@BhavyaRShahMD@EMiddlebrooksMD@MichaelOkun@KDFooteMD@DrAlfonsoFasano@andreashorn_@foxmdphd Again the NEJM paper was by experts in the field and the toxicities were very high despite using biofeedback. The reality is MR thermometry is not as accurate as we’d like based on extrapolations for phase shift equations and thermal gradients are not steep. Bystander effect.
@EMiddlebrooksMD@MichaelOkun@KDFooteMD@DrAlfonsoFasano@andreashorn_ I would tell them to look at the prospective FUS thalamotomy data in NEJM showing UNACCEPTABLE toxicities - 20% risk of ataxia (4% persisted), 16% unsteadiness (5% persisted), 36% rate of paresthesias and numbness in 38% (9% and 14% persisted)
@EvanThomas84 Thanks @EvanThomas84 ! Was so nice to hang at @the_RSS and hear about the sweet things you’re doing in the space! Let’s connect soon and make an impact together :)
@SprakerMDPhD @ParikhSimul @IJROBP@ASTRO_org@ACRORadOnc@VUMCRadOnc@VUMCPsych@PsychNews I envisioned studies comparing SRS w/ DBS, RFA or MRgFUS though I couldn’t convince other specialties to join because patients naturally gravitate towards the only one of these that doesn’t require incisions, anesthesia, or shaving of one’s head (esp in mental health population)
@ParikhSimul @IJROBP@ASTRO_org@ACRORadOnc@VUMCRadOnc@VUMCPsych@PsychNews Also, you’ll see after the full pub comes out, but we captured actually changes in the connectome that happens after treatment (actual structural changes and functional reorganization). This is usually not consistent with placebo :)
@ParikhSimul @IJROBP@ASTRO_org@ACRORadOnc@VUMCRadOnc@VUMCPsych@PsychNews Absolutely, and commonly a “lessebo” effect, where the intervention arm actually does worse because a patient does not feel deserving of a positive response. Totally, a RCT would be great, the problem is getting the collaborators to do it!
@ParikhSimul @IJROBP@ASTRO_org@ACRORadOnc@VUMCRadOnc@VUMCPsych@PsychNews I should mention that this brief report does not do justice to these patients’ lives that have been completely changed (and saved)! These patients are no longer suicidal, off heavy duty and debilitating treatments (ECT, ketamine) etc and finally living the way they want to be.
@ParikhSimul @IJROBP@ASTRO_org@ACRORadOnc@VUMCRadOnc@VUMCPsych@PsychNews This data is prospectively acquired and the imaging component (connectome analysis) as part of our clinical trial https://t.co/d6qaSzENJS
This lesioning has been done by RFA and other invasive techniques for years, radiosurgical ablation is just a less invasive means!
It was an honor to be a part of this @acousticneuroma study w/ @Nauman_eardoc & colleagues @vumcskullbase Planned STR with salvage radiosurgery to the residual is a great option for patients with complex tumors, allowing safe decompression and excellent tumor control.
Researchers wanted to evaluate the predictors of remnant tumor regrowth and need for salvage therapy after less than gross total resection of vestibular schwannoma. #VestibularSchwannoma#AcousticNeuroma @vumcskullbase
https://t.co/n8tWa3qg4u
Are you a patient with #acousticneuroma or a caregiver? Join our Minneapolis/St. Paul/Western Wisconsin @ANAssociation support group meeting on March 13, 2022 where I will help answer your questions by registering below!
https://t.co/BtX02bxGDC