gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Quantification of WHO grade IV-glioma removal by intraoperative high-field magnetic resonance imaging

Meeting Abstract

  • Daniela Kuhnt - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Deutschland
  • Oliver Ganslandt - Klinik für Neurochirurgie, Universitätsklinikum Erlangen, Deutschland
  • Andreas Becker - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Deutschland
  • Michael Buchfelder - Klinik für Neurochirurgie, Universitätsklinikum Erlangen, Deutschland
  • Christopher Nimsky - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1564

DOI: 10.3205/10dgnc040, URN: urn:nbn:de:0183-10dgnc0409

Published: September 16, 2010

© 2010 Kuhnt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: To investigate the contribution of high-field intraoperative magnetic resonance imaging (iMRI) and navigation with integrated functional image data on the amount of resected tumor volume in glioblastoma-surgery.

Methods: We investigated 135 patients with supratentorial glioblastoma multiforme (WHO grade IV), who underwent glioma surgery with 1.5 Tesla iMRI. Quantitative analysis and volumetric assessment were performed in pre- and intraoperative MR-images and evaluated retrospectively.

Results: The surgical procedure was influenced by iMRI in 14.1% (19 patients). Subgroups were evaluated for the percentage of resected tumor-volume: 99.9– 98%: 0 patients, 97.9–95%: 3 patients, 94.9–90%: 1 patient and less than 90%: 15 patients. Further resection led to gross-total resection in 9 patients, resected tumor-volume of 99.9–98% in 1 patient, 97.9–95% in 0 patients, 94.9–90% in 1 patient and less than 90% in 8 patients. In 116 cases, further resection was abstained because of either initially achieved gross-total resection or adjacence to eloquent brain areas. Complete resection was here achieved in 47 patients (resection rate 99.9–98%: 3 patients, 97.9–95%: 2 patients, 94.9–90%: 11 patients and less than 90%: 53 patients). Thus, the rate of gross-total resection could be increased from 34.8% (47 patients) to 41.5% (56 patients). Volumetric assessment showed that the overall tumor volume could be significantly reduced after iMRI and continued surgery from 34.3%±23.7% (9.9±20.9 cm3) vs 1.2%±16.2% (0.3±15.9 cm3), p<0.01.

Conclusions: Intraoperative high-field MRI significantly improved tumor-volume resection in surgery of glioblastoma multiforme (WHO grade IV) supported by quantitative analysis and assessment of tumor-volume in 135 cases.