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64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Intraoperative MRI-guided resection of recurrent glioblastoma

Meeting Abstract

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  • Christian Senft - Klinik für Neurochirurgie, Klinikum der Goethe-Universität Frankfurt
  • Florian Gessler - Klinik für Neurochirurgie, Klinikum der Goethe-Universität Frankfurt
  • Kea Franz - Klinik für Neurochirurgie, Klinikum der Goethe-Universität Frankfurt
  • Volker Seifert - Klinik für Neurochirurgie, Klinikum der Goethe-Universität Frankfurt

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMI.06.02

doi: 10.3205/13dgnc323, urn:nbn:de:0183-13dgnc3239

Published: May 21, 2013

© 2013 Senft et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Intraoperative MRI (iMRI) is an appropriate tool for influencing surgical radicality and outcome of patients with contrast-enhancing brain tumors as shown by a randomized trial. Our own institutional data as well as pooled data from the Neurooncological subspecialty section of the DGNC suggest that the extent of resection also influences the survival of patients with recurrent glioblastoma (rGBM). Our aim was to analyze the clinical results of intraoperative MRI (iMRI) guidance for patients undergoing resection of rGBM.

Method: 25 unselected patients with histologically proven rGBM underwent tumor resection with iMRI guidance. Early postoperative MRI was used to define the extent of resection. Complete resection was defined as absence of any residual contrast enhancement. All patients had adjuvant treatment following surgery.

Results: Intraoperative MRI detected residual contrast-enhancing tissue leading to continued tumor resection in 6 cases (24%). In five patients, residual tumor tissue was deliberately left because of the risk of inducing neurological deficits. A complete tumor resection was finally achieved in 20 patients (80%) and confirmed by early postoperative MRI. The complication rate was acceptably low with only one patient (5%) experiencing a disabling neurological deficit due to surgery. Median overall survival following surgery for rGBM was statistically significantly better for patients undergoing complete (52.6 weeks) vs. incomplete tumor resection (26.0 weeks, P=0.023).

Conclusions: Patients with rGBM undergoing complete resection of contrast-enhancing tumor have a better prognosis than patients with residual tumor. Intraoperative MRI also helps to improve the extent of resection in these patients. Resection of rGBM should be offered to patients with surgically amenable lesions, and the use of an intraoperative resection control is justified in achieving best possible results.