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3. Impact of Imaging-Guided Localization on Performance of Tailored Axillary Surgery in Patients with Clinically Node-Positive Breast Cancer: Prospective Cohort Study Within TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101)

Author

Weber, Walter P., Heidinger, Martin, Hayoz, Stefanie, Matrai, Zoltan, Tausch, Christoph, Henke, Guido, Zwahlen, Daniel R., Gruber, Günther, Zimmermann, Frank, Montagna, Giacomo, Andreozzi, Mariacarla, Goldschmidt, Maite, Schulz, Alexandra, Mueller, Andreas, Ackerknecht, Markus, Tampaki, Ekaterini Christina, Bjelic-Radisic, Vesna, Kurzeder, Christian, Sávolt, Ákos, Smanykó, Viktor, Hagen, Daniela, Müller, Dieter J., Gnant, Michael, Loibl, Sibylle, Fitzal, Florian, Markellou, Pagona, Bekes, Inga, Egle, Daniel, Heil, Jörg, and Knauer, Michael

Published
2024
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4. Trends in use of neoadjuvant systemic therapy in patients with clinically node-positive breast cancer in Europe: prospective TAXIS study (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101)

Author

Tausch, Christoph, Däster, Kavitha, Hayoz, Stefanie, Matrai, Zoltan, Fitzal, Florian, Henke, Guido, Zwahlen, Daniel R., Gruber, Günther, Zimmermann, Frank, Andreozzi, Mariacarla, Goldschmidt, Maite, Schulz, Alexandra, Maggi, Nadia, Saccilotto, Ramon, Heidinger, Martin, Mueller, Andreas, Tampaki, Ekaterini Christina, Bjelic-Radisic, Vesna, Sávolt, Ákos, Smanykó, Viktor, Hagen, Daniela, Müller, Dieter J., Gnant, Michael, Loibl, Sibylle, Markellou, Pagona, Bekes, Inga, Egle, Daniel, Ruhstaller, Thomas, Muenst, Simone, Kuemmel, Sherko, Vrieling, Conny, Satler, Rok, Becciolini, Charles, Bucher, Susanne, Kurzeder, Christian, Simonson, Colin, Fehr, Peter M., Gabriel, Natalie, Maráz, Robert, Sarlos, Dimitri, Dedes, Konstantin J., Leo, Cornelia, Berclaz, Gilles, Fansa, Hisham, Hager, Christopher, Reisenberger, Klaus, Singer, Christian F., Montagna, Giacomo, Reitsamer, Roland, Winkler, Jelena, Lam, Giang Thanh, Fehr, Mathias K., Naydina, Tatiana, Kohlik, Magdalena, Clerc, Karine, Ostapenko, Valerijus, Lelièvre, Loïc, Heil, Jörg, Knauer, Michael, and Weber, Walter Paul

Published
2023
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5. Erectile function preservation after salvage radiation therapy for biochemically recurrent prostate cancer after prostatectomy: Five-year results of the SAKK 09/10 randomized phase 3 trial

Author

Zwahlen, Daniel R., Schröder, Christina, Holer, Lisa, Bernhard, Jürg, Hölscher, Tobias, Arnold, Winfried, Polat, Bülent, Hildebrandt, Guido, Müller, Arndt-Christian, Martin Putora, Paul, Papachristofilou, Alexandros, Schär, Corinne, Hayoz, Stefanie, Sumila, Marcin, Zaugg, Kathrin, Guckenberger, Matthias, Ost, Piet, Giovanni Bosetti, Davide, Reuter, Christiane, Gomez, Silvia, Khanfir, Kaouthar, Beck, Marcus, Thalmann, George N., Aebersold, Daniel M., and Ghadjar, Pirus

Published
2024
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8. ASO Visual Abstract: Impact of Imaging-Guided Localization on Performance of Tailored Axillary Surgery in Patients with Clinically Node-Positive Breast Cancer: Prospective Cohort Study Within TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101)

Author

Weber, Walter P., Heidinger, Martin, Hayoz, Stefanie, Matrai, Zoltan, Tausch, Christoph, Henke, Guido, Zwahlen, Daniel R., Gruber, Günther, Zimmermann, Frank, Montagna, Giacomo, Andreozzi, Mariacarla, Goldschmidt, Maite, Schulz, Alexandra, Mueller, Andreas, Ackerknecht, Markus, Tampaki, Ekaterini Christina, Bjelic-Radisic, Vesna, Kurzeder, Christian, Sávolt, Ákos, Smanykó, Viktor, Hagen, Daniela, Müller, Dieter J., Gnant, Michael, Loibl, Sibylle, Fitzal, Florian, Markellou, Pagona, Bekes, Inga, Egle, Daniel, Heil, Jörg, and Knauer, Michael

Published
2024
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9. Adherence to Contouring and Treatment Planning Requirements Within a Multicentric Trial: Results of the Quality Assurance of the SAKK 09/10 trial

Author

Beck, Marcus, Sassowsky, Manfred, Schär, Sämi, Mathier, Etienne, Halter, Matthias, Zwahlen, Daniel R., Hölscher, Tobias, Arnold, Winfried, Polat, Bülent, Hildebrandt, Guido, Müller, Arndt-Christian, Putora, Paul M., Papachristofilou, Alexandros, Hayoz, Stefanie, Schär, Corinne, Li, Qiyu, Sumila, Marcin, Zaugg, Kathrin, Guckenberger, Matthias, Ost, Piet, Bosetti, Davide G., Reuter, Christiane, Gomez, Silvia, Khanfir, Kaouthar, Aebersold, Daniel M., Ghadjar, Pirus, and Pra, Alan Dal

Published
2022
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10. Discontinuation of Palliative Brain Radiotherapy in Patients with Brain Metastases: A Case–Control Study.

Author

Windisch, Paul, Lütscher, Jamie, Förster, Robert, Zwahlen, Daniel R., and Schröder, Christina

Subjects
TERMINATION of treatment, MENINGEAL cancer, RECURSIVE partitioning, CASE-control method, CLINICAL deterioration, RADIOTHERAPY
Abstract

Background: Discontinuation of radiotherapy is rarely discussed in the scientific literature. The goal of this study was, therefore, to estimate the frequency of and reasons for treatment discontinuations in patients receiving radiotherapy for brain metastases from solid tumors and to identify factors predicting said discontinuations. Methods: All patients treated for brain metastases from solid tumors between 2010 and 2020 at our institution were retrospectively reviewed. In addition to collecting relevant patient characteristics, the Recursive Partitioning Analysis (RPA) and disease-specific Graded Prognostic Assessment (GPA) groups for each patient were calculated to assess the performance of these scores in predicting treatment discontinuations. Results: Out of 468 patients who underwent cranial radiotherapy, 35 treatments (7.5%) were discontinued. The most frequent reason was clinical deterioration, which was documented in 26 (74.3%) of discontinued treatments. Patients whose radiotherapy was discontinued had, on average, more leptomeningeal disease (20.0% vs. 12.6%), worse ECOG performance status (mean ECOG performance status 1.86 vs. 1.39), and more uncontrolled extracranial metastases (85.3% vs. 70.8%). The frequencies of treatment discontinuation increased with worse prognosis and differed significantly across RPA groups (p = 0.037) but not across GPA groups (p = 0.612). Conclusions: Treatment discontinuation occurred in 7.5% of cases, mostly due to clinical deterioration. Poor performance status, as well as more advanced disease and, in turn, poor prognosis, were associated with higher discontinuation rates. [ABSTRACT FROM AUTHOR]

Published
2024
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11. Impact of Early Prophylactic Cranial Irradiation With Hippocampal Avoidance on Neurocognitive Function in Patients With Limited Disease Small Cell Lung Cancer. A Multicenter Phase 2 Trial (SAKK 15/12)

Author

Vees, Hansjörg, Caparrotti, Francesca, Eboulet, Eric Innocents, Xyrafas, Alexandros, Fuhrer, Andrea, Meier, Urs, Mark, Michael, Elicin, Olgun, Aebersold, Daniel M., Zwahlen, Daniel R., Finazzi, Tobias, Allal, Abdelkarim Said, Putora, Paul Martin, Martucci, Francesco, Rudolf, Christine Biaggi, and Ribi, Karin

Published
2020
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12. Measures of infection prevention and incidence of SARS-CoV-2 infections in cancer patients undergoing radiotherapy in Germany, Austria and Switzerland

Author

Matuschek, Christiane, Fischer, Johannes C., Combs, Stephanie E., Fietkau, Rainer, Corradini, Stefanie, Zänker, Kurt, Bölke, Edwin, Djiepmo-Njanang, Freddy-Joel, Tamaskovics, Balint, Fischer, Joachim E., Stuschke, Martin, Pöttgen, Christoph, Förster, Robert, Zwahlen, Daniel R., Papachristofilou, Alexandros, Ganswindt, Ute, Pelka, Rainer, Schneider, E. Marion, Feldt, Torsten, Jensen, Björn Erik Ole, Häussinger, Dieter, Knoefel, Wolfram Trudo, Kindgen-Milles, Detlef, Pedoto, Alessia, Grebe, Olaf, van Griensven, Martijn, Budach, Wilfried, and Haussmann, Jan

Published
2020
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15. ASO Visual Abstract: Impact of Imaging-Guided Localization on Performance of Tailored Axillary Surgery in Patients with Clinically Node-Positive Breast Cancer: Prospective Cohort Study Within TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101)

Author

Weber, Walter P., primary, Heidinger, Martin, additional, Hayoz, Stefanie, additional, Matrai, Zoltan, additional, Tausch, Christoph, additional, Henke, Guido, additional, Zwahlen, Daniel R., additional, Gruber, Günther, additional, Zimmermann, Frank, additional, Montagna, Giacomo, additional, Andreozzi, Mariacarla, additional, Goldschmidt, Maite, additional, Schulz, Alexandra, additional, Mueller, Andreas, additional, Ackerknecht, Markus, additional, Tampaki, Ekaterini Christina, additional, Bjelic-Radisic, Vesna, additional, Kurzeder, Christian, additional, Sávolt, Ákos, additional, Smanykó, Viktor, additional, Hagen, Daniela, additional, Müller, Dieter J., additional, Gnant, Michael, additional, Loibl, Sibylle, additional, Fitzal, Florian, additional, Markellou, Pagona, additional, Bekes, Inga, additional, Egle, Daniel, additional, Heil, Jörg, additional, and Knauer, Michael, additional

Published
2023
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16. Impact of Imaging-Guided Localization on Performance of Tailored Axillary Surgery in Patients with Clinically Node-Positive Breast Cancer: Prospective Cohort Study Within TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101)

Author

Weber, Walter P., primary, Heidinger, Martin, additional, Hayoz, Stefanie, additional, Matrai, Zoltan, additional, Tausch, Christoph, additional, Henke, Guido, additional, Zwahlen, Daniel R., additional, Gruber, Günther, additional, Zimmermann, Frank, additional, Montagna, Giacomo, additional, Andreozzi, Mariacarla, additional, Goldschmidt, Maite, additional, Schulz, Alexandra, additional, Mueller, Andreas, additional, Ackerknecht, Markus, additional, Tampaki, Ekaterini Christina, additional, Bjelic-Radisic, Vesna, additional, Kurzeder, Christian, additional, Sávolt, Ákos, additional, Smanykó, Viktor, additional, Hagen, Daniela, additional, Müller, Dieter J., additional, Gnant, Michael, additional, Loibl, Sibylle, additional, Fitzal, Florian, additional, Markellou, Pagona, additional, Bekes, Inga, additional, Egle, Daniel, additional, Heil, Jörg, additional, and Knauer, Michael, additional

Published
2023
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17. Impact of dose intensified salvage radiation therapy on urinary continence recovery after radical prostatectomy: Results of the randomized trial SAKK 09/10

Author

Ghadjar, Pirus, Hayoz, Stefanie, Bernhard, Jürg, Zwahlen, Daniel R., Stein, Jürgen, Hölscher, Tobias, Gut, Philipp, Polat, Bülent, Hildebrandt, Guido, Müller, Arndt-Christian, Putora, Paul Martin, Papachristofilou, Alexandros, Schär, Corinne, Dal Pra, Alan, Biaggi Rudolf, Christine, Wust, Peter, Aebersold, Daniel M., and Thalmann, George N.

Published
2018
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18. Dose-Volume Histogram Parameters and Quality of Life in Patients with Prostate Cancer Treated with Surgery and High-Dose Volumetric-Intensity-Modulated Arc Therapy to the Prostate Bed

Author

Hanke, Luca, primary, Tang, Hongjian, additional, Schröder, Christina, additional, Windisch, Paul, additional, Kudura, Ken, additional, Shelan, Mohamed, additional, Buchali, André, additional, Bodis, Stephan, additional, Förster, Robert, additional, and Zwahlen, Daniel R., additional

Published
2023
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22. Abstract PD15-11: PD15-11 Axillary dissection to determine nodal burden to inform systemic therapy recommendations in patients with clinically node-positive breast cancer: Pre-planned substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101)

Author

Weber, Walter P., primary, Matrai, Zoltan, additional, Hayoz, Stefanie, additional, Tausch, Christoph, additional, Henke, Guido, additional, Zwahlen, Daniel R., additional, Gruber, Günther, additional, Zimmermann, Frank, additional, Ruhstaller, Thomas, additional, Muenst, Simone, additional, Ackerknecht, Markus, additional, Küemmel, Sherko, additional, Bjelic-Radisic, Vesna, additional, Smanykó, Viktor, additional, Vrieling, Conny, additional, Satler, Rok, additional, Meyer, Inna, additional, Becciolini, Charles, additional, Bucher, Susanne, additional, Simonson, Colin, additional, Fehr, Peter M., additional, Gabriel, Natalie, additional, Maráz, Robert, additional, Sarlos, Dimitri, additional, Dedes, Konstantin J., additional, Leo, Cornelia, additional, Berclaz, Gilles, additional, Fansa, Hisham, additional, Hager, Christopher, additional, Reisenberger, Klaus, additional, Sávolt, Ákos, additional, Singer, Christian F., additional, Reitsamer, Roland, additional, Winkler, Jelena, additional, Lam, Giang Thanh Lam, additional, Fehr, Mathias K., additional, Naydina, Tatiana, additional, Kohlik, Magdalena, additional, Clerc, Karine, additional, Ostapenko, Valerijus, additional, Fitzal, Florian, additional, Heidinger, Martin, additional, Maggi, Nadia, additional, Schulz, Alexandra, additional, Markellou, Pagona, additional, Lelièvre, Loïc, additional, Egle, Daniel, additional, Heil, Jörg, additional, Knauer, Michael, additional, and Kurzeder, Christian, additional

Published
2023
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23. Applications of Machine Learning in Palliative Care: A Systematic Review

Author

Vu, Erwin; https://orcid.org/0000-0002-3298-517X, Steinmann, Nina; https://orcid.org/0000-0003-1069-896X, Schröder, Christina; https://orcid.org/0000-0002-4168-2795, Förster, Robert; https://orcid.org/0000-0002-7664-9207, Aebersold, Daniel M; https://orcid.org/0000-0002-9493-3834, Eychmüller, Steffen, Cihoric, Nikola, Hertler, Caroline; https://orcid.org/0000-0001-6181-2895, Windisch, Paul; https://orcid.org/0000-0003-1040-4888, Zwahlen, Daniel R; https://orcid.org/0000-0003-4359-7735, Vu, Erwin; https://orcid.org/0000-0002-3298-517X, Steinmann, Nina; https://orcid.org/0000-0003-1069-896X, Schröder, Christina; https://orcid.org/0000-0002-4168-2795, Förster, Robert; https://orcid.org/0000-0002-7664-9207, Aebersold, Daniel M; https://orcid.org/0000-0002-9493-3834, Eychmüller, Steffen, Cihoric, Nikola, Hertler, Caroline; https://orcid.org/0000-0001-6181-2895, Windisch, Paul; https://orcid.org/0000-0003-1040-4888, and Zwahlen, Daniel R; https://orcid.org/0000-0003-4359-7735

Abstract

Objective: To summarize the available literature on using machine learning (ML) for palliative care practice as well as research and to assess the adherence of the published studies to the most important ML best practices. Methods: The MEDLINE database was searched for the use of ML in palliative care practice or research, and the records were screened according to PRISMA guidelines. Results: In total, 22 publications using machine learning for mortality prediction (n = 15), data annotation (n = 5), predicting morbidity under palliative therapy (n = 1), and predicting response to palliative therapy (n = 1) were included. Publications used a variety of supervised or unsupervised models, but mostly tree-based classifiers and neural networks. Two publications had code uploaded to a public repository, and one publication uploaded the dataset. Conclusions: Machine learning in palliative care is mainly used to predict mortality. Similarly to other applications of ML, external test sets and prospective validations are the exception.

Published
2023

24. Association of Axillary Dissection With Systemic Therapy in Patients With Clinically Node-Positive Breast Cancer.

Author

Weber, Walter P., Matrai, Zoltan, Hayoz, Stefanie, Tausch, Christoph, Henke, Guido, Zimmermann, Frank, Montagna, Giacomo, Fitzal, Florian, Gnant, Michael, Ruhstaller, Thomas, Muenst, Simone, Mueller, Andreas, Lelièvre, Loïc, Heil, Jörg, Knauer, Michael, Egle, Daniel, Sávolt, Ákos, Heidinger, Martin, Kurzeder, Christian, and Zwahlen, Daniel R.

Published
2023
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26. Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (TAXIS): study protocol for a multicenter, randomized phase-III trial

Author

Henke, Guido, Knauer, Michael, Ribi, Karin, Hayoz, Stefanie, Gérard, Marie-Aline, Ruhstaller, Thomas, Zwahlen, Daniel R., Muenst, Simone, Ackerknecht, Markus, Hawle, Hanne, Fitzal, Florian, Gnant, Michael, Mátrai, Zoltan, Ballardini, Bettina, Gyr, Andreas, Kurzeder, Christian, and Weber, Walter P.

Published
2018
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27. Cranial Radiotherapy for Prostate Cancer Patients With Brain Metastases Inaccessible to Stereotactic Radiotherapy

Author

SCHRÖDER, CHRISTINA, WINDISCH, PAUL, LÜTSCHER, JAMIE, ZWAHLEN, DANIEL R., and FÖRSTER, ROBERT

Subjects
Male, Pharmacology, Cancer Research, Brain Neoplasms, Prostatic Neoplasms, Prognosis, Radiosurgery, General Biochemistry, Genetics and Molecular Biology, Treatment Outcome, Humans, Cranial Irradiation, Research Article, Aged, Retrospective Studies
Abstract

Background/Aim: To evaluate patients and treatment characteristics as well as clinical outcome in patients with intracranial metastases from prostate cancer (PCA) treated with palliative radiotherapy. Patients and Methods: Fifteen patients treated for intracranial metastases of PCA were identified. The median age of patients was 69 years. 80% of patients received whole brain radiotherapy and 20% received partial brain radiotherapy. Clinical outcome was assessed. Univariate analysis was performed to analyze the impact of patient specific parameters on survival. Results: There was no >G2 acute or any late toxicity. Median time from the first diagnosis of PCA to first diagnosis of intracranial metastases was 62 months (range=15-160 months). Median survival from first diagnosis of intracranial metastases was 14 weeks (range=0-126 weeks) and 6 weeks (range=0-47 weeks) from the start of radiotherapy. In univariate analysis, survival was significantly better for patients with an Eastern Cooperative Oncology Group (ECOG) performance status 1 compared to ECOG 2-3 [18 weeks (range=5-47 weeks) vs. 3 weeks (range=0-21 weeks), p=0.030] and Recursive Partitioning Analysis (RPA) class 2 compared to RPA class 3 [18 weeks (range=5-47 weeks) vs. 6 weeks (range=0-21 weeks), p=0.045]. Conclusion: Overall survival of the patients with wide-spread intracranial metastases from PCA was poor. The decision for a radiotherapy should be done on individual patient basis.

Published
2022

28. Dose-Volume Histogram Parameters and Quality of Life in Patients with Prostate Cancer Treated with Surgery and High-Dose Volumetric-Intensity-Modulated Arc Therapy to the Prostate Bed

Author

Hanke, Luca, Tang, Hongjian, Schröder, Christina, Windisch, Paul, Kudura, Ken, Shelan, Mohamed, Buchali, André, Bodis, Stephan, Förster, Robert, and Zwahlen, Daniel R

Subjects
610 Medicine & health
Abstract

INTRODUCTION Prostate bed radiotherapy (RT) is a major affecter of patients' long-term quality of life (QoL). To ensure the best possible outcome of these patients, dose constraints are key for optimal RT planning and delivery. However, establishing refined dose constraints requires access to patient-level data. Therefore, we aimed to provide such data on the relationship between OAR and gastrointestinal (GI) as well as genitourinary (GU) QoL outcomes of a homogenous patient cohort who received dose-intensified post-operative RT to the prostate bed. Furthermore, we aimed to conduct an exploratory analysis of the resulting data. METHODS Patients who were treated with prostate bed RT between 2010 and 2020 were inquired about their QoL based on the Expanded Prostate Cancer Index Composite (EPIC). Those (n = 99) who received volumetric arc therapy (VMAT) of at least 70 Gy to the prostate bed were included. Dose-volume histogram (DVH) parameters were gathered and correlated with the EPIC scores. RESULTS The median age at the time of prostate bed RT was 68.9 years, and patients were inquired about their QoL in the median 2.3 years after RT. The median pre-RT prostate-specific antigen (PSA) serum level was 0.35 ng/mL. The median duration between surgery and RT was 1.5 years. The median prescribed dose to the prostate bed was 72 Gy. A total of 61.6% received prostate bed RT only. For the bladder, the highest level of statistical correlation (p < 0.01) was seen for V10-20Gy, Dmean and Dmedian with urinary QoL. For bladder wall, the highest level of statistically significant correlation (p < 0.01) was seen for V5-25Gy, Dmean and Dmedian with urinary QoL. Penile bulb V70Gy was statistically significantly correlated with sexual QoL (p < 0.05). A larger rectal volume was significantly correlated with improved bowel QoL (p < 0.05). Sigmoid and urethral DVH parameters as well as the surgical approach were not statistically significantly correlated with QoL. CONCLUSION Specific dose constraints for bladder volumes receiving low doses seem desirable for the further optimization of prostate bed RT. This may be particularly relevant in the context of the aspiration of establishing focal RT of prostate cancer and its local recurrences. Our comprehensive dataset may aid future researchers in achieving these goals.

Published
2023
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29. Applications of Machine Learning in Palliative Care: A Systematic Review

Author

Vu, Erwin, Steinmann, Nina, Schröder, Christina, Förster, Robert, Aebersold, Daniel M, Eychmüller, Steffen, Cihoric, Nikola, Hertler, Caroline, Windisch, Paul, Zwahlen, Daniel R, University of Zurich, and Windisch, Paul

Subjects
Cancer Research, Oncology, 2730 Oncology, 1306 Cancer Research, 610 Medicine & health, 10044 Clinic for Radiation Oncology
Abstract

Objective: To summarize the available literature on using machine learning (ML) for palliative care practice as well as research and to assess the adherence of the published studies to the most important ML best practices. Methods: The MEDLINE database was searched for the use of ML in palliative care practice or research, and the records were screened according to PRISMA guidelines. Results: In total, 22 publications using machine learning for mortality prediction (n = 15), data annotation (n = 5), predicting morbidity under palliative therapy (n = 1), and predicting response to palliative therapy (n = 1) were included. Publications used a variety of supervised or unsupervised models, but mostly tree-based classifiers and neural networks. Two publications had code uploaded to a public repository, and one publication uploaded the dataset. Conclusions: Machine learning in palliative care is mainly used to predict mortality. Similarly to other applications of ML, external test sets and prospective validations are the exception.

Published
2023
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30. Use of EORTC Target Definition Guidelines for Dose-Intensified Salvage Radiation Therapy for Recurrent Prostate Cancer: Results of the Quality Assurance Program of the Randomized Trial SAKK 09/10

Author

Sassowsky, Manfred, Gut, Philipp, Hölscher, Tobias, Hildebrandt, Guido, Müller, Arndt-Christian, Najafi, Yousef, Kohler, Götz, Kranzbühler, Helmut, Guckenberger, Matthias, Zwahlen, Daniel R., Azinwi, Ngwa C., Plasswilm, Ludwig, Takacs, Istvan, Reuter, Christiane, Sumila, Marcin, Manser, Peter, Ost, Piet, Böhmer, Dirk, Pilop, Christiane, Aebersold, Daniel M., and Ghadjar, Pirus

Published
2013
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31. Classifying the Acquisition Sequence for Brain MRIs Using Neural Networks on Single Slices

Author

Braeker, Norbert, Schmitz, Cornelia, Wagner, Natalie, Stanicki, Badrudin J., Schroeder, Christina, Ehret, Felix, Fuerweger, Christoph, Zwahlen, Daniel R., Foerster, Robert, Muacevic, Alexander, Windisch, Paul, Braeker, Norbert, Schmitz, Cornelia, Wagner, Natalie, Stanicki, Badrudin J., Schroeder, Christina, Ehret, Felix, Fuerweger, Christoph, Zwahlen, Daniel R., Foerster, Robert, Muacevic, Alexander, and Windisch, Paul

Abstract

Background Neural networks for analyzing MRIs are oftentimes trained on particular combinations of perspectives and acquisition sequences. Since real-world data are less structured and do not follow a standard denomination of acquisition sequences, this impedes the transition from deep learning research to clinical application. The purpose of this study is therefore to assess the feasibility of classifying the acquisition sequence from a single MRI slice using convolutional neural networks. Methods A total of 113 MRI slices from 52 patients were used in a transfer learning approach to train three convolutional neural networks of different complexities to predict the acquisition sequence, while 27 slices were used for internal validation. The model then underwent external validation on 600 slices from 273 patients belonging to one of four classes (T1-weighted without contrast enhancement, T1-weighted with contrast enhancement, T2-weighted, and diffusion-weighted). Categorical accuracy was noted, and the results of the predictions for the validation set are provided with confusion matrices. Results The neural networks achieved a categorical accuracy of 0.79, 0.81, and 0.84 on the external validation data. The implementation of Grad-CAM showed no clear pattern of focus except for T2-weighted slices, where the network focused on areas containing cerebrospinal fluid. Conclusion Automatically classifying the acquisition sequence using neural networks seems feasible and could be used to facilitate the automatic labelling of MRI data.

Published
2022

32. Convolutional Neural Networks to Detect Vestibular Schwannomas on Single MRI Slices: A Feasibility Study

Author

Koechli, Carole, Vu, Erwin, Sager, Philipp, Naf, Lukas, Fischer, Tim, Putora, Paul M., Ehret, Felix, Fuerweger, Christoph, Schroder, Christina, Forster, Robert, Zwahlen, Daniel R., Muacevic, Alexander, Windisch, Paul, Koechli, Carole, Vu, Erwin, Sager, Philipp, Naf, Lukas, Fischer, Tim, Putora, Paul M., Ehret, Felix, Fuerweger, Christoph, Schroder, Christina, Forster, Robert, Zwahlen, Daniel R., Muacevic, Alexander, and Windisch, Paul

Abstract

Simple Summary Due to the fact that they take inter-slice information into account, 3D- and 2.5D-convolutional neural networks (CNNs) potentially perform better in tumor detection tasks than 2D-CNNs. However, this potential benefit is at the expense of increased computational power and the need for segmentations as an input. Therefore, in this study we aimed to detect vestibular schwannomas (VSs) in individual magnetic resonance imaging (MRI) slices by using a 2D-CNN. We retrained (539 patients) and internally validated (94 patients) a pretrained CNN using contrast-enhanced MRI slices from one institution. Furthermore, we externally validated the CNN using contrast-enhanced MRI slices from another institution. This resulted in an accuracy of 0.949 (95% CI 0.935-0.963) and 0.912 (95% CI 0.866-0.958) for the internal and external validation, respectively. Our findings indicate that 2D-CNNs might be a promising alternative to 2.5-/3D-CNNs for certain tasks thanks to the decreased requirement for computational power and the fact that there is no need for segmentations. In this study. we aimed to detect vestibular schwannomas (VSs) in individual magnetic resonance imaging (MRI) slices by using a 2D-CNN. A pretrained CNN (ResNet-34) was retrained and internally validated using contrast-enhanced T1-weighted (T1c) MRI slices from one institution. In a second step, the model was externally validated using T1c- and T1-weighted (T1) slices from a different institution. As a substitute, bisected slices were used with and without tumors originating from whole transversal slices that contained part of the unilateral VS. The model predictions were assessed based on the categorical accuracy and confusion matrices. A total of 539, 94, and 74 patients were included for training, internal validation, and external T1c validation, respectively. This resulted in an accuracy of 0.949 (95% CI 0.935-0.963) for the internal validation and 0.912 (95% CI 0.866-0.958) for the external T1c valid

Published
2022

35. Convolutional Neural Networks to Detect Vestibular Schwannomas on Single MRI Slices: A Feasibility Study

Author

Koechli, Carole, primary, Vu, Erwin, additional, Sager, Philipp, additional, Näf, Lukas, additional, Fischer, Tim, additional, Putora, Paul M., additional, Ehret, Felix, additional, Fürweger, Christoph, additional, Schröder, Christina, additional, Förster, Robert, additional, Zwahlen, Daniel R., additional, Muacevic, Alexander, additional, and Windisch, Paul, additional

Published
2022
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36. Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101)

Author

Weber, Walter P, Matrai, Zoltan, Hayoz, Stefanie, Tausch, Christoph, Henke, Guido, Zwahlen, Daniel R, Gruber, Günther, Zimmermann, Frank, Seiler, Stefanie, Maddox, Charlotte, Ruhstaller, Thomas, Muenst, Simone, Ackerknecht, Markus, Kuemmel, Sherko, Bjelic-Radisic, Vesna, Kurzeder, Christian, Újhelyi, Mihály, Vrieling, Conny, Satler, Rok, Meyer, Inna, Becciolini, Charles, Bucher, Susanne, Simonson, Colin, Fehr, Peter M, Gabriel, Natalie, Maráz, Robert, Sarlos, Dimitri, Dedes, Konstantin J, Leo, Cornelia, Berclaz, Gilles, et al, University of Zurich, and Weber, Walter P

Subjects
610 Medicine & health, 2730 Oncology, 1306 Cancer Research, Surgery, General Medicine, 10174 Clinic for Gynecology, 2746 Surgery
Published
2021

39. Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101)

Author

Weber, Walter P., primary, Matrai, Zoltan, additional, Hayoz, Stefanie, additional, Tausch, Christoph, additional, Henke, Guido, additional, Zwahlen, Daniel R., additional, Gruber, Günther, additional, Zimmermann, Frank, additional, Seiler, Stefanie, additional, Maddox, Charlotte, additional, Ruhstaller, Thomas, additional, Muenst, Simone, additional, Ackerknecht, Markus, additional, Kuemmel, Sherko, additional, Bjelic-Radisic, Vesna, additional, Kurzeder, Christian, additional, Újhelyi, Mihály, additional, Vrieling, Conny, additional, Satler, Rok, additional, Meyer, Inna, additional, Becciolini, Charles, additional, Bucher, Susanne, additional, Simonson, Colin, additional, Fehr, Peter M., additional, Gabriel, Natalie, additional, Maráz, Robert, additional, Sarlos, Dimitri, additional, Dedes, Konstantin J., additional, Leo, Cornelia, additional, Berclaz, Gilles, additional, Dubsky, Peter, additional, Exner, Ruth, additional, Fansa, Hisham, additional, Hager, Christopher, additional, Reisenberger, Klaus, additional, Singer, Christian F., additional, Reitsamer, Roland, additional, Reinisch, Mattea, additional, Winkler, Jelena, additional, Lam, Giang Thanh, additional, Fehr, Mathias K., additional, Naydina, Tatiana, additional, Kohlik, Magdalena, additional, Clerc, Karine, additional, Ostapenko, Valerijus, additional, Fitzal, Florian, additional, Nussbaumer, Rahel, additional, Maggi, Nadia, additional, Schulz, Alexandra, additional, Markellou, Pagona, additional, Lelièvre, Loïc, additional, Egle, Daniel, additional, Heil, Jörg, additional, and Knauer, Michael, additional

Published
2021
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42. Convolutional Neural Networks for Classifying Laterality of Vestibular Schwannomas on Single MRI Slices—A Feasibility Study

Author

Sager, Philipp, primary, Näf, Lukas, additional, Vu, Erwin, additional, Fischer, Tim, additional, Putora, Paul M., additional, Ehret, Felix, additional, Fürweger, Christoph, additional, Schröder, Christina, additional, Förster, Robert, additional, Zwahlen, Daniel R., additional, Muacevic, Alexander, additional, and Windisch, Paul, additional

Published
2021
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44. Dose-intensified Versus Conventional-dose Salvage Radiotherapy for Biochemically Recurrent Prostate Cancer After Prostatectomy: The SAKK 09/10 Randomized Phase 3 Trial

Author

Ghadjar, Pirus, primary, Hayoz, Stefanie, additional, Bernhard, Jürg, additional, Zwahlen, Daniel R., additional, Hölscher, Tobias, additional, Gut, Philipp, additional, Polat, Bülent, additional, Hildebrandt, Guido, additional, Müller, Arndt-Christian, additional, Plasswilm, Ludwig, additional, Papachristofilou, Alexandros, additional, Schär, Corinne, additional, Sumila, Marcin, additional, Zaugg, Kathrin, additional, Guckenberger, Matthias, additional, Ost, Piet, additional, Reuter, Christiane, additional, Bosetti, Davide G., additional, Khanfir, Kaouthar, additional, Gomez, Silvia, additional, Wust, Peter, additional, Thalmann, George N., additional, Aebersold, Daniel M., additional, Gut, P., additional, Thum, P., additional, Collon, J., additional, Putora, P.M., additional, Plasswilm, L., additional, Sassowsky, M., additional, Thalmann, G.N., additional, Aebersold, D.M., additional, Sumila, M., additional, Kranzbühler, H., additional, Zaugg, K., additional, Papachristofilou, A., additional, Zimmermann, F., additional, Najafi, Y., additional, Brown, M., additional, Guckenberger, M., additional, Wuttke, S., additional, Reuter, C., additional, Oehler, C., additional, Zwahlen, D.R., additional, Azinwi, N.C., additional, Bosetti, D.G., additional, Pesce, G., additional, Tacacs, I., additional, Bodis, S., additional, Gomez, S., additional, Khanfir, K., additional, Behrensmeier, F., additional, Beer, K., additional, Messer, P., additional, Hölscher, T., additional, Baumann, M., additional, Polat, B., additional, Flentje, M., additional, Lewitzki, V., additional, Hildebrandt, G., additional, Müller, A.C., additional, Zips, D., additional, Ghadjar, P., additional, Wust, P., additional, Budach, V., additional, Ganswindt, U., additional, Belka, C., additional, Pinkawa, M., additional, Eble, M.J., additional, Berkovic, K., additional, Stuschke, M., additional, Ost, P., additional, and Vandaele, F., additional

Published
2021
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46. Dose-intensified Versus Conventional-dose Salvage Radiotherapy for Biochemically Recurrent Prostate Cancer After Prostatectomy: The SAKK 09/10 Randomized Phase 3 Trial

Author

Ghadjar, Pirus, Hayoz, Stefanie, Bernhard, Jürg, Zwahlen, Daniel R, Hölscher, Tobias, Gut, Philipp, Polat, Bülent, Hildebrandt, Guido, Müller, Arndt-Christian, Plasswilm, Ludwig, Papachristofilou, Alexandros, Schär, Corinne, Sumila, Marcin, Zaugg, Kathrin, Guckenberger, Matthias, Ost, Piet, Reuter, Christiane, Bosetti, Davide G, Khanfir, Kaouthar, Gomez, Silvia, Wust, Peter, Thalmann, George N, Aebersold, Daniel M, University of Zurich, and Ghadjar, Pirus

Subjects
2748 Urology, 610 Medicine & health, 10044 Clinic for Radiation Oncology
Abstract

BACKGROUND Salvage radiotherapy (SRT) is utilized for biochemical progression of prostate cancer after radical prostatectomy (RP). OBJECTIVE To report the outcomes of the SAKK 09/10 trial comparing conventional and dose-intensified SRT. DESIGN, SETTING, AND PARTICIPANTS SAKK 09/10 was a randomized, multicenter, phase 3 trial that recruited men with biochemical progression after RP. INTERVENTION Patients were randomly assigned to conventional-dose (64 Gy) or dose-intensified SRT (70 Gy) to the prostate bed without hormonal therapy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary endpoint was freedom from biochemical progression (FFBP). Secondary endpoints included clinical progression-free survival (PFS), time to hormonal treatment, overall survival (OS), acute and late toxicity (Common Terminology Criteria for Adverse Events v4.0), and quality of life (QoL). RESULTS AND LIMITATIONS Between February 2011 and April 2014, 350 patients were randomly assigned to 64 Gy (n = 175) or 70 Gy (n = 175). Median prostate-specific antigen at randomization was 0.3 ng/ml. After median follow-up of 6.2 yr, the median FFBP was 8.2 yr in the 64 Gy arm and 7.6 in the 70 Gy arm (log-rank p = 0.4), with a hazard ratio of 1.14 (95% confidence interval 0.82-1.60). The 6-year FFBP rates were 62% and 61%, respectively. No significant differences in clinical PFS, time to hormonal treatment, or OS were observed. Late grade 2 and 3 genitourinary toxicity was observed in 35 (21%) and 13 (7.9%) patients in the 64 Gy arm, and 46 (26%) and seven (4%) in the 70 Gy arm, respectively (p = 0.8). Late grade 2 and 3 gastrointestinal toxicity was observed in 12 (7.3%) and seven patients (4.2%) in the 64 Gy arm, and 35 (20%) and four (2.3%) in the 70 Gy arm, respectively (p = 0.009). There were no significant differences in QoL. CONCLUSIONS Conventional-dose SRT to the prostate bed is sufficient in patients with early biochemical progression of prostate cancer after RP. PATIENT SUMMARY The optimal radiation therapy dose for patients who have increased tumor markers after surgery for prostate cancer is unclear. We found that administering a higher dose only increased the gastrointestinal side effects without providing any benefits to the patient. This clinical trial is registered on ClinicalTrials.gov as NCT01272050.

Published
2021
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47. Convolutional Neural Networks for Classifying Laterality of Vestibular Schwannomas on Single MRI Slices-A Feasibility Study

Author

Sager, Philipp, Naef, Lukas, Vu, Erwin, Fischer, Tim, Putora, Paul M., Ehret, Felix, Fuerweger, Christoph, Schroeder, Christina, Foerster, Robert, Zwahlen, Daniel R., Muacevic, Alexander, Windisch, Paul, Sager, Philipp, Naef, Lukas, Vu, Erwin, Fischer, Tim, Putora, Paul M., Ehret, Felix, Fuerweger, Christoph, Schroeder, Christina, Foerster, Robert, Zwahlen, Daniel R., Muacevic, Alexander, and Windisch, Paul

Abstract

Introduction: Many proposed algorithms for tumor detection rely on 2.5/3D convolutional neural networks (CNNs) and the input of segmentations for training. The purpose of this study is therefore to assess the performance of tumor detection on single MRI slices containing vestibular schwannomas (VS) as a computationally inexpensive alternative that does not require the creation of segmentations. Methods: A total of 2992 T1-weighted contrast-enhanced axial slices containing VS from the MRIs of 633 patients were labeled according to tumor location, of which 2538 slices from 539 patients were used for training a CNN (ResNet-34) to classify them according to the side of the tumor as a surrogate for detection and 454 slices from 94 patients were used for internal validation. The model was then externally validated on contrast-enhanced and non-contrast-enhanced slices from a different institution. Categorical accuracy was noted, and the results of the predictions for the validation set are provided with confusion matrices. Results: The model achieved an accuracy of 0.928 (95% CI: 0.869-0.987) on contrast-enhanced slices and 0.795 (95% CI: 0.702-0.888) on non-contrast-enhanced slices from the external validation cohorts. The implementation of Gradient-weighted Class Activation Mapping (Grad-CAM) revealed that the focus of the model was not limited to the contrast-enhancing tumor but to a larger area of the cerebellum and the cerebellopontine angle. Conclusions: Single-slice predictions might constitute a computationally inexpensive alternative to training 2.5/3D-CNNs for certain detection tasks in medical imaging even without the use of segmentations. Head-to-head comparisons between 2D and more sophisticated architectures could help to determine the difference in accuracy, especially for more difficult tasks.

Published
2021

49. The Apple Watch spO2 sensor and outliers in healthy users.

Author

Schröder, Christina, Förster, Robert, Zwahlen, Daniel R., and Windisch, Paul

Subjects
MEDICAL equipment reliability, HUMAN research subjects, RESEARCH evaluation, SELF-evaluation, OXYGEN saturation, WEARABLE technology, HEALTH outcome assessment, INFORMED consent (Medical law), DOCUMENTATION, HEART beat, ASSISTIVE technology, DESCRIPTIVE statistics, PULSE oximeters
Abstract

It is unclear how frequently the Apple Watch produces spO2 measurements outside of the normal range in healthy individuals at rest. We conducted a head-to-head comparison in 38 healthy individuals between two watches and two medical-grade pulse oximeters. Fourteen percent of watch measurements yielded spO2 values below 95%, with no values below 92%. Results suggest that outliers measured by the watch should not be a cause for concern in otherwise healthy individuals. [ABSTRACT FROM AUTHOR]

Published
2023
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