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

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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Health-related quality of life after intraoperative high-field magnetic resonance imaging and electrophysiological monitoring guided resection of gliomas involving eloquent motor areas: A prospective, controlled study

Meeting Abstract

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  • Fang-ye Li - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Xiao-lei Chen - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Yuan-zheng Hou - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Jia-shu Zhang - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Jin-jiang Li - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Gang Zheng - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Ting Zhang - Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
  • Bai-Nan Xu - Department 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.17.03

doi: 10.3205/13dgnc149, urn:nbn:de:0183-13dgnc1493

Published: May 21, 2013

© 2013 Li 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

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Objective: This study was designed to evaluate the impact of intraoperative high-field magnetic resonance imaging (iMRI), functional neuronavigation and intraoperative electrophysiological monitoring on the extent of resection and health-related quality of life for gliomas involving eloquent motor areas.

Method: A consecutive series of 426 patients with gliomas involving eloquent motor areas were prospectively enrolled from 2009 to 2012. The patients were divided into study group (n=262) and control group (n=164). Blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) and diffusion tensor imaging (DTI) based fiber tracking for visualization of pyramidal tracts were routinely performed preoperatively in the study group, followed by iMRI and functional navigation guided tumor resection. Direct cortical stimulation was performed in lesions involving primary motor cortex. The control group was operated on with conventional neuronavigation. To assess the extent of resection, MRI scan was performed postoperatively within 24 hours. All patients evaluated health-related quality of life at last follow-up using the questionnaire Short Form 36 Health Survey (SF-36).

Results: In 32.1% (84/262) of patients in the study group, iMRI found residual tumors which needed further resection. Final iMRI confirmed extent of resection in the study group was significantly higher than that in the control group (95.5% versus 82.3%, P<0.05). Long-term health-related quality of life of the study group was significantly higher than that of the control group (p<0.05).

Conclusions: Intraoperative high-field MRI, functional neuronavigation and intraoperative electrophysiological monitoring help to maximize tumor resection while preserving motor function which is associated with high health-related quality of life.