BACKGROUND AND OBJECTIVE: Patients with glioma experience a high symptom burden and have diverse palliative care needs. However, the assessment scales used in palliative care remain non-standardized and highly heterogeneous. To evaluate the application patterns of the current scales used in palliative care for glioma, we aim to identify gaps and assess the need for disease-specific scales in glioma palliative care. METHODS: We conducted a systematic search of five databases including PubMed, Web of Science, Medline, EMBASE, and CINAHL for quantitative studies that reported scale-based assessments in glioma palliative care. We extracted data on scale characteristics, domains, frequency, and psychometric properties. Quality assessments were performed using the Cochrane ROB 2.0 and ROBINS-I tools. RESULTS: Of the 3,405 records initially identified, 72 studies were included. These studies contained 75 distinct scales that were used 193 times. Mood (21.7%), quality of life (24.4%), and supportive care needs (5.2%) assessments were the most frequently assessed items, exceeding half of all scale applications. Among the various assessment dimensions, the Distress Thermometer (DT) was the most frequently used tool for assessing mood, while the Short Form-36 Health Survey Questionnaire (SF-36) was the most frequently used tool for assessing quality of life. The Mini Mental Status Examination (MMSE) was the most common tool for cognitive assessment. Performance status (5.2%) and social support (6.8%) were underrepresented. Only three brain tumor-specific scales were identified. Caregiver-focused scales were limited and predominantly burden-oriented. CONCLUSIONS: There are significant heterogeneity, domain imbalances, and validation gaps in the current use of assessment scales for patients with glioma receiving palliative care. The scale selected for use should be comprehensive and user-friendly.
Humans ; Glioma/psychology* ; Palliative Care/methods* ; Quality of Life ; Psychometrics ; Brain Neoplasms/psychology*

Recently, deep learning has achieved impressive results in medical image tasks. However, this method usually requires large-scale annotated data, and medical images are expensive to annotate, so it is a challenge to learn efficiently from the limited annotated data. Currently, the two commonly used methods are transfer learning and self-supervised learning. However, these two methods have been little studied in multimodal medical images, so this study proposes a contrastive learning method for multimodal medical images. The method takes images of different modalities of the same patient as positive samples, which effectively increases the number of positive samples in the training process and helps the model to fully learn the similarities and differences of lesions on images of different modalities, thus improving the model's understanding of medical images and diagnostic accuracy. The commonly used data augmentation methods are not suitable for multimodal images, so this paper proposes a domain adaptive denormalization method to transform the source domain images with the help of statistical information of the target domain. In this study, the method is validated with two different multimodal medical image classification tasks: in the microvascular infiltration recognition task, the method achieves an accuracy of (74.79 ± 0.74)% and an F1 score of (78.37 ± 1.94)%, which are improved as compared with other conventional learning methods; for the brain tumor pathology grading task, the method also achieves significant improvements. The results show that the method achieves good results on multimodal medical images and can provide a reference solution for pre-training multimodal medical images.
Humans ; Algorithms ; Brain/diagnostic imaging* ; Brain Neoplasms/diagnostic imaging* ; Recognition, Psychology

PURPOSE: The purpose of this study was to identify the influences of sleep quality and mood state on fatigue in primary brain tumor patients. METHODS: The participants were 118 patients with primary brain tumors between May 2015 and March 2016. Data were collected using questionnaires including individual and disease related characteristics, the Pittsburgh Sleep Quality Index, Linear Analogue Self-Assessment scales, and The Fatigue Scale for Cancer Patients developed by Kim Kyeong-hee (2006). Data were analyzed using descriptive statistics, Pearson correlation, and hierarchical multiple regression. RESULTS: Fatigue had significant correlations with sleep quality (r=.55, p<.001) and mood state (r=.74, p<.001). The influencing factors for fatigue were mood state (β=.46, p<.001) was the best predictor of fatigue, followed by age (β=.17, p=.049), and performance status (β=-.19, p=.011). CONCLUSION: The research findings show that understanding of psychological factors such as anxiety, depression, confusion, energy and anger should be given priority for fatigue management in primary brain tumor patients. This study provides base data for managing fatigue in patients with primary brain tumors, and is expected to contribute to the improvement of the health of patients with primary brain tumor.
Anger ; Anxiety ; Brain Neoplasms* ; Depression ; Fatigue* ; Humans ; Psychology ; Self-Assessment ; Weights and Measures

11C-methionine (Met) positron emission tomography (PET) is one of the most commonly used PET tracers for evaluating brain tumors. However, few reports have described tips and pitfalls of 11C-Met PET for general practitioners. Physiological 11C-Met uptake, anatomical variations, vascular disorders, non-tumorous lesions such as inflammation or dysplasia, benign brain tumors and patient condition during 11C-Met PET examination can potentially affect the image interpretation and cause false positives and negatives. These pitfalls in the interpretation of 11C-Met PET images are important for not only nuclear medicine physicians but also general radiologists. Familiarity with the spectrum and pitfalls of 11C-Met images could help prevent unfavorable clinical results caused by misdiagnoses.
Brain Neoplasms ; Diagnostic Errors ; Electrons* ; General Practitioners ; Humans ; Inflammation ; Methionine ; Nuclear Medicine ; Positron-Emission Tomography* ; Recognition (Psychology) ; Vascular Diseases

PURPOSE: The purpose of this study was to assess clinical practice and barriers associated with cancer rehabilitation from the perspective of Korean physiatrists. MATERIALS AND METHODS: All active members of the Korean Academy of Rehabilitation Medicine were invited to complete an online survey developed after focus group discussions. RESULTS: A total of 97 physiatrists (72 males and 25 females) in Korea completed the survey. Of these, 77% reported familiarity with the term 'cancer survivors.' More than 50% of respondents reported that they provided rehabilitation services for patients with breast cancer (61.9%), brain tumors (64.9%), and spinal tumors (63.9%), whereas 86.6% of respondents reported that they had never or rarely provided rehabilitation programs for patients with gynecological, colorectal, or prostate cancer. Physiatrists who received referrals from a well-organized cooperative referral system reported providing services such as exercise programs for patients with gynecological cancer (odds ratio [OR], 2.16; p=0.044) as well as education regarding lymphedema (OR, 1.81; p=0.047) and neuropathic pain (OR, 1.96; p=0.026). CONCLUSION: Although most of the physiatrists surveyed believed that they should contribute to the management of cancer patients, they considered themselves ill equipped to provide appropriate rehabilitation services. This lack of understanding of the effectiveness of rehabilitation services for cancer patients and absence of a cooperative referral system are the major barriers to providing rehabilitation services to cancer survivors in Korea.
Brain Neoplasms ; Breast Neoplasms ; Data Collection ; Education ; Focus Groups ; Humans ; Korea ; Lymphedema ; Male ; Neuralgia ; Physical and Rehabilitation Medicine ; Professional Practice ; Prostatic Neoplasms ; Recognition (Psychology) ; Referral and Consultation ; Rehabilitation* ; Survivors

Gliomas are malignant primary brain tumors and yet incurable. Palliation and the maintenance or improvement of the patient's quality of life is therefore of main importance. For that reason, health-related quality of life (HRQoL) has become an important outcome measure in clinical trials, next to traditional outcome measures such as overall and progression-free survivals, and radiological response to treatment. HRQoL is a multidimensional concept covering physical, psychological, and social domains, as well as symptoms induced by the disease and its treatment. HRQoL is assessed by using self-reported, validated questionnaires. Various generic HRQoL questionnaires, which can be supplemented with a brain tumor- specific module, are available. Both the tumor and its treatment can have a negative effect on HRQoL. However, treatment with surgery, radiotherapy, chemotherapy, and supportive treatment may also improve patients' HRQoL, in addition to extending survival. It is expected that the impact of HRQoL measurements in both clinical trials and clinical practice will increase. Hence, it is important that HRQoL data are collected, analyzed, and interpreted correctly. Methodological issues such as selection bias and missing data may hamper the interpretation of HRQoL data and should therefore be accounted. In clinical trials, HRQoL can be used to assess the benefits of a new treatment strategy, which should be weighed carefully against the adverse effects of that treatment. In daily clinical practice, HRQoL assessments of an individual patient can be used to inform physicians about the impact of a specific treatment strategy, and it may facilitate the communication between the physicians and the patients.
Brain Neoplasms ; pathology ; psychology ; therapy ; Glioma ; pathology ; psychology ; therapy ; Health Status ; Humans ; Neoplasm Grading ; Outcome Assessment (Health Care) ; Quality of Life ; Surveys and Questionnaires

BACKGROUNDTumor surgery in brain motor functional areas remains challenging. Novel techniques are being developed to gain maximal and safe resection for brain tumor surgery. Herein, we assessed the magnetic resonance diffusion tensor imaging (MR-DTI) and fluorescein sodium dyeing (FLS) guiding technique for surgery of glioma located in brain motor functional areas.

METHODSTotally 83 patients were enrolled according to our inclusion and exclusion criteria (56 patients in experimental group, 27 patients in control group). In the experimental group, the surgical approach was designed by DTI imaging, which showed the relationship between the tumor and motor tract. The range of resection in the operation was determined using the FLS-stained area, which recognized the tumor and its infiltrated tissue. The traditional routine method was used in the control group. Postoperatively, all patients underwent enhanced brain MRI within 72 hours to ascertain the extent of resection. Patients were followed in our outpatient clinic over 6 - 24 months. Neurological deficits and Karnofsky scoring (KPS) were evaluated.

RESULTSThere were no significant differences in balance test indexes of preoperative data (sex, age, lesion location and volume, and neurological deficits before operation) and diagnosis of histopathology between the two groups. There was a trend in the experimental group for greater rates of gross total resection (80.4% vs. 40.7%), and the paralysis rate caused by surgery was lower in experimental (25.0%) vs. control (66.7%) groups (P < 0.05). The 6-month KPS in the low-grade and high-grade gliomas was 91 ± 11 and 73 ± 26, respectively, in the experimental group vs. 82 ± 9 and 43 ± 27, respectively, in the control group (P < 0.05 for both).

CONCLUSIONSMR-DTI and FLS dye guiding for surgery of glioma located in brain motor functional areas can increase the gross total resection rate, decrease the paralysis rate caused by surgery, and improve patient quality of life compared with traditional glioma surgery.

Adolescent ; Adult ; Aged ; Brain Neoplasms ; pathology ; psychology ; surgery ; Diffusion Tensor Imaging ; methods ; Female ; Fluorescein ; Glioma ; pathology ; psychology ; surgery ; Humans ; Male ; Middle Aged ; Motor Cortex ; pathology ; Muscle Strength ; Prognosis

Nocardiosis is an uncommon Gram-positive bacterial infection caused by aerobic actinomycetes in the genus Nocardia. Nocardia spp. have the ability to cause localized or systemic suppurative disease in humans and animals. Nocardiosis is typically regarded as an opportunistic infection, but approximately one-third of infected patients are immunocompetent. We report a rare case of pulmonary nocardiosis and a brain abscess caused by Nocardia asteroides in an elderly woman with a history of Crohn's disease. Radiographic imaging revealed a contrast-enhancing lesion with perilesional parenchymal edema that was preoperatively thought to be a neoplasm. The patient experienced aggressive disease progression simulating a metastatic brain tumor. Early diagnosis of norcadiosis, the absence of underlying disease, and the administration of appropriate antibiotics has a positive impact on prognosis. Familiarity with the magnetic resonance and computed tomography findings associated with CNS nocardiosis, such as those presented here, is essential for making an early diagnosis.
Actinobacteria ; Aged ; Animals ; Anti-Bacterial Agents ; Brain ; Brain Abscess ; Brain Neoplasms ; Crohn Disease ; Disease Progression ; Early Diagnosis ; Edema ; Female ; Gram-Positive Bacterial Infections ; Humans ; Magnetic Resonance Spectroscopy ; Nocardia ; Nocardia asteroides ; Nocardia Infections ; Opportunistic Infections ; Prognosis ; Recognition (Psychology)

PURPOSE: Our study aimed to examine the relationship between intelligence and health-related quality of life (HRQOL) in children (6-13 years old) diagnosed as having a brain tumor. MATERIALS AND METHODS: We administered a Korean version of the Wechsler Intelligence Scale for Children-III, the Pediatric Quality of Life Inventory, version 4.0 (PedsQL), the Korean version of the Parenting Stress Index-Short Form, and the Korean Version of the Parenting Sense of Competence (K-PSOC) scale before or after initial radiotherapy (T1) and after treatment termination (T2). In total, 13 patients completed both the T1 and T2 interviews. RESULTS: Scores significantly declined between T1 and T2 on the full-scale intelligence quotients (FIQ), verbal intelligence quotients (VIQ), performance intelligence quotients (PIQ), similarity and coding tests, as well as the K-PSOC, which measures parental anxiety. FIQ scores at T1 were correlated with the self-reported PedsQL total scores (r=0.739) and the parent proxy-report PedsQL scores for school functioning (r=0.706) at T2. Also, the FIQ scores at T2 were correlated with the self-reported PedsQL total scores (r=0.748) and scores for physical health (r=0.728) at T2. CONCLUSION: The cognitive ability and intelligence level of the patients significantly declined between on and off treatment periods, and higher intelligence functioning at both on and off treatment was correlated with long-term higher HRQOL. Further investigations that monitor intelligence, HRQOL and parenting stress over a longer period, using a greater number of participants, are needed.
Adolescent ; Anxiety ; Brain Neoplasms/complications/physiopathology/*psychology ; Child ; *Cognition ; Female ; Humans ; Intelligence Tests ; Longitudinal Studies ; Male ; Parenting ; Parents/psychology ; Prospective Studies ; *Quality of Life ; Stress, Psychological/*diagnosis ; Time Factors

A 20-month-old boy presented with a intraparenchymal mass in the right frontoparietal area manifesting as complex partial seizure, secondary generalization and left hemiparesis. Magnetic resonance images (MRI) of the brain showed inhomogeneously enhancing mass in the right frontoparietal area which has irregular margin and perilesional edema. Based on the radiological findings, a preoperative diagnosis was an intraaxial tumor, such as pilocytic astrocytoma or dysembryoplastic neuroepithelial tumor. The patient underwent a surgery including frontal craniotomy. The tumor had a partially extreme adherence to the surrounding brain tissue but it showed no dural attachment. Gross-total resection of the tumor was achieved. Postoperative follow-up computed tomography scans showed no residual tumor. The pathological findings confirmed the tumor as a WHO grade I meningioma, transitional type. Nine months after the surgery, follow-up brain MRI showed no recurrence of the tumor, porencephaly in site where the tumor was resected; the patient's symptoms had fully recovered. We report the case of a meningioma in a 20-month-old boy.
Astrocytoma ; Brain ; Child ; Craniotomy ; Edema ; Follow-Up Studies ; Generalization (Psychology) ; Humans ; Infant ; Magnetic Resonance Spectroscopy ; Meningioma ; Neoplasm, Residual ; Neoplasms, Neuroepithelial ; Paresis ; Recurrence ; Seizures