Speakers

Neuro-oncology imaging. (Especially glioma imaging)
1108 08:30-08:40
Neuro-oncology/305
Radiological images play a pivotal role in glioma patient care. They provide qualitative tumor information, such as presumed pathological diagnosis and molecular status. In addition, they could provide anatomical information necessary for surgery and help monitor treatment response. Despite extensive research in deep-learning-based image analysis, its diagnostic accuracy for detecting IDH mutation is limited to approximately 85% sensitivity and specificity. Diagnosis of 1p/19q codeletion is 10% less accurate than IDH mutation, and MGMT promoter methylation is still uncertain. On the other hand, qualitative image features are valuable assets in interpreting biological features of gliomas, but different image acquisition parameters can heavily influence them. This presentation discusses tips and pitfalls for maximizing the amount of information derived from glioma images.

Surgical Neuro-oncology using an exoscope.
1108 09:50-10:00
Neuro-oncology/305
We sometimes encounter the emergence of technological innovations that overturn the previous standard in an industry. The law of diffusion of innovation (innovator theory) is a theory by sociologist Everitt Rogers in his book "Innovation Diffusion Studies" that explains how new technologies diffuse or fail to diffuse in society. The 2.5% of innovators actively adopt new technologies, and the 13.5% of Early Adopters follow the innovators in adopting new technologies and begin to diffuse them in society. However, for a new technology to be fully adopted by society, more than support from 16% of users is required, and support from the next 34% of users, the Early Majority, is required. Conversely, when a new technology begins to be supported by even a portion of the Early Majority, the technology will begin to spread rapidly in society. The presenter was fortunate to have had the opportunity to introduce exoscopy at two different institutions. In the early stages of the introduction, many surgeons were skeptical about using the exoscope and did not actively try to use it. In contrast, those directly involved in introducing the exoscope (innovators) dared to use it. The types of surgeries in which they are used are also limited to those of low difficulty. However, as the level of difficulty of the operations performed by the innovators using an exoscope increases, the Early Adopters follow the innovators and begin to use an exoscope. Early Majority of the patients started to use an exoscope while the Early Adopters completed the standard surgery with no difficulty. Two different centers reproducibly experienced this typical diffusion of innovation over approximately three months. Eventually, in both centers, the microscope was downgraded to a backup device, and the mainstay of the system was the exoscope. Based on these experiences, we can say with certainty that conventional microsurgical procedures in neurosurgery will be reduced and replaced by exoscopic procedures. It should be remembered that this future will come cruelly independently of the wishes of surgeons and medical device manufacturers.