Article
Low- and high-grade gliomas resection with intraoperative MRI: a retrospective analysis
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Published: | June 2, 2015 |
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Objective: The goal of surgery for brain gliomas is to maximize the extent of tumor resection avoiding functional injury. Intraoperative-magnetic resonance imaging (iMRI) has emerged as a procedure to guide their resection.
Method: 92 patients who underwent craniotomy for glioma resection were retrospectively evaluated between March 2009 and March 2013 at Sapienza University of Rome. We compared 50 patients operated without iMRI and 42 patients underwent surgery with iMRI. Volumetric analysis and EOR were performed, using postcontrast T1-weighted images for tumors showing contrast enhancement and T2-weighted images for non enhancing tumors. All patients were operated by the senior author.
Results: For enhancing gliomas, the median EOR increased was 78% (range, 60% - 96%) and 96% (range, 94% - 99%) in patients operated on with and without iMRI respectively. While, the median EOR increased from 72% (range 58% - 86%) in the first group to 90% (range 82% - 98%) in the second group of non enhancing gliomas. The present study reports the progression free survivall (PFS) at 6 months only in 74 patients operated on for high-grade gliomas (III-IV): an increase of 23 % was observed in the cases who underwent further surgery for tumor residual detected by iMRI.
Conclusions: 1.5T intraoperative MRI is a safe technique, and its use optimizes significantly the extent of glioma resection and the overall survivall of the patients.