OBJECTIVE: Glutamate chemical exchange saturation transfer (GluCEST) is a non-invasive CEST imaging technique for detecting glutamate levels in tissues. We aimed to investigate the reproducibility of the 5T GluCEST technique in healthy volunteers and preliminarily explore its potential clinical application in patients with brain tumors.
METHODS: Ten volunteers (4 males, mean age 29 years) underwent three 5T GluCEST imaging scans. The reproducibility of the three imaging GluCEST measurements was assessed using one-way repeated measures analysis of variance (ANOVA), generalized estimating equations, and linear mixed models. Twenty-eight patients with brain tumors (10 males, mean age 54 years) underwent a single GluCEST scan preoperatively, and t-tests were used to compare the differences in GluCEST values between different brain tumors. In addition, the diagnostic accuracy of GluCEST values in differentiating brain tumors was assessed using the receiver work characteristics (ROC) curve.
RESULTS: The coefficients of variation of GluCEST values in healthy volunteers were less than 5% for intra-day, inter-day, and within-subjects and less than 10% for between-subjects. High-grade gliomas (HGG) had higher GluCEST values compared to low-grade gliomas (LGG) (P < 0.001). In addition, cerebellopontine angle (CPA) meningiomas had higher GluCEST values than acoustic neuromas (P < 0.001). The area under the curve (AUC) of the GluCEST value for differentiating CPA meningioma from acoustic neuroma was 0.93.
CONCLUSIONS: 5T GluCEST images are highly reproducible in healthy brains. In addition, the 5T GluCEST technique has potential clinical applications in differentiating LGG from HGG and CPA meningiomas from acoustic neuromas.

BACKGROUND: Tinnitus is very common in patients with vestibular schwannoma (VS). We analyzed the related factors of tinnitus after surgery.
METHODS: One hundred seventy-three patients diagnosed with unilateral VS operated via the retrosigmoid approach were included in the study. All patients underwent relevant examinations and completed the THI scale before surgery and 6 months after surgery. The prognosis of tinnitus was evaluated according to the changes in THI.
RESULTS: Of the 129 preoperative tinnitus patients, postoperative tinnitus resolved in 12.4%, improved in 29.5%, remained unchanged in 28.6%, and worsened in 29.5%. 18.2% of 44 patients without preoperative tinnitus appeared new-onset tinnitus postoperatively. Thirty-six patients never had tinnitus. Patients with smaller tumor sizes (≤ 3 cm) were more likely to experience preoperative tinnitus. Younger patients and those with serviceable hearing preoperatively were more likely to report their tinnitus unchanged or worsened. A new onset of postoperative tinnitus in the preoperative non-tinnitus group was found in better preoperative hearing function.
CONCLUSIONS: In this study, 70% of patients had persistent tinnitus after vestibular schwannoma resection. The prognosis of tinnitus was influenced by age and preoperative hearing function. Tinnitus is a bothersome symptom and is often underestimated by doctors. Assessment of tinnitus is mandatory during the management of vestibular schwannoma.

UNASSIGNED: To investigate potential differences in absolute deviation values of subjective visual vertical and horizontal between unilateral acoustic neuroma patients and healthy young adults under varying degrees of static head tilt, as well as the impact of proprioception on these values, with the aim of determining the effect of acoustic neuroma on gravity sensory pathway function in patients.
UNASSIGNED: We recruited 22 patients diagnosed with unilateral acoustic neuroma and 25 healthy young adults and employed virtual reality technology to assess the absolute deviation values of subjective visual vertical (SVV) and subjective visual horizontal (SVH) under eight different static tilted head positions (Head centered (0° tilt), PdP, Head tilt 15°, 30°, 45° to the left and right), then compare and analyze intergroup differences.
UNASSIGNED: In the Head-centered position, both SVV and SVH absolute deviated values were significantly higher in the AN group compared to healthy young adults. The AN group exhibited significantly higher absolute deviation values of SVV compared to the healthy group when tilting their head 30° left and right. Additionally, when tilting their heads to the right at 15° and 45° the AN group showed significant increases in SVH absolute deviated values compared to healthy adults. The SVV and SVH absolute deviation values of LAN and SAN groups did not reach statistical significance. The results of the SVV test for PDP position did not show any significant differences among all groups. However, the SVH test revealed that the absolute deviation values of the LAN group was significantly higher than that of healthy individuals.
UNASSIGNED: Our study shows that the gravity sensing function of patients with unilateral acoustic neuroma is affected to different degrees, however, the degree of gravity sensing function damage of patients has little relationship with tumor size. When acoustic neuroma is larger than 2 cm, the effect of proprioception on patients\' SVH outcome is noteworthy. So, we should pay attention to the postoperative follow-up of patients with acoustic neuroma and the evaluation of vestibular rehabilitation effect. Meanwhile, for patients opting for conservative treatment, it is imperative to monitor the dynamic changes in vestibular function and seize timely opportunities for intervention.

Inflammatory myofibroblastic tumor (IMT) stands as a rare neoplasm, initially documented by Bahadori and Liebow in 1973; however, its biological behavior and underlying pathogenesis continue to elude comprehensive understanding. Throughout the years, this tumor has been designated by various alternative names, including pseudosarcomatoid myofibroblastoma, fibromyxoid transformation, and plasma cell granuloma among others. In 2002, the World Health Organization (WHO) officially classified it as a soft tissue tumor and designated it as IMT. While IMT primarily manifests in the lungs, the common clinical symptoms encompass anemia, low-grade fever, limb weakness, and chest pain. The mesentery, omentum, and retroperitoneum are subsequent sites of occurrence with intracranial involvement being exceedingly rare. Due to the absence of specific clinical symptoms and characteristic radiographic features, diagnosing intracranial inflammatory myofibroblastic tumor (IIMT) remains challenging. Successful instances of pharmacological treatment for IIMT indicate that surgery may not be the sole therapeutic recourse, thus underscoring the imperative of an accurate diagnosis and apt treatment selection to improve patient outcomes.

Acoustic neuroma is one of the most common tumors in the cerebellopontine angle area. Patients with acoustic neuroma have clinical manifestations of the cerebellopontine angle occupying syndrome, such as tinnitus, hearing impairment and even hearing loss. Acoustic neuromas often grow in the internal auditory canal. Neurosurgeons need to observe the lesion contour with the help of MRI images, which not only takes a lot of time, but also is easily affected by subjective factors. Therefore, the automatic and accurate segmentation of acoustic neuroma in cerebellopontine angle on MRI is of great significance for surgical treatment and expected rehabilitation. In this paper, an automatic segmentation method based on Transformer is proposed, using TransUNet as the core model. As some acoustic neuromas are irregular in shape and grow into the internal auditory canal, larger receptive fields are thus needed to synthesize the features. Therefore, we added Atrous Spatial Pyramid Pooling to CNN, which can obtain a larger receptive field without losing too much resolution. Since acoustic neuromas often occur in the cerebellopontine angle area with relatively fixed position, we combined channel attention with pixel attention in the up-sampling stage so as to make our model automatically learn different weights by adding the attention mechanism. In addition, we collected 300 MRI sequence nuclear resonance images of patients with acoustic neuromas in Tianjin Huanhu hospital for training and verification. The ablation experimental results show that the proposed method is reasonable and effective. The comparative experimental results show that the Dice and Hausdorff 95 metrics of the proposed method reach 95.74% and 1.9476 mm respectively, indicating that it is not only superior to the classical models such as UNet, PANet, PSPNet, UNet++, and DeepLabv3, but also show better performance than the newly-proposed SOTA (state-of-the-art) models such as CCNet, MANet, BiseNetv2, Swin-Unet, MedT, TransUNet, and UCTransNet.

OBJECTIVE: This study aims to construct and validate a predictable deep learning model associated with clinical data and multi-sequence magnetic resonance imaging (MRI) for short-term postoperative facial nerve function in patients with acoustic neuroma.
METHODS: A total of 110 patients with acoustic neuroma who underwent surgery through the retrosigmoid sinus approach were included. Clinical data and raw features from four MRI sequences (T1-weighted, T2-weighted, T1-weighted contrast enhancement, and T2-weighted-Flair images) were analyzed. Spearman correlation analysis along with least absolute shrinkage and selection operator regression were used to screen combined clinical and radiomic features. Nomogram, machine learning, and convolutional neural network (CNN) models were constructed to predict the prognosis of facial nerve function on the seventh day after surgery. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to evaluate model performance. A total of 1050 radiomic parameters were extracted, from which 13 radiomic and 3 clinical features were selected.
RESULTS: The CNN model performed best among all prediction models in the test set with an area under the curve (AUC) of 0.89 (95% CI, 0.84-0.91).
CONCLUSIONS: CNN modeling that combines clinical and multi-sequence MRI radiomic features provides excellent performance for predicting short-term facial nerve function after surgery in patients with acoustic neuroma. As such, CNN modeling may serve as a potential decision-making tool for neurosurgery.

To compare shallow machine learning models and deep neural network (DNN) model in prediction of vestibular schwannoma (VS) surgical outcome.
One hundred eighty-eight patients with VS were included; all underwent suboccipital retrosigmoid sinus approach, and preoperative magnetic resonance imaging recorded a series of patient characteristics. Degree of tumor resection was collected during surgery, and facial nerve function was evaluated on the eighth day after surgery. Potential predictors of VS surgical outcome were obtained by univariate analysis, including tumor diameter, tumor volume, tumor surface area, brain tissue edema, tumor property, and tumor shape. This study proposes a DNN framework to predict the prognosis of VS surgical outcomes based on potential predictors and compares it with a series of classic machine learning algorithms including logistic regression.
The results showed that 3 predictors of tumor diameter, tumor volume, and tumor surface area were the most important prognostic factors for VS surgical outcomes, followed by tumor shape, while brain tissue edema and tumor property were the least influential. Different from shallow machine learning models, such as logistic regression with average performance (area under the curve: 0.8263; accuracy: 81.38%), the proposed DNN shows better performance, where area under the curve and accuracy were 0.8723 and 85.64%, respectively.
Based on potential risk factors, DNN can be exploited to achieve preoperative automatic assessment of VS surgical outcomes, and its performance is significantly better than other methods. It is therefore highly warranted to continue to investigate their utility as complementary clinical tools in predicting surgical outcomes preoperatively.

BACKGROUND: Vestibular schwannoma is the most common benign tumor in the pontocerebellar horn region. As the tumor grows, it often causes severe hearing loss due to compression of nearby nerves, resulting in a lower quality of life. This study examined vestibular schwannoma-related research through a bibliometric and visualization analysis, and it explored current trends and research hot spots.
METHODS: Research related to vestibular schwannoma published from 2002 to 2021 was searched using the Web of Science Core Collection. The processing and visualization analysis of the data were conducted using R software, VOSviewer, and CiteSpace.
RESULTS: A total of 3,909 publications were included in this study, and an overall increasing trend in the annual output of publications was found. The United States, Germany, and the United Kingdom were the most prolific countries, publishing the most articles. Germany had the most frequent international cooperation and the highest centrality score. The Mayo Clinic, University of California, and Harvard University were the three most productive institutions. Otology & Neurotology was the most prolific journal, and MJ Link was the most productive and highest scoring author for centrality. Current frontier topics mainly focused on \"hearing preservation\" and \"radiosurgery\". A map of trends in topics and a thematic graph revealed that \"hearing loss\", \"vertigo\", \"magnetic resonance imaging\", \"radiosurgery\", \"stereotactic radiosurgery\", and \"gamma knife\" were the topics of focus of current discussions.
CONCLUSIONS: Hearing preservation is a current frontier topic in this area. Radiosurgery has a promising future in the field of vestibular schwannoma, and stereotactic radiosurgery is a focus of global attention. Bibliometric and visualization analysis offer a unique and objective perspective of the field of vestibular schwannoma and may assist scholars in the identification of new research directions.

BACKGROUND: Brain cancer is one of the most aggressive cancer types owing to poor treatment effects. Epidemiological studies have demonstrated that allergies may increase the disease risk. Therefore, this study evaluated the association between eczema and the risk of various brain cancers.
METHODS: We systematically searched the PubMed and Embase databases from their inception until June 23, 2022. Two reviewers independently reviewed and screened the articles, extracted data, assessed the study quality, and pooled the results. Stata software was used to generate pooled odds ratios and 95% confidence intervals (CIs).
RESULTS: We included 20 studies comprising 5,117,222 patients that investigated the relationship between eczema and brain cancer. Eczema was significantly inversely associated with the risk of brain cancer (odds ratio [OR], 0.82; 95% CI, 0.77-0.87), glioma (OR, 0.53; 95% CI, 0.14-2.02), meningioma (OR, 0.74; 95% CI, 0.66-0.84), and acoustic neuroma (OR, 0.60; 95% CI, 0.41-0.88). Interesting, The strong correlation between eczema and the reduced risk of brain cancer was observed in people over 16 years old (OR, 0.79; 95% CI, 0.71-0.88), but not in those under 16 years old (OR, 0.94; 95% CI, 0.79-1.11). In addition, subgroup analyses found that eczema significantly decreased the glioma risk in Europeans (OR, 0.73; 95% CI, 0.65-0.82) but not Australians (OR, 0.53; 95% CI, 0.14-2.02) or Americans (OR, 1.01; 95% CI, 0.69-1.46).
CONCLUSIONS: Eczema may be considered as a potential protective factor of brain cancer in population aged over 16 years. However, this relationship requires verification using large-scale clinical data.

Objective:This study was conducted to evaluate the applications of vestibular function tests in diagnosis, identifying tumor origins and prognosis of vestibular rehabilitation of patients with acoustic neuroma. Methods:This research is a single-center cross-sectional clinical study, which retrospectively analyzed the data of 335 patients with acoustic neuroma from March 2013 to March 2020 in the Eye and ENT Hospital of Fudan University. The study included caloric test, cervical and ocular vestibular evoked myogenic potentials（cVEMP, oVEMP）, video head impulse test（vHIT） and sensory organization test（SOT）. Firstly, the sensitivity, specificity, and Yoden index of each test were calculated. Secondly, the internal relevance of these tests was studied for application in judging the origins of the tumor. Results:The abnormal rates of caloric test, cVEMP, oVEMP, vHIT and SOT was 85.3%, 86.1%, 85.5%, 55.6% and 67.7% in these participants. Among all the vestibular function tests included, the caloric test showed the best sensitivity（0.855）, specificity（0.981）, and Yoden index（0.836）. The study found that the higher the Koos grades, the higher the abnormal rates of the caloric test, vHIT, and oVEMP（Cochran-Armitage test, P<0.05）. There was no significant relationship between the combination of abnormal vestibular function tests and tumor origin nerves（P>0.05）. Conclusion:Majorlty of the participants in this study with acoustic neuroma showed abnormal results in SOT related to poor balance control. More than half of the patients had at least two abnormal result of the battery of vestibular function tests, among which the caloric test was proved to have better sensitivity and specificity. The higher the Koos grades of the tumor, the higher the abnormal rates of the caloric test, vHIT, and oVEMP.
目的：通过对听神经瘤患者前庭功能进行多方面评估，探究不同前庭检测技术在前庭功能障碍诊断、代偿建立及肿瘤起源分析中的价值，为听神经瘤患者的前庭功能预后评价及康复策略提供借鉴。 方法：回顾性分析2013年3月—2020年3月复旦大学附属眼耳鼻喉科医院耳鼻喉科收治的335例听神经瘤患者的多种术前前庭功能检查结果，包括温度试验、颈性前庭诱发肌源性电位（cVEMP）、眼性前庭诱发肌源性电位（oVEMP）、视频头脉冲试验（vHIT）及感觉统合试验（SOT），研究其在听神经瘤侧别判断中的灵敏度、特异度和约登指数等，分析各项检查的内部相关性，以及在肿瘤起源判断中的价值，并根据SOT结果对患者前庭代偿情况进行总结。 结果：入组患者中温度试验、cVEMP、oVEMP、vHIT、SOT检查异常率依次为85.3%、86.1%、85.5%、55.6%和67.7%，其中温度试验表现出相对最优的灵敏度（0.855）、特异度（0.981）和约登指数（0.836）。相关性分析结果提示随听神经瘤Koos分级增加，温度试验、vHIT和oVEMP检查异常率也在增加（Cochran-Armitage趋势检验，P<0.05）。各项前庭功能检查异常与对应肿瘤来源神经之间未见显著相关性（P>0.05）。 结论：多数听神经瘤患者术前存在前庭相关平衡障碍。超过50%的患者存在两项及以上前庭功能检查异常，提示前庭功能损伤范围较广。Koos分级越高，患者术前温度试验、vHIT和oVEMP检查异常率也更高。在判断患侧前庭功能异常方面，温度试验相对于cVEMP、oVEMP和vHIT检查显示出更佳的灵敏度与特异度。.