Herwin Speckter
A5005352939- Meningioma and schwannoma management
- Neurofibromatosis and Schwannoma Cases
- Glioma Diagnosis and Treatment
- Vascular Malformations Diagnosis and Treatment
- Head and Neck Surgical Oncology
- Pituitary Gland Disorders and Treatments
- Neurological diseases and metabolism
- Advanced Neuroimaging Techniques and Applications
- Cerebrospinal fluid and hydrocephalus
- Intracranial Aneurysms: Treatment and Complications
- Hereditary Neurological Disorders
- Parkinson's Disease Mechanisms and Treatments
- Facial Nerve Paralysis Treatment and Research
- Advanced MRI Techniques and Applications
- Trigeminal Neuralgia and Treatments
- Cerebral Venous Sinus Thrombosis
- RNA regulation and disease
- Adrenal and Paraganglionic Tumors
- Growth Hormone and Insulin-like Growth Factors
- Bone Tumor Diagnosis and Treatments
- Brain Metastases and Treatment
- Radiomics and Machine Learning in Medical Imaging
- Genetic Neurodegenerative Diseases
- Cardiac Imaging and Diagnostics
- Intracerebral and Subarachnoid Hemorrhage Research
Instituto Tecnológico de Santo Domingo
2014-2025
Centrum Gamma Knife
2016-2025
Dominican University
2024
University of Virginia
2022
Benha University
2022
Ain Shams University
2022
New York University
2022
University of Pittsburgh
2022
Centro de Medicina Avanzada Dr. Abel Gonzalez
2020
Oxford University Press (United Kingdom)
2020
The optimal management of patients with incidental meningiomas remains unclear. aim this study was to characterize the radiologic and neurological outcomes expectant stereotactic radiosurgery (SRS) asymptomatic meningioma patients.Using data from 14 centers across 10 countries, compares SRS active surveillance meningiomas. Local tumor control development new deficits attributable were evaluated in conservatively managed groups.In unmatched cohorts, 727 underwent followed for a mean 57.2...
BACKGROUND: Vestibular schwannomas (VSs) related to neurofibromatosis type 2 (NF2) are challenging tumors. The increasing use of stereotactic radiosurgery (SRS) necessitates further investigations its role and safety. OBJECTIVE: To evaluate tumor control, freedom from additional treatment (FFAT), serviceable hearing preservation, radiation-related risks patients with NF2 after SRS for VS. METHODS: We performed a retrospective study 267 (328 VSs) who underwent single-session at 12 centers...
OBJECTIVE Stereotactic radiosurgery (SRS) is used for the treatment of residual/recurrent nonfunctional pituitary adenoma (NFPA). The aim this study was to evaluate factors related long-term tumor control and delayed endocrinopathies following SRS. METHODS This retrospective, multicenter included patients with recurrent/residual NFPA treated single-fraction SRS; they were then divided into two arms. first arm at least 5 years radiographic follow-up all local progression. second...
Abstract Purpose: To present some unusual MR findings in a group of patients from the south‐west Dominican Republic suffering Pantothenate Kinase Associated Neurodegeneration (PKAN). Materials and Methods: Twenty one preclinical case homozygous for PANK2 mutation, 13 heterozygous gene carriers 14 healthy volunteers were scanned prospectively using 3 Tesla system. Results: All showed typical signal reduction within globus pallidus substantia nigra. A surprising finding was absence bright spot...
Though stereotactic radiosurgery (SRS) is an established safe treatment for small- and medium-sized vestibular schwannomas (VSs), its role in the management of Koos grade IV VS still unclear. In this retrospective multicenter study, authors evaluated tumor control patient outcomes primary, single-session SRS VS.
Background Cerebral cavernous malformations (CCMs) frequently manifest with haemorrhages. Stereotactic radiosurgery (SRS) has been employed for CCM not suitable resection. Its effect on reducing haemorrhage risk is still controversial. The aim of this study was to expand the safety and efficacy SRS haemorrhagic CCM. Methods This retrospective multicentric included at least one treated single-session SRS. annual rate (AHR) calculated before after Recurrent event analysis Cox regression were...
OBJECTIVE Recent studies have suggested that biologically effective dose (BED) is an important correlate of pain relief and sensory dysfunction after Gamma Knife radiosurgery (GKRS) for trigeminal neuralgia (TN). The goal this study was to determine if BED superior prescription in predicting outcomes TN patients undergoing GKRS as a first procedure. METHODS This retrospective 871 with type 1 from 13 centers. Patient demographics, characteristics, treatment parameters, were reviewed. compared...
Abstract Introduction Management for elderly patients (> 65yo) with incidental meningiomas remains unclear. This study aims to characterize the functional and tumor outcomes of expectant stereotactic radiosurgery (SRS) management asymptomatic meningioma patients. Methods Using retrospectively collected data from 14 centers, SRS were compared radiographic clinical observation in following propensity score matching. Results Following matching, 114 each cohort. Tumor control was achieved at...
Purpose: Gamma Knife radiosurgery (GKRS) is widely performed as an adjuvant management of patients with residual or recurrent pituitary adenoma (PA). However, the variability in tumor volume response to GKRS emphasizes need for reliable predictors treatment outcomes. The application radiomics, analytical approach quantitative imaging, remains unexplored predicting responses PAs. This study aims pioneer use radiomic MRI analysis predict volumetric PA GKRS. Approach: retrospective...
There are limited data on dosimetric predictors of radiation-induced changes (RICs) for brainstem metastases or arteriovenous malformations (AVMs) following single-fraction stereotactic radiosurgery (SRS). We examined a multi-institutional cohort patients with AVMs treated SRS. evaluated RICs graded per CTCAE(Common Terminology Criteria Adverse Events), including D5%, D95%, D0.03 cc, and D0.5 cc (brainstem minus lesion). Univariate logistic regressions were initially performed independent...
INTRODUCTION: The appropriate management of Koos grade I vestibular schwannomas (VS) remains controversial. METHODS: In a multicenter study, this report gathered and analyzed data retrospectively on VS patients who underwent SRS (SRS group) or were observed (observation group). Propensity score matching was utilized to equilibrate demographics, tumor size, audiometric across groups. outcome included control, preservation serviceable hearing (SHP), neurological function. RESULTS: study...
INTRODUCTION: Affecting 2.93 per 100,000 in the U.S., vestibular schwannomas (VS) are benign tumors of eighth nerve. The management includes observation, operative resection, and stereotactic radiosurgery (SRS). METHODS: A retrospective, multicentric analysis was conducted, focusing on patients with Koos grade II VS who either received SRS (SRS group) or were observed (observation group). To ensure comparability between groups, propensity score matching employed, including factors such as...
INTRODUCTION: Stereotactic radiosurgery (SRS) is used to treat residual and recurrent nonfunctioning pituitary adenomas (NFPA). Hypopituitarism the most common complication with increasing rates over time. We present largest multicentric cohort evaluating outcomes after for NFPA. METHODS: Twelve centers contributed retrospective data on 869 patients treated SRS between 1992 2022. Tumor progression was defined as a volumetric increase of =20% from baseline. New-onset hypopituitarism...
Atypical and anaplastic meningiomas have reduced progression-free/overall survival (PFS/OS) compared to benign meningiomas. Stereotactic radiosurgery (SRS) for atypical (AMs) (malignant meningiomas, MMs) has not been adequately described.To define clinical/radiographic outcomes patients undergoing SRS AM/MMs.An international, multicenter, retrospective cohort study was performed clinical/imaging receiving AM/MMs. Tumor progression assessed with response assessment in neuro-oncology (RANO)...
The optimal management of asymptomatic, presumed WHO grade I meningiomas remains controversial.To define the safety and efficacy stereotactic radiosurgery (SRS) compared with active surveillance for patients asymptomatic parafalcine/parasagittal (PFPS) meningiomas.Data from SRS-treated 14 centers managed conservatively an PFPS meningioma were compared. Local tumor control rate new neurological deficits development evaluated in cohorts.There 173 98 unmatched cohorts. After matching patient...
OBJECTIVE The object of this study was to evaluate the safety, efficacy, and long-term outcomes stereotactic radiosurgery (SRS) in management intracranial chordomas. METHODS This retrospective multicenter involved consecutive patients managed with single-session SRS for an chordoma at 10 participating centers. Radiological neurological were assessed after SRS, predictive factors evaluated via statistical methodology. RESULTS A total 93 (56 males [60.2%], mean age 44.8 years [SD 16.6])...
The COVID-19 pandemic disproportionately impacted Latin America (LATAM), significantly disrupting cardiovascular testing. This study evaluated cardiac procedure recovery in LATAM one year after the outbreak. International Atomic Energy Agency (IAEA) surveyed 669 centers 107 countries worldwide, including 135 facilities 19 countries, to assess volumes March 2019, April 2020, and 2021, changes center practices staffing conditions into pandemic. reported a 21 % decrease 2021 from...
BACKGROUND: Delayed hypopituitarism is the most common complication after stereotactic radiosurgery (SRS) for pituitary adenomas. OBJECTIVE: To investigate relationship between neuroanatomic structure distances from radiation target and anterior function preservation SRS through multicenter study. METHODS: We retrospectively reviewed International Radiosurgery Research Foundation database January 2002 to December 2021 adult patients undergoing adenomas with >6 months of follow-up....
OBJECTIVE The goal of this study was to identify parameters from routine T1- and T2-weighted MR sequences diffusion tensor imaging (DTI) that best predict the volumetric changes in a meningioma after treatment with Gamma Knife radiosurgery (GKRS). METHODS In 32 patients meningioma, MRI DTI data were measured before GKRS. A total 78 derived first-level texture analysis pretreatment images, including calculation mean, SD, 2.5th 97.5th percentiles, kurtosis skewness histograms on voxel-wise...
Stereotactic radiosurgery (SRS) provides a safe and effective therapeutic modality for patients with pituitary adenomas. The mechanism of delayed endocrine deficits based on targeted radiation to the hypothalamic-pituitary axis remains unclear. Radiation normal neuroendocrine structures likely plays role in hypopituitarism after SRS. In this multicenter study by International Radiosurgery Research Foundation (IRRF), authors aimed evaluate tolerance surrounding adenomas identify predictors...
The assessment of shunt reduction after an embolization arteriovenous malformation (AVM) or fistula (AVF) from conventional angiography is often difficult and may be subjective. Here we present a completely non-invasive method using magnetic resonance imaging (MRI) to measure reduction. Using pulsed arterial spin labeling (PASL), determined the relative amount signal attributed over 1.75 s 6 different slices covering lesion. This was related total all measured before embolization. showed...