gms | German Medical Science

64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. - 29. Mai 2013, Düsseldorf

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Intraoperative magnetic resonance imaging and multimodal navigation-guided resection of gliomas involving language areas: a prospective, controlled study

Meeting Abstract

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  • Jiashu Zhang - Departments of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Xiaolei Chen - Departments of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Yan Zhao - Departments of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Fei Wang - Departments of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Fangye Li - Departments of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Gang Zheng - Departments of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Jinjiang Li - Departments of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Xueming Lv - Departments of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Ting Zhang - Departments of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Shen Hu - Departments of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Bainan Xu - Departments of Neurosurgery, Chinese PLA General Hospital, Beijing, China

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. DocMO.17.05

doi: 10.3205/13dgnc151, urn:nbn:de:0183-13dgnc1519

Veröffentlicht: 21. Mai 2013

© 2013 Zhang et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

Text

Objective: This prospective, controlled study is designed to evaluate the impact of high-field intraoperative magnetic resonance imaging (iMRI) and functional neuronavigation (FN) on the extent of resection (EoR), prognosis of language function (PoF) and progression-free survival (PFS) in patients with gliomas involving language areas.

Methods: 217 consecutive patients with suspected cerebral gliomas involving language areas were prospectively enrolled between 2009 and 2012. These patients were divided into study group (n = 124) and control group (n = 93). Perioperative images were acquired to assess EoR and gross total resection (GTR), volumetric calculation was based on T1 contrast for high-grade gliomas (HGGs) and T2 FLAIR for low-grade gliomas (LGGs). Aphasia Quotients (AQ) were obtained perioperatively and at the 6-month follow-up to evaluate PoF. Durations of PFS were also recorded. Functional MRI and Diffusion Tensor Imaging were routinely performed preoperatively for the study group, followed by iMRI and FN-guided microsurgeries. The control group underwent conventional navigation-guided microsurgeries.

Results: EoR and the rate of GTR were significantly higher in the study group than in the control group (EoR, 95.50 % versus 89.85 %, P < 0.001; GTR, 69.6 % versus 47.7 %, P = 0.001) (Table 1 [Tab. 1]). For PoF, 6-month AQ were statistically higher in the study group than in the control group (87.47 versus 78.73, P = 0.001) (Figure 1). Furthermore, new postoperative aphasia occurred in 34.8 % of the control group, whereas it occurred in only 2.3 % of the study group (P < 0.001) (Table 2 [Tab. 2]). Patients with glioblastomas had a longer PFS in the study group than in the control group (median PFS, 12.5 m versus 6.6 m, P = 0.003) (Figure 2).

Conclusions: Compared with conventional navigation, iMRI and FN helped maximize safe tumor resection, minimize long-term language deficits in patients with gliomas involving language areas and increase high-quality survival for patients with glioblastomas.