2025 VOL 10 , Issue S1

Exploring the Role of Neuroradiologists in NeuroOncology Tumor Boards: A Review

Alisha Ahmed^1,*, Sumaira Rehman¹, Fatima Shaukat², Zainab Anwar^1
1Jinnah Sindh Medical University, Karachi, Pakistan.
²Department of Radiation Oncology, Cyberknife and Tomotherapy Centre, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan.

Abstract: The role of Neuroradiology in diagnosing and managing nervous system malignancies places it as an essential component of Neuro-oncology multidisciplinary tumor boards. Lesions are identified and characterized using advanced imaging, and choices of therapy are guided. They provide crucial insights to surgeons in planning resections and biopsies in vitally sensitive brain regions. In addition, they aid post treatment follow-up and radiotherapy. They collaborate with neurosurgeons, neuropathologists, radiation and medical oncologists in these meetings to review cancer cases, integrate imaging with histopathology, formulate treatment plans for best patient interest. The paper aims to study the role of Neuroradiologists in nMTB. Neuroradiologists face many challenges and limitations during interdisciplinary collaborations owing to the complexities of emerging neuroradiological imaging modalities. Other than that there are problems such as communication barriers mainly due to the use of technical words, lack of patient communication, and lack of interpersonal communication between neuroradiologists and referring clinicians that can have a negative impact on the understanding or potentially the clinical outcomes of MTBs. The new and emerging diagnostic modalities can be useful to neuroradiologists in accurate diagnosis, grading, management, and prognosis prediction in multidisciplinary. Advanced AI models such as Radionomics, radiogenomics, and deep learning models can detect complex imaging features, and distinguish between brain GBM and brain metastasis which can help predict patient survival. However, their potential rests in the new knowledge about this condition as these clinical data are limited due to lack of generalizability and reproducibility. Interpreting neuroradiological results are precise; accurate diagnosis requires specialized training in neuroradiology. Structured training program also ensures that neuroradiologist adheres to standardized practices and prevents any clash of difference among neuroradiologists.

Keyword: Neuro oncology Multidisciplinary Tumor Board (nMTB), Glioblastoma, Multidisciplinary Tumor Board (MTB), Radionomics, neuroradiologist.

Received: October 01, 2024
Revised: June 20, 2025
Accepted: June 23, 2025

doi.org/10.21089/njhs.10S1.00S3

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Virtual Multidisciplinary Teams in Oncology and their Application in Pakistan: A Review

Urooba Jawwad^1,*, Nimrata Kumari¹, Arisha Issa², Muhammad Abdul Rehman¹, Areesha Mansoor¹, Fatima Shaukat³, Agha Muhammad Hammad Khan^4
1Dow Medical College, Karachi, Pakistan.
²Jinnah Sindh Medical University, Karachi, Pakistan.
³Department of Radiation Oncology, Cyberknife and Tomotherapy Centre, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan.
⁴Department of Radiation Oncology, McGill University, Montreal QC, Canada.

Abstract: The recent pandemic has led to the transition of multidisciplinary tumor boards (MTB) to the virtual domain. The shift enabled collaborations across geographical barriers, improving accessibility and efficiency, both administratively and clinically. For a low-middle income country (LMIC) like Pakistan, where MTBs are not prevalent due to resource limitations, Virtual multidisciplinary tumor boards (VMTBs) are an ideal solution. Aptly, the initiative, Tumor Board Establishment Facilitation Forum (TEFF) has successfully used VMTBs to fill this unfortunate clinical gap. Where VMTBs fulfill their role by providing clinical input, they also educate participants, allow physicians to resolve challenging cases, enable isolated clinics to receive input from tertiary care centers, and provide options for remote consultations and cross-border discussions. Although VMTBs may not provide the comfort of in-person engagement, and low levels of technological literacy present significant challenges, they have been proven to be as clinically efficient as in-person MTBs. If one is to consider all aspects, a well-rounded opinion would sit in favor of VMTBs, as evident during the recent pandemic.

Keyword: Neoplasms, Patient Care Team, Telemedicine, Developing Countries, Health Literacy, Education, Medical.

Received: September 30, 2024
Revised: June 02, 2025
Accepted: June 04, 2025

doi.org/10.21089/njhs.10S1.0S11

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Strength in Synergy: The Essential Role of Onco-Nutrition Multidisciplinary Teams in Cancer Care and Recovery

Amna Farooqui^1,*, Tooba Ali², Laraib Khan², Saba Karim¹, Maria Tariq^2
1Abbasi Shaheed Hospital, Karachi Metropolitan University, Karachi, Pakistan.
²Department of Radiation Oncology, Aga Khan Hospital, Karachi, Pakistan.

Abstract: Cancer-associated cachexia and anorexia syndrome (CACS) is a significant problem of oncology population, which is characterized by an unintentional loss of weight and constant inflammation. Malnutrition is encountered in about 75 % of all patients with cancer, which increases likelihood of complication, lowers the adherence to treatment, and lowers the quality of life. Malnutrition predisposition is especially relevant in older people and patients with head and neck, lung, and stomach cancer patients.
The Nutritional screening and intervention is essential to the identification and recovery of malnourished patients because of a timely approach. Research has shown that post-operative nutrition intake may be improved through nutritional supplementation and that early clinical nutrition interventions are linked to substantially better treatment outcomes. There are multiple tools of nutritional assessment screening malnutrition, and acting nutrition assessment and intervention showed better patient outcome.
Nutritional therapy has continued to be an important part of cancer management and it includes personalized interventions, including oral nutritional supplement and nutritional counseling. Constant nutritional screening and evaluation is crucial in the formulation of efficient treatment plans. Focus on nutritional issues and individualized approach may enhance the treatment results and allow the patients to live a better life. Since healthcare professionals can alleviate the harmful consequences of malnutrition, they will be able to improve patient care and maximize their outcomes. Eating therefore should form part and parcel of the treatment of cancer in order to push towards patient outcomes.

Keyword: Cachexia, Neoplasms, Malnutrition, Diet Therapy, Patient Care Team, Nutritional Assessment, Nutrition Therapy.

Received: October 01, 2024
Revised: May 15, 2025
Accepted: May 27, 2025

doi.org/10.21089/njhs.10S1.0S17

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Integrating Artificial Intelligence in Multidisciplinary Tumor Boards: A Scoping Review of its Impact and Potential

Anzalna Kamran^1,*, Iqra¹, Yasmeen Sufi¹, Anas Ali¹, Kanwar Arham¹, Fatima Shaukat^2
1Karachi Medical and Dental College, Karachi Metropolitan University, Karachi, Pakistan.
²Department of Radiation Oncology, Cyberknife and Tomotherapy Centre, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan.

Abstract: Multidisciplinary Tumor Boards (MDTs) are meetings where experts get together to decide what the best treatment for cancer patients is. But we could make even better treatment decisions by adding Artificial Intelligence (AI) to these teams. In this review, we examine how AI can contribute to selecting the appropriate treatments for MDTs. While there is still some work to be done, AI has certainly already shown that it can help us better diagnose and treat cancer. It reviewed 22 studies from 2016 to 2024 that looked at how often AI’s suggestions matched with what MDTs decided. In most cases, AI and MDT agreed, and rates of concordance ranged from 48.9 to 99.1 percent, mostly 72 to 87 percent. Concordance rates in the other studies were somewhat lower, but were not that significantly different from ours. In at least one study, agreement varied based on patient age, possible treatment side effects or lack of financial resources. AI, although a few hurdles, is proving to be an invaluable tool for MDTs. Yet in order to make it work in more rapid and more precise fashion, we need to keep working at improving the technology, to get doctors comfortable with how to use it, and to scrub out the same legal and access barriers that we’ve always had with other forms of commerce that have been somewhat slower to come to medicine.

Keyword: Multidisciplinary Tumor Boards (MDTs), Artificial Intelligence (AI), Cancer treatment, AI-assisted diagnosis, Oncology care, Decision support systems.

Received: September 30, 2024
Revised: May 15, 2025
Accepted: May 29, 2025

doi.org/10.21089/njhs.10S1.0S21

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Multidisciplinary and Interdisciplinary Tumor Boards in Optimizing Patient Outcomes: An Integrated Approach

Rabia Tahseen¹, Asifa Maheen², Mariam Fahim^2,*, Maria Tariq³, Yumna Ahmed¹, Fatima Shaukat¹, Agha Muhammad Hammad Khan^4
1Department of Radiation Oncology, Cyberknife and Tomotherapy Centre, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan.
²Jinnah Sindh Medical University, Karachi, Pakistan.
³Department of Radiation Oncology, The Aga Khan University Hospital, Karachi, Pakistan.
⁴Department of Radiation Oncology, McGill University, Montreal QC, Canada.

Abstract: Multidisciplinary and interdisciplinary tumor boards (MTBs and ITBs) are critical components in optimizing oncological diagnosis, management, and treatment protocols. Over the past few decades, the implementation of multidisciplinary tumor boards has become a standard practice in developed regions and is experiencing steady growth globally. There is a wealth of research exploring the advantages of integrating MTBs and ITBs into cancer care, revealing improvements across various domains including patient satisfaction and clinical outcomes. This article presents a comprehensive review of the existing literature on the impact of tumor boards on patient outcomes, including the relevant statistical data. Additionally, we discuss emerging paradigms and future recommendations, including the use of novel technologies and strategies for more effective tumor boards, thereby providing a holistic perspective on the evolution of cancer care practices.

Keyword: Multidisciplinary tumor boards, Cancer mortality, Patient-Centered Care (PCC), Personalized medicine, Healthcare systems.

Received: October 01, 2024
Revised: May 17, 2025
Accepted: May 27, 2025

doi.org/10.21089/njhs.10S1.0S30

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Challenges and Solutions in Implementing Multidisciplinary Tumor Boards in Low-Resource Settings

Lamea Bint Sahban^1,*, Ayesha Kamran¹, Samra Mamur², Fatima Shaukat^3
1Jinnah Sindh Medical University, Karachi, Pakistan.
²Karachi Medical and Dental College, Karachi, Pakistan.
³Department of Radiation Oncology, Cyberknife and Tomotherapy Centre, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan.

Abstract: Multidisciplinary Tumor Boards (MDTBs) have become a key component of modern cancer care, promoting joint decision-making to help improve the diagnosis, treatment planning and results. However, their application in low-resource settings (LRS) fails due to a number of systemic, technical, and cultural barriers. This analysis mainly focuses on the problems of improving MDTBs in LRS, such as poor healthcare facilities, lack of skilled workers, insufficient staff, inability to generate funds, and lack of digital health records. Other additional barriers include problems with transportation, time limitation, lack of community knowledge, and cultural norms to modern cancer care treatment. These problems impair prompt diagnosis, treatment, and long-term monitoring of cancer patients.
Despite difficulties, as our analysis elaborates, various approaches have been thought to improve the availability and value of MDTBs in these settings with limited resources. Telemedicine and virtual tumor boards can help address regional demands of the community, while training programs and simpler MDTB activities can enhance long-term sustainability. It is also important to strengthen partnerships with international health system, adopt user-friendly digital record systems, and engage in specified community education programs. Furthermore, policy funding and collaborative support is required to integrate MDTBs into national cancer control plans.
This review underscores that, with strategic planning and targeted investments, effective multidisciplinary cancer care is attainable even in the most underserved regions. By establishing MDTB programs to local needs and making use of available technologies and partnerships, low-resource settings can move toward equitable, patient-centered oncology care. Ultimately, the successful implementation of MDTBs can play a transformative role in reducing the global disparity in cancer outcomes.

Keyword: Multidisciplinary Tumor Boards (MDTBs), Low-resource settings, Cancer care, Telemedicine, Healthcare infrastructure, Oncology workforce shortages.

Received: October 02, 2024
Revised: June 15, 2025
Accepted: June 17, 2025

doi.org/10.21089/njhs.10S1.0S36

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Precision Oncology for Metastatic Cancers: The Essential Role of Multidisciplinary Tumor Boards

Areesha Mansoor^*,1, Muhammad Twaha Zia², Dua Ghori¹, Syeda Shahnoor¹, Agha Muhammad Hammad Khan^3
1Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
²Department of Neurosurgery, Dow University of Health Sciences, Karachi, Pakistan.
³Department of Radiation Oncology, McGill University, Montreal QC, Canada.

Abstract: Metastatic cancers are a great challenge in cancer treatment. Due to their vast genetics and aggressive nature these malignancies often develop resistance to standard therapies. Even for advanced tumors healthcare providers are forced to use chemotherapy and radiation to relieve symptoms without being able to address the complex molecular characteristics of metastatic tumors. Precision medicine is an approach that offers tailored cancer treatment to the phenotypic characteristics of each tumor. We conducted a literature review to assess the impact of multidisciplinary collaboration of precision medicine and oncology. The articles extracted from Pubmed, Google Scholar, Scopus and Cochrane supported the use of tumor boards for development of treatment plans. These specialized tumor boards also called Molecular Tumor Boards (MlTBs) use precision medicine tools. MlTBs incorporate advanced technologies, such as genome sequencing and liquid biopsies, which have the ability to significantly enhance and identify actionable genetic changes. These precision tools enable the development of targeted therapies, which are more effective and less toxic than standard chemotherapy/ radiation therapy treatments. With the integration of multiple dataset models MlTBs can help doctors to bridge connections between complex genomic profiles and identify opportunities for precise treatment plans. There are some known drawbacks of MlTBs, namely requirement of a well-oiled system.
Multidisciplinary teams meetings are time consuming and require a lot of planning. However, once incorporated in clinical practice they open opportunities for educational training and clinical trials. MlTBs are new to many physicians and their adaptation might take time, but strong evidence supporting their impact in enhanced treatment precision and improved patient outcomes, highlights their credibility. Making MlTBs a meritorious addition to oncological practice.

Keyword: Molecular Tumor Boards (MlTBs), Radiation therapy, Malignant cells, Metastatic cancers, Heterogeneous lesions, Randomized controlled trials (RCTs).

Received: October 02, 2024
Revised: June 04, 2025
Accepted: June 04, 2025

doi.org/10.21089/njhs.10S1.0S43

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Impact of Multidisciplinary Teams on Quality of Life in Gastrointestinal Cancer Patient Care: A Comprehensive Review

Arisha Issa¹, Alisha Ahmed¹, Maryam Mohsin^1,*, Urooba Jawwad², Fatima Shaukat³, Tayyab Siddiqui^4
1Jinnah Sindh Medical University, Karachi, Pakistan.
²Dow Medical College, Karachi, Pakistan.
³Department of Radiation Oncology, Cyberknife and Tomotherapy Centre, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan.
⁴Department of Surgical Oncology, Dow University Hospital, Karachi, Pakistan.

Abstract: Multidisciplinary teams (MDTs) have shown great importance in help to diagnose the patient in a timely manner, patient tailored treatment plan, better symptom management, greater recovery and a better palliative care. MDTs are currently being extensively researched for integration into the management of GI cancers. GI cancers represent a multifaceted disease with a high morbidity and mortality rate. These cancers typically present at later stages of disease making them exceedingly challenging to treat and as a result significantly impacting patient’s QOL. The purpose of this review is to describe the MDT’s role in making management recommendations for GI cancers and to outline their impact on patients’ QOL in detail. The review discusses the different types of GI cancers, the accurate diagnosis, as well as management of GI cancers with the role of collaborative teams in developing the most effective treatment plan for these patients.
MDT is a useful tool in GI cancers that facilitates the provision of an appropriate diagnosis and help make suitable management recommendations based on a team approach in this subspecialty and is anticipated to address the growing global cancer burden. Future research should focus on factors vital to establishing a team approach in GI oncology and identify the barriers to formation of a sustainable MDT ecosystem.

Keyword: Narrative review, Multidisciplinary teams, GI cancers, Patient care, Quality of Life.

Received: October 01, 2024
Revised: June 23, 2025
Accepted: June 26, 2025

doi.org/10.21089/njhs.10S1.0S50