi survey and consensus meeting), as well as dissemination plans. Developing COS for neuro-oncology is potentially challenging due to extensive tumor subclassification (including molecular stratification), different symptoms related to anatomical tumor location, and variation in treatment options. Development of a COS specific to tumor subtype, in a specific location, for a particular intervention may be too narrow and would be unlikely to be used. Equally, a COS that is applicable across a wider area of neuro-oncology may be too broad and therefore lack specificity. This review describes why and how a COS may be developed, and discusses challenges for their development, specific to neuro-oncology. The COS under development are briefly described, including: adult glioma, incidental/untreated meningioma, meningioma requiring intervention, and adverse events from surgical intervention for pediatric brain tumors.

Published
2022

11. Development of ‘Core Outcome Sets’ for Meningioma in Clinical Studies (The COSMIC Project): protocol for two systematic literature reviews, eDelphi surveys and online consensus meetings

Author

Millward, Christopher P, Armstrong, Terri S, Barrington, Heather, Bell, Sabrina, Brodbelt, Andrew R, Bulbeck, Helen, Crofton, Anna, Dirven, Linda, Georgious, Theo, Grundy, Paul L, Islim, Abdurrahman I, Javadpour, Mohsen, Keshwara, Sumirat M, Koszdin, Shelli D, Marson, Anthony G, McDermott, Michael W, Meling, Torstein R, Oliver, Kathy, Plaha, Puneet, Preusser, Matthias, Santarius, Thomas, Srikandarajah, Nisaharan, Taphoorn, Martin JB, Turner, Carole, Watts, Colin, Weller, Michael, Williamson, Paula R, Zadeh, Gelareh, Najafabadi, Amir H Zamanipoor, Jenkinson, Michael D, Aldape, Kenneth, Au, Karolyn, Barnhartz-Sloan, Jill, Bi, Wenya Linda, Behling, Felix, Brastianos, Priscilla K, Brodie, Chaya, Butowski, Nicholas, Carlotti, Carlos, Castro, Ana, Cohen-Gadol, Aaron, Couce, Marta, Cusimano, Michael D, DiMeco, Francesco, Drummond, Katharine, Dunn, Ian F, Erker, Craig, Felicella, Michelle, Fountain, Daniel M, Galanis, Evanthia, Galldiks, Norbert, Giannini, Caterina, Goldbrunner, Roland, Griffith, Brent, Hashizume, Rintaro, Hanemann, C Oliver, Herold-Mende, Christel, Hnenny, Luke, Horbinski, Craig, Huang, Raymond Y, James, David, Jungk, Christine, Jungwirth, Gerhard, Kaufmann, Timothy J, Krischek, Boris, Kurz, Sylvia, Lachance, Daniel, Lafougère, Christian, Lamszus, Katrin, Lee, Ian, Liu, Jeff C, Makarenko, Serge, Malta, Tathiana, Mamatjan, Yasin, Mansouri, Alireza, Mawrin, Christian, McDermott, Michael, Moliterno-Gunel, Jennifer, Morokoff, Andrew, Munoz, David, Nassiri, Farshad, Noushmehr, Houtan, Ng, Ho-Keung, Perry, Arie, Pirouzmand, Farhad, Poisson, Laila M, Pollo, Bianca, Ragunathan, Aditya, Raleigh, David, Renovanz, Mirjam, Ricklefs, Franz, Sahm, Felix, Saladino, Andrea, Santacroce, Antonio, Schittenhelm, Jens, and Schichor, Christian

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Neurosciences, Brain Disorders, Clinical Research, Clinical Trials and Supportive Activities, Cancer, Consensus, Delphi Technique, Humans, Meningeal Neoplasms, Meningioma, Research Design, Systematic Reviews as Topic, Treatment Outcome, EORTC BTG, ICOM, EANO, SNO, RANO-PRO, BNOS, SBNS, BIMS, TBTC, International Brain Tumour Alliance, Brainstrust, and Brain Tumour Foundation of Canada, clinical trial, core outcome set, meningioma, Public Health and Health Services, Other Medical and Health Sciences, Biomedical and clinical sciences, Health sciences, Psychology
Abstract

IntroductionMeningioma is the most common primary intracranial tumour in adults. The majority are non-malignant, but a proportion behave more aggressively. Incidental/minimally symptomatic meningioma are often managed by serial imaging. Symptomatic meningioma, those that threaten neurovascular structures, or demonstrate radiological growth, are usually resected as first-line management strategy. For patients in poor clinical condition, or with inoperable, residual or recurrent disease, radiotherapy is often used as primary or adjuvant treatment. Effective pharmacotherapy treatments do not currently exist. There is heterogeneity in the outcomes measured and reported in meningioma clinical studies. Two 'Core Outcome Sets' (COS) will be developed: (COSMIC: Intervention) for use in meningioma clinical effectiveness trials and (COSMIC: Observation) for use in clinical studies of incidental/untreated meningioma.Methods and analysisTwo systematic literature reviews and trial registry searches will identify outcomes measured and reported in published and ongoing (1) meningioma clinical effectiveness trials, and (2) clinical studies of incidental/untreated meningioma. Outcomes include those that are clinician reported, patient reported, caregiver reported and based on objective tests (eg, neurocognitive tests), as well as measures of progression and survival. Outcomes will be deduplicated and categorised to generate two long lists. The two long lists will be prioritised through two, two-round, international, modified eDelphi surveys including patients with meningioma, healthcare professionals, researchers and those in caring/supporting roles. The two final COS will be ratified through two 1-day online consensus meetings, with representation from all stakeholder groups.Ethics and disseminationInstitutional review board (University of Liverpool) approval was obtained for the conduct of this study. Participant eConsent will be obtained prior to participation in the eDelphi surveys and consensus meetings. The two systematic literature reviews and two final COS will be published and freely available.Trial registration numberCOMET study ID 1508.

Published
2022

13. Clinical Presentation and Prognosis

Author

Millward, Christopher P., Keshwara, Sumirat, Islim, Abdurrahman I., Zakaria, Rasheed, Jenkinson, Michael D., Crusio, Wim E., Series Editor, Dong, Haidong, Series Editor, Radeke, Heinfried H., Series Editor, Rezaei, Nima, Series Editor, Steinlein, Ortrud, Series Editor, Xiao, Junjie, Series Editor, Zadeh, Gelareh, editor, Goldbrunner, Roland, editor, Krischek, Boris, editor, and Nassiri, Farshad, editor

Published
2023
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15. Fission fragments intrinsic spins and their correlations

Author

Bulgac, A., Abdurrahman, I., Jin, S., Godbey, K., Schunck, N., and Stetcu, I.

Subjects
Nuclear Theory, Nuclear Experiment
Abstract

The intrinsic spins and their correlations are the least understood characteristics of fission fragments from both theoretical and experimental points of view. In many nuclear reactions the emerging fragments are typically excited and acquire an intrinsic excitation energy and an intrinsic spin depending on the type of the reactions and interaction mechanism. Both the intrinsic excitation energies and the fragments intrinsic spins and parities are controlled by the interaction mechanism and conservations laws, which lead to their correlations and determines the character of their de-excitation mechanism. We outline here a framework for the theoretical extraction of the intrinsic spin distributions of the fragments and their correlations within the fully microscopic real-time density functional theory formalism and illustrate it on the example of induced fission of $^{236}$U and $^{240}$Pu, using two nuclear energy density functionals. These fission fragment intrinsic spin distributions display new qualitative features previously not discussed in literature. Within this fully microscopic framework we extract for the first time the intrinsic spin distributions of fission fragments of $^{236}$U and $^{240}$Pu as well as the correlations of their intrinsic spins, which have been debated in literature for more than six decades with no definite conclusions so far., Comment: 6 pages, 2 figures, published version

Published
2020
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17. Radiological follow-up of endovascularly treated intracranial aneurysms: a survey of current practice in the UK and Ireland

Author

Hannan, Cathal John, Islim, Abdurrahman I., Alalade, Andrew F., Bacon, Andrew, Ghosh, Anthony, Dalton, Arthur, Abouharb, Ashraf, Walsh, Daniel Colman, Bulters, Diederik, White, Edward, Chavredakis, Emmanouil, Kounin, George, Critchley, Giles, Dow, Graham, Patel, Hiren C., Brydon, Howard, Anderson, Ian A., Fouyas, Ioannis, Galea, James, St. George, Jerome, Bal, Jarnail, Patel, Krunal, Kamel, Mahmoud, Teo, Mario, Fanning, Noel, Mukerji, Nitin, Grover, Patrick, Mitchell, Patrick, Whitfield, Peter C., Trivedi, Rikin, Crockett, Matthew T., Brennan, Paul, and Javadpour, Mohsen

Published
2023
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19. Quality of life outcomes in incidental and operated meningiomas (QUALMS): a cross-sectional cohort study

Author

Keshwara, Sumirat M., Gillespie, Conor S., Mustafa, Mohammad A., George, Alan M., Richardson, George E., Clynch, Abigail L., Wang, Justin Z., Lawson, David D. A., Gilkes, Catherine E., Farah, J. Osman, Yousaf, Jawad, Chavredakis, Emmanuel, Mills, Samantha J., Brodbelt, Andrew R., Zadeh, Gelareh, Millward, Christopher P., Islim, Abdurrahman I., and Jenkinson, Michael D.

Published
2023
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21. Direct derivation of the comma 3-Vertex in the full string basis

Author

Abdurrahman, A, Abdurrahman, I, and Gassem, M

Subjects
Mathematical Physics, High Energy Physics - Theory
Abstract

The interacting comma 3-vertex for the bosonic open string in the full string basis is derived using the half string overlap relations directly. Thus avoiding the coherent states technique employed in earlier derivations. The resulting form of the interacting 3-vertex turns out to be precisely the desired expression obtained in terms of the full string oscillator modes. This derivation establishes that the comma 3-vertex and Witten's 3-vertex are identical and therefore are interchangeable., Comment: 32 pages

Published
2019
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26. Assessing the reporting quality of pediatric neuro-oncology protocols, abstracts, and trials: Adherence to the SPIRIT and CONSORT statements.

Author

Suppree, Joshua S, Hart, Sophia, Keshwara, Sumirat M, Krishna, Sandhya Trichinopoly, Gillespie, Conor S, Richardson, George E, Mustafa, Mohammad A, Mallucci, Conor L, Pizer, Barry, Hayden, James, Islim, Abdurrahman I, Jenkinson, Michael D, and Millward, Christopher P

Subjects
CLINICAL trials, BIBLIOGRAPHIC databases, BRAIN tumors, MEDICAL protocols, ELECTRONIC information resource searching
Abstract

Background It is of vital importance to comprehensively and transparently report clinical trial activity. The SPIRIT 2013 and CONSORT 2010 statements exist to define items to be reported in clinical trial protocols and randomized controlled trials, respectively. The aim of this methodological review was to assess the reporting quality of pediatric neuro-oncology trial protocols and trial result articles. Methods Published trial protocols and phase II/III trial result articles relating to pediatric brain tumors (published after the introduction of the SPIRIT 2013 statement), were identified through searches of 4 electronic bibliographic databases. The reporting quality of included trial protocols and result articles was assessed against the aforementioned statements. In addition, the CONSORT-A checklist was used to assess the abstracts of trial result articles. Percentage adherence was calculated for each article. Results Nine trial protocols, 68 phase II trials, and 8 phase III trial result articles were included. Mean adherence of trial protocols to the SPIRIT statement was 76.8% (SD : 0.09). Mean adherence of trial abstracts to CONSORT-A was 67.4% (SD : 0.13) for phase II abstracts and 47.5% (SD : 0.09) for phase III abstracts. Adherence of trial result articles to CONSORT was 71.3% (SD : 0.10) for phase II trials and 70.3% (SD : 0.13) for phase III trials. Conclusions The reporting quality of pediatric neuro-oncology trial protocols and trial result articles requires improvement, particularly in the areas of randomization and blinding. This is consistent with our previously published findings following similar assessment of reporting quality for adult neuro-oncology trial protocols and result articles. [ABSTRACT FROM AUTHOR]

Published
2024
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27. Stereotactic radiosurgery versus active surveillance for incidental, convexity meningiomas: a matched cohort analysis from the IMPASSE study

Author

Pikis, Stylianos, Mantziaris, Georgios, Islim, Abdurrahman I., Peker, Selcuk, Samanci, Yavuz, Nabeel, Ahmed M., Reda, Wael A., Abdelkarim, Khaled, El-Shehaby, Amr M. N., Tawadros, Sameh R., Emad, Reem M., Delabar, Violaine, Mathieu, David, Lee, Cheng-chia, Yang, Huai-che, Licsak, Roman, Hanuska, Jaromir, Alvarez, Roberto Martinez, Patel, Dev N., Kondziolka, Douglas, Bernstein, Kenneth, Moreno, Nuria Martinez, Tripathi, Manjul, Speckter, Herwin, Albert, Camilo, Bowden, Greg N., Benveniste, Ronald J., Lunsford, Dade L., Jenkinson, Michael D., and Sheehan, Jason

Published
2022
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28. Stereotactic radiosurgery versus active surveillance for asymptomatic, skull-based meningiomas: an international, multicenter matched cohort study

Author

Mantziaris, Georgios, Pikis, Stylianos, Samanci, Yavuz, Peker, Selcuk, Nabeel, Ahmed M., Reda, Wael A., Tawadros, Sameh R., El-Shehaby, Amr M. N., Abdelkarim, Khaled, Emad, Reem M., Delabar, Violaine, Mathieu, David, Lee, Cheng-chia, Yang, Huai-che, Liscak, Roman, Hanuska, Jaromir, Alvarez, Roberto Martinez, Moreno, Nuria Martinez, Tripathi, Manjul, Speckter, Herwin, Albert, Camilo, Benveniste, Ronald J., Bowden, Greg N., Patel, Dev N., Kondziolka, Douglas, Bernstein, Kenneth, Lunsford, L. Dade, Jenkinson, Michael D., Islim, Abdurrahman I., and Sheehan, Jason

Published
2022
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29. Assessing the reporting quality of pediatric neuro-oncology protocols, abstracts and trials:Adherence to the SPIRIT and CONSORT statements

Author

Suppree, Mr Joshua S, primary, Hart, Miss Sophia, additional, Keshwara, Sumirat M, additional, Trichinopoly Krishna, Miss Sandhya, additional, Gillespie, Conor S, additional, Richardson, George E, additional, Mustafa, Mohammad A, additional, Mallucci, Conor L, additional, Pizer, Barry, additional, Hayden, James, additional, Islim, Abdurrahman I, additional, Jenkinson, Michael D, additional, and Millward, Mr Christopher P, additional

Published
2024
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30. Volumetric growth of residual meningioma – A systematic review

Author

Gillespie, Conor S., Taweel, Basel A., Richardson, George E., Mustafa, Mohammad A., Keshwara, Sumirat M., Babar, Roshan K., Alnaham, Khaleefa E., Kumar, Siddhant, Bakhsh, Ali, Millward, Christopher P., Islim, Abdurrahman I., Brodbelt, Andrew R., Mills, Samantha J., and Jenkinson, Michael D.

Published
2021
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31. The outcomes measured and reported in intracranial meningioma clinical trials: A systematic review

Author

Millward, Christopher P; https://orcid.org/0000-0001-7727-1157, Keshwara, Sumirat M, Armstrong, Terri S; https://orcid.org/0000-0002-2414-0492, Barrington, Heather; https://orcid.org/0000-0001-9103-2670, Bell, Sabrina, Brodbelt, Andrew R, Bulbeck, Helen, Dirven, Linda; https://orcid.org/0000-0001-9157-9895, Grundy, Paul L, Islim, Abdurrahman I, Javadpour, Mohsen, Koszdin, Shelli D, Marson, Anthony G, McDermott, Michael W, Meling, Torstein R, Oliver, Kathy, Plaha, Puneet, Preusser, Matthias; https://orcid.org/0000-0003-3541-2315, Santarius, Thomas, Srikandarajah, Nisaharan; https://orcid.org/0000-0001-9578-508X, Taphoorn, Martin J B; https://orcid.org/0000-0001-9949-4722, Turner, Carole, Watts, Colin; https://orcid.org/0000-0003-3531-8791, Weller, Michael; https://orcid.org/0000-0002-1748-174X, Williamson, Paula R, Zadeh, Gelareh; https://orcid.org/0000-0002-6637-4502, Zamanipoor Najafabadi, Amir H, Jenkinson, Michael D, Aldape, Kenneth; https://orcid.org/0000-0001-5119-7550, et al, Millward, Christopher P; https://orcid.org/0000-0001-7727-1157, Keshwara, Sumirat M, Armstrong, Terri S; https://orcid.org/0000-0002-2414-0492, Barrington, Heather; https://orcid.org/0000-0001-9103-2670, Bell, Sabrina, Brodbelt, Andrew R, Bulbeck, Helen, Dirven, Linda; https://orcid.org/0000-0001-9157-9895, Grundy, Paul L, Islim, Abdurrahman I, Javadpour, Mohsen, Koszdin, Shelli D, Marson, Anthony G, McDermott, Michael W, Meling, Torstein R, Oliver, Kathy, Plaha, Puneet, Preusser, Matthias; https://orcid.org/0000-0003-3541-2315, Santarius, Thomas, Srikandarajah, Nisaharan; https://orcid.org/0000-0001-9578-508X, Taphoorn, Martin J B; https://orcid.org/0000-0001-9949-4722, Turner, Carole, Watts, Colin; https://orcid.org/0000-0003-3531-8791, Weller, Michael; https://orcid.org/0000-0002-1748-174X, Williamson, Paula R, Zadeh, Gelareh; https://orcid.org/0000-0002-6637-4502, Zamanipoor Najafabadi, Amir H, Jenkinson, Michael D, Aldape, Kenneth; https://orcid.org/0000-0001-5119-7550, and et al

Abstract

Background Meningioma clinical trials have assessed interventions including surgery, radiotherapy, and pharmacotherapy. However, agreement does not exist on what, how, and when outcomes of interest should be measured. To do so would allow comparative analysis of similar trials. This systematic review aimed to summarize the outcomes measured and reported in meningioma clinical trials. Methods Systematic literature and trial registry searches were performed to identify published and ongoing intracranial meningioma clinical trials (PubMed, Embase, Medline, CINAHL via EBSCO, and Web of Science, completed January 22, 2022). Reported outcomes were extracted verbatim, along with an associated definition and method of measurement if provided. Verbatim outcomes were deduplicated and the resulting unique outcomes were grouped under standardized outcome terms. These were classified using the taxonomy proposed by the “Core Outcome Measures in Effectiveness Trials” (COMET) initiative. Results Thirty published articles and 18 ongoing studies were included, describing 47 unique clinical trials: Phase 2 n = 33, phase 3 n = 14. Common interventions included: Surgery n = 13, radiotherapy n = 8, and pharmacotherapy n = 20. In total, 659 verbatim outcomes were reported, of which 84 were defined. Following de-duplication, 415 unique verbatim outcomes remained and were grouped into 115 standardized outcome terms. These were classified using the COMET taxonomy into 29 outcome domains and 5 core areas. Conclusions Outcome measurement across meningioma clinical trials is heterogeneous. The standardized outcome terms identified will be prioritized through an eDelphi survey and consensus meeting of key stakeholders (including patients), in order to develop a core outcome set for use in future meningioma clinical trials.

Published
2024

32. The outcomes measured and reported in observational studies of incidental and untreated intracranial meningioma: A systematic review

Author

Millward, Christopher P; https://orcid.org/0000-0001-7727-1157, Islim, Abdurrahman I, Armstrong, Terri S; https://orcid.org/0000-0002-2414-0492, Barrington, Heather; https://orcid.org/0000-0001-9103-2670, Bell, Sabrina, Brodbelt, Andrew R, Bulbeck, Helen, Dirven, Linda; https://orcid.org/0000-0001-9157-9895, Grundy, Paul L, Javadpour, Mohsen, Keshwara, Sumirat M, Koszdin, Shelli D, Marson, Anthony G, McDermott, Michael W, Meling, Torstein R, Oliver, Kathy, Plaha, Puneet, Preusser, Matthias; https://orcid.org/0000-0003-3541-2315, Santarius, Thomas, Srikandarajah, Nisaharan; https://orcid.org/0000-0001-9578-508X, Taphoorn, Martin J B; https://orcid.org/0000-0001-9949-4722, Turner, Carole, Watts, Colin; https://orcid.org/0000-0003-3531-8791, Weller, Michael; https://orcid.org/0000-0002-1748-174X, Williamson, Paula R, Zadeh, Gelareh; https://orcid.org/0000-0002-6637-4502, Zamanipoor Najafabadi, Amir H, Jenkinson, Michael D, Aldape, Kenneth; https://orcid.org/0000-0001-5119-7550, et al, Millward, Christopher P; https://orcid.org/0000-0001-7727-1157, Islim, Abdurrahman I, Armstrong, Terri S; https://orcid.org/0000-0002-2414-0492, Barrington, Heather; https://orcid.org/0000-0001-9103-2670, Bell, Sabrina, Brodbelt, Andrew R, Bulbeck, Helen, Dirven, Linda; https://orcid.org/0000-0001-9157-9895, Grundy, Paul L, Javadpour, Mohsen, Keshwara, Sumirat M, Koszdin, Shelli D, Marson, Anthony G, McDermott, Michael W, Meling, Torstein R, Oliver, Kathy, Plaha, Puneet, Preusser, Matthias; https://orcid.org/0000-0003-3541-2315, Santarius, Thomas, Srikandarajah, Nisaharan; https://orcid.org/0000-0001-9578-508X, Taphoorn, Martin J B; https://orcid.org/0000-0001-9949-4722, Turner, Carole, Watts, Colin; https://orcid.org/0000-0003-3531-8791, Weller, Michael; https://orcid.org/0000-0002-1748-174X, Williamson, Paula R, Zadeh, Gelareh; https://orcid.org/0000-0002-6637-4502, Zamanipoor Najafabadi, Amir H, Jenkinson, Michael D, Aldape, Kenneth; https://orcid.org/0000-0001-5119-7550, and et al

Abstract

Background The clinical management of patients with incidental intracranial meningioma varies markedly and is often based on clinician choice and observational data. Heterogeneous outcome measurement has likely hampered knowledge progress by preventing comparative analysis of similar cohorts of patients. This systematic review aimed to summarize the outcomes measured and reported in observational studies. Methods A systematic literature search was performed to identify published full texts describing active monitoring of adult cohorts with incidental and untreated intracranial meningioma (PubMed, EMBASE, MEDLINE, and CINAHL via EBSCO, completed January 24, 2022). Reported outcomes were extracted verbatim, along with an associated definition and method of measurement if provided. Verbatim outcomes were de-duplicated and the resulting unique outcomes were grouped under standardized outcome terms. These were classified using the taxonomy proposed by the “Core Outcome Measures in Effectiveness Trials” (COMET) initiative. Results Thirty-three published articles and 1 ongoing study were included describing 32 unique studies: study designs were retrospective n = 27 and prospective n = 5. In total, 268 verbatim outcomes were reported, of which 77 were defined. Following de-duplication, 178 unique verbatim outcomes remained and were grouped into 53 standardized outcome terms. These were classified using the COMET taxonomy into 9 outcome domains and 3 core areas. Conclusions Outcome measurement across observational studies of incidental and untreated intracranial meningioma is heterogeneous. The standardized outcome terms identified will be prioritized through an eDelphi survey and consensus meeting of key stakeholders (including patients), in order to develop a Core Outcome Set for use in future observational studies.

Published
2024

34. Imaging timing after surgery for glioblastoma: an evaluation of practice in Great Britain and Ireland (INTERVAL-GB)- a multi-centre, cohort study.

Author

INTERVAL-GB Collaborative, Gillespie, Conor S, Bligh, Emily R, Poon, Michael TC, Islim, Abdurrahman I, Solomou, Georgios, Gough, Melissa, Millward, Christopher P, Rominiyi, Ola, Zakaria, Rasheed, Price, Stephen J., Watts, Colin, Camp, Sophie, Booth, Thomas C, Thompson, Gerard, Mills, Samantha J, Waldman, Adam, Brennan, Paul M., Jenkinson, Michael D, and Abdullmalek, Hidayatul

Abstract

Purpose: Post-operative MRI is used to assess extent of resection, monitor treatment response and detect progression in high-grade glioma. However, compliance with accepted guidelines for follow-up MRI, and impact on management/outcomes is unclear. Methods: Multi-center, retrospective observational cohort study of patients with confirmed WHO grade 4 glioma (August 2018-February 2019) receiving oncological treatment. Primary objective: investigate follow-up MRI surveillance practice and compliance with recommendations from NICE (Post-operative scan < 72h, MRI every 3–6 months) and EANO (Post-operative scan < 48h, MRI every 3 months). Results: There were 754 patients from 26 neuro-oncology centers with a median age of 63 years (IQR 54–70), yielding 10,100 (median, 12.5/person, IQR 5.2–19.4) person-months of follow-up. Of patients receiving debulking surgery, most patients had post-operative MRI within 72 h of surgery (78.0%, N = 407/522), and within 48 h of surgery (64.2%, N = 335/522). The median number of subsequent follow-up MRI scans was 1 (IQR 0–4). Compliance with NICE and EANO recommendations for follow-up MRI was 52.8% (N = 398/754) and 24.9% (N = 188/754), respectively. On multivariable Cox regression analysis, increased time spent in recommended follow-up according to NICE guidelines was associated with longer OS (HR 0.56, 95% CI 0.46–0.66, P < 0.001), but not PFS (HR 0.93, 95% CI 0.79–1.10, P = 0.349). Increased time spent in recommended follow-up according to EANO guidelines was associated with longer OS (HR 0.54, 95% CI 0.45–0.63, P < 0.001) but not PFS (HR 0.99, 95% CI 0.84–1.16, P = 0.874). Conclusion: Regular surveillance follow-up for glioblastoma is associated with longer OS. Prospective trials are needed to determine whether regular or symptom-directed MRI influences outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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35. Imaging timing after surgery for glioblastoma: an evaluation of practice in Great Britain and Ireland (INTERVAL-GB)- a multi-centre, cohort study.

Author

Gillespie, Conor S, Bligh, Emily R, Poon, Michael TC, Islim, Abdurrahman I, Solomou, Georgios, Gough, Melissa, Millward, Christopher P, Rominiyi, Ola, Zakaria, Rasheed, Price, Stephen J., Watts, Colin, Camp, Sophie, Booth, Thomas C, Thompson, Gerard, Mills, Samantha J, Waldman, Adam, Brennan, Paul M., Jenkinson, Michael D, Abdullmalek, Hidayatul, and Abualsaud, Suhaib

Abstract

Purpose: Post-operative MRI is used to assess extent of resection, monitor treatment response and detect progression in high-grade glioma. However, compliance with accepted guidelines for follow-up MRI, and impact on management/outcomes is unclear. Methods: Multi-center, retrospective observational cohort study of patients with confirmed WHO grade 4 glioma (August 2018-February 2019) receiving oncological treatment. Primary objective: investigate follow-up MRI surveillance practice and compliance with recommendations from NICE (Post-operative scan < 72h, MRI every 3–6 months) and EANO (Post-operative scan < 48h, MRI every 3 months). Results: There were 754 patients from 26 neuro-oncology centers with a median age of 63 years (IQR 54–70), yielding 10,100 (median, 12.5/person, IQR 5.2–19.4) person-months of follow-up. Of patients receiving debulking surgery, most patients had post-operative MRI within 72 h of surgery (78.0%, N = 407/522), and within 48 h of surgery (64.2%, N = 335/522). The median number of subsequent follow-up MRI scans was 1 (IQR 0–4). Compliance with NICE and EANO recommendations for follow-up MRI was 52.8% (N = 398/754) and 24.9% (N = 188/754), respectively. On multivariable Cox regression analysis, increased time spent in recommended follow-up according to NICE guidelines was associated with longer OS (HR 0.56, 95% CI 0.46–0.66, P < 0.001), but not PFS (HR 0.93, 95% CI 0.79–1.10, P = 0.349). Increased time spent in recommended follow-up according to EANO guidelines was associated with longer OS (HR 0.54, 95% CI 0.45–0.63, P < 0.001) but not PFS (HR 0.99, 95% CI 0.84–1.16, P = 0.874). Conclusion: Regular surveillance follow-up for glioblastoma is associated with longer OS. Prospective trials are needed to determine whether regular or symptom-directed MRI influences outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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36. Neurosurgery activity levels in the United Kingdom and republic of Ireland during the first wave of the covid-19 pandemic – a retrospective cross-sectional cohort study.

Author

Richardson, George E., Islim, Abdurrahman I., Albanese, Erminia, Ahmed, Ahmed, Aly, Ahmed, Ammar, Amr, Amoo, Michael, Bhatt, Harsh, Bodkin, Peter, Coulter, Ian, Corr, Paula, Elmaadawi, Ibrahim, Elserius, Anne, Fountain, Daniel M., George, K. Joshi, Gillespie, Conor S., Goel, Aimee, Grundy, Paul L., Gurusinghe, Nihal, and Hartley, Jessica

Subjects
*COVID-19 pandemic, *COVID-19, *COHORT analysis, *CROSS-sectional method, *NEUROSURGERY
Abstract

The impact of Covid-19 on surgical patients worldwide has been substantial. In the United Kingdom (UK) and the Republic of Ireland (RoI), the first wave of the pandemic occurred in March 2020. The aims of this study were to: (1) evaluate the volume of neurosurgical operative activity levels, Covid-19 infection rate and mortality rate in April 2020 with a retrospective cross-sectional cohort study conducted across 16 UK and RoI neurosurgical centres, and (2) compare patient outcomes in a single institution in April–June 2020 with a comparative cohort in 2019. Across the UK and RoI, 818 patients were included. There were 594 emergency and 224 elective operations. The incidence rate of Covid-19 infection was 2.6% (21/818). The overall mortality rate in patients with a Covid-19 infection was 28.6% (6/21). In the single centre cohort analysis, an overall reduction in neurosurgical operative activity by 65% was observed between 2020 (n = 304) and 2019 (n = 868). The current and future impact on UK neurosurgical operative activity has implications for service delivery and neurosurgical training. [ABSTRACT FROM AUTHOR]

Published
2024
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39. A semi-automatic segmentation method for meningioma developed using a variational approach model.

Author

Burrows, Liam, Patel, Jay, Islim, Abdurrahman I, Jenkinson, Michael D, Mills, Samantha J, and Chen, Ke

Abstract

Background: Meningioma is the commonest primary brain tumour. Volumetric post-contrast magnetic resonance imaging (MRI) is recognised as gold standard for delineation of meningioma volume but is hindered by manual processing times. We aimed to investigate the utility of a model-based variational approach in segmenting meningioma. Methods: A database of patients with a meningioma (2007–2015) was queried for patients with a contrast-enhanced volumetric MRI, who had consented to a research tissue biobank. Manual segmentation by a neuroradiologist was performed and results were compared to the mathematical model, using a battery of tests including the Sørensen–Dice coefficient (DICE) and JACCARD index. A publicly available meningioma dataset (708 segmented T1 contrast-enhanced slices) was also used to test the reliability of the model. Results: 49 meningioma cases were included. The most common meningioma location was convexity (n = 15, 30.6%). The mathematical model segmented all but one incidental meningioma, which failed due to the lack of contrast uptake. The median meningioma volume by manual segmentation was 19.0 cm3 (IQR 4.9–31.2). The median meningioma volume using the mathematical model was 16.9 cm3 (IQR 4.6–28.34). The mean DICE score was 0.90 (SD = 0.04). The mean JACCARD index was 0.82 (SD = 0.07). For the publicly available dataset, the mean DICE and JACCARD scores were 0.90 (SD = 0.06) and 0.82 (SD = 0.10), respectively. Conclusions: Segmentation of meningioma volume using the proposed mathematical model was possible with accurate results. Application of this model on contrast-enhanced volumetric imaging may help reduce work burden on neuroradiologists with the increasing number in meningioma diagnoses. [ABSTRACT FROM AUTHOR]

Published
2024
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44. Cranial meningioma with bone involvement: surgical strategies and clinical considerations

Author

Abigail L. Clynch, Max Norrington, Mohammad A. Mustafa, George E. Richardson, John A. Doherty, Thomas J. Humphries, Conor S. Gillespie, Sumirat M. Keshwara, Catherine J. McMahon, Abdurrahman I. Islim, Michael D. Jenkinson, Christopher P. Millward, and Andrew R. Brodbelt

Subjects
Surgery, Neurology (clinical)
Abstract

Background Intracranial meningioma with bone involvement and primary intraosseous meningioma is uncommon. There is currently no consensus for optimal management. This study aimed to describe the management strategy and outcomes for a 10-year illustrative cohort, and propose an algorithm to aid clinicians in selecting cranioplasty material in such patients. Methods A single-centre, retrospective cohort study (January 2010–August 2021). All adult patients requiring cranial reconstruction due to meningioma with bone involvement or primary intraosseous meningioma were included. Baseline patient and meningioma characteristics, surgical strategy, and surgical morbidity were examined. Descriptive statistics were performed using SPSS v24.0. Data visualisation was performed using R v4.1.0. Results Thirty-three patients were identified (mean age 56 years; SD 15) There were 19 females. Twenty-nine patients had secondary bone involvement (88%). Four had primary intraosseous meningioma (12%). Nineteen had gross total resection (GTR; 58%). Thirty had primary ‘on-table’ cranioplasty (91%). Cranioplasty materials included pre-fabricated polymethyl methacrylate (pPMMA) (n = 12; 36%), titanium mesh (n = 10; 30%), hand-moulded polymethyl methacrylate cement (hPMMA) (n = 4; 12%), pre-fabricated titanium plate (n = 4; 12%), hydroxyapatite (n = 2; 6%), and a single case combining titanium mesh with hPMMA cement (n = 1; 3%). Five patients required reoperation for a postoperative complication (15%). Conclusion Meningioma with bone involvement and primary intraosseous meningioma often requires cranial reconstruction, but this may not be evident prior to surgical resection. Our experience demonstrates that a wide variety of materials have been used successfully, but that pre-fabricated materials may be associated with fewer postoperative complications. Further research within this population is warranted to identify the most appropriate operative strategy.

Published
2023
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45. Long term quality of life outcomes following surgical resection alone for benign paediatric intracranial tumours

Author

Siddhant Kumar, Abdurrahman I. Islim, Richard Moon, Christopher P. Millward, Dawn Hennigan, Antonia Thorpe, Mitchell Foster, Barry Pizer, Conor L. Mallucci, and Michael D. Jenkinson

Subjects
Cancer Research, Neurology, Oncology, Neurology (clinical)
Abstract

Survivors of paediatric intracranial tumours are at increased risk of psychosocial, neuro-developmental, and functional impairment. This study aimed to evaluate long-term health-related quality-of-life (HRQOL) outcomes in patients with benign paediatric brain tumours treated curatively with surgical resection alone.This was a cross-sectional study of patients with benign paediatric intracranial tumours managed with surgery alone between 2000 and 2015. Eligible patients with a minimum of 5-years follow-up after surgery were identified. Validated health-related quality of life (HRQOL) questionnaires were administered: SF-36, QLQ-BN20, QLQ-C30 and PedsQL™.Twenty-three patients participated (median age at surgery 13 years; range 1-18; 12 male). The most common diagnosis was pilocytic astrocytoma (n = 15). Median time from surgery to participation was 11 years(range 6-19). Fourteen patients achieved A-level qualifications and two obtained an undergraduate degree. Twelve patients were employed, eight were studying and three were unemployed or volunteering. HRQOL outcomes demonstrated significant limitation from social functioning (p = 0.03) and cognitive functioning (p = 0.023) compared to the general population. Patients also experienced higher rates of loss of appetite (p = 0.009) and nausea and vomiting (p = 0.031). Ten patients were under transitional teenager and young-adult (TYA) clinic follow-up. TYA patients achieved higher levels of education (p = 0.014), were more likely to hold a driver's license (p = 0.041) compared to patients not followed-up through these services.Childhood brain-tumour survivors have a greater risk of developing psychological, neuro-cognitive and physical impairment. Early comprehensive assessment, specialist healthcare and TYA services are vital to support these patients.

Published
2023
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48. Quality of life outcomes in incidental and operated meningiomas (QUALMS): a cross-sectional cohort study

Author

Sumirat M. Keshwara, Conor S. Gillespie, Mohammad A. Mustafa, Alan M. George, George E. Richardson, Abigail L. Clynch, Justin Z. Wang, David D. A. Lawson, Catherine E. Gilkes, J. Osman Farah, Jawad Yousaf, Emmanuel Chavredakis, Samantha J. Mills, Andrew R. Brodbelt, Gelareh Zadeh, Christopher P. Millward, Abdurrahman I. Islim, and Michael D. Jenkinson

Subjects
Cancer Research, Neurology, Oncology, Neurology (clinical)
Abstract

Introduction: Few studies have evaluated meningioma patients’ longer-term health-related quality of life (HRQoL) following diagnosis and treatment, particularly in those with incidental, actively monitored tumours. Methods: A single-center, cross-sectional study was completed. Adult patients with surgically managed or actively monitored meningioma with more than five years of follow-up were included. The patient-reported outcome measures RAND SF-36, EORTC QLQ-C30 and QLQ-BN20 were used to evaluate HRQoL. HRQoL scores were compared to normative population data. Outcome determinants were evaluated using multivariate linear regression analysis. Results: 243 patient responses were analyzed, and the mean time from diagnosis was 9.8 years (range 5.0–40.3 years). Clinically relevant, statistically significant HRQoL impairments were identified across several SF-36 and QLQ-C30 domains. Increasing education level (β = 2.9, 95% CI 0.9 to 4.9), P = .004), employment (β = 7.7, 95% CI 2.2 to 13.1, P = .006) and absence of postoperative complications (β=-6.7, 95% CI -13.2 to (-)0.3, P = .041) were associated with a better QLQ-C30 summary score. Other tumour and treatment variables were not. Conclusion: This study highlights the longer-term disease burden of patients with meningioma nearly one decade after diagnosis or surgery. Patients with actively monitored meningioma have similar HRQoL to operated meningioma patients. Healthcare professionals should be mindful of HRQoL impairments and direct patients to sources of support as needed.

Published
2022
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50. Sporadic multiple intracranial meningioma does not infer worse patient outcomes: results from a case control study

Author

Abdurrahman I, Islim, Jing X, Lee, Mohammad A, Mustafa, Christopher P, Millward, Conor S, Gillespie, George E, Richardson, Basel A, Taweel, Emmanuel, Chavredakis, Samantha J, Mills, Andrew R, Brodbelt, and Michael D, Jenkinson

Subjects
Cancer Research, Neurology, Oncology, Neurology (clinical)
Abstract

Sporadic multiple meningioma are uncommon. Population-based data suggests that these patients have a reduced overall survival when compared to patients with solitary meningioma. The aim of this study was to investigate the clinical outcomes in multiple and solitary meningioma.A single-center matched cohort study (2008-2018) was performed. Patients with synchronous multiple meningioma at presentation, with no history of prior intracranial radiation, concurrent hormone replacement therapy or features of NF2-schwannomatosis were included. Eligible patients were matched 1:1 to patients with solitary meningioma. Outcomes of interest were occurrence of an intervention, recurrence, new meningioma development and mortality.Thirty-four patients harboring 76 meningioma at presentation were included. Mean age was 59.3 years (SD = 13.5). Thirty-one (91.2%) were female. The median number of meningioma per patient was 2 (range 2-6). Eighteen patients (52.9%) were symptomatic at presentation. Median overall follow-up was 80.6 months (IQR 44.1-99.6). Compared to patients with a sporadic meningioma, there was no difference in intervention rates (67.6% vs 70.6%, P = 0.792). Eight patients (34.8%) with a multiple meningioma had a WHO grade 2 meningioma compared to 7 (29.2%) with a solitary meningioma (P = 0.679). Median recurrence-free survival was 89 months (95% CI 76-104) with no difference between the two groups (P = 0.209). Mean overall survival was 132 months (95% CI 127-138) with no difference between the two groups (P = 0.860). One patient with multiple meningioma developed two further new meningioma 36 months following diagnosis.Sporadic multiple meningioma may not have worse clinical outcomes. Management of patients with sporadic multiple meningioma should be tailored towards the symptomatic meningioma or high-risk asymptomatic meningioma.

Published
2022
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