High-field intraoperative MRI in glioma ...
Type de document :
Compte-rendu et recension critique d'ouvrage
PMID :
Titre :
High-field intraoperative MRI in glioma surgery: A prospective study with volumetric analysis of extent of resection and functional outcome
Auteur(s) :
Leroy, H.-A. [Auteur]
Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 [ONCO-THAI]
Delmaire, C. [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Le Rhun, Emilie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Drumez, E. [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Lejeune, J.-P. [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Reyns, N. [Auteur]
Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 [ONCO-THAI]
Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 [ONCO-THAI]
Delmaire, C. [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Le Rhun, Emilie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Drumez, E. [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Lejeune, J.-P. [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Reyns, N. [Auteur]
Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 [ONCO-THAI]
Titre de la revue :
Neurochirurgie
Pagination :
155-160
Éditeur :
Elsevier Masson
Date de publication :
2018-06
ISSN :
0028-3770
Mot(s)-clé(s) en anglais :
Extent of resection
Functional outcome
High-field intraoperative MRI
Low-grade glioma
Functional outcome
High-field intraoperative MRI
Low-grade glioma
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Background: High-field intraoperative MRI (IoMRI) is a useful tool to improve the extent of glioma resection (EOR).Objective: To compare the interest of 1.5T IoMRI in glioma surgery between enhancing and non-enhancing ...
Lire la suite >Background: High-field intraoperative MRI (IoMRI) is a useful tool to improve the extent of glioma resection (EOR).Objective: To compare the interest of 1.5T IoMRI in glioma surgery between enhancing and non-enhancing tumors, based on volumetric analysis.Methods: A prospective single-center study included consecutive adult patients undergoing glioma surgery with IoMRI. Volumetric evaluation was based on FLAIR hypersignal after gadolinium injection in non-enhancing tumors and T1 hypersignal after gadolinium injection in enhancing tumors. Endpoints comprised: residual tumor volume (RTV), EOR, workflow and clinical outcome on Karnofsky performance score (KPS).Results: Fifty-three surgeries were performed from July 2014 to January 2016. Thirty-four patients underwent one IoMRI, and 19 two IoMRIs. In non-enhancing tumors, intraoperative RTV on 1st IoMRI T2/FLAIR was higher than in enhancing tumors on T1 sequences (7.25cm3 vs. 0.74cm3, respectively; P=0.008), whereas the RTV on 2nd IoMRIs and final RTV were no longer significantly different. After IoMRI, 72% of patients underwent additional resection. In non-enhancing tumors, EOR increased from 77.3% on 1st IoMRI to 97.4% on last MRI (P<0.001). Taking all tumors together, final RTV values were: median=0cm3, mean=3.9cm3. Mean final EOR was 94%. In 25% of patients, KPS was reduced during early postoperative course; at 3 and 6 months postoperatively, median KPS was 90.Conclusion: Intraoperative MRI guidance significantly enhanced the extent of glioma resection, especially for non- or minimally enhancing tumors, while preserving patient autonomy.Lire moins >
Lire la suite >Background: High-field intraoperative MRI (IoMRI) is a useful tool to improve the extent of glioma resection (EOR).Objective: To compare the interest of 1.5T IoMRI in glioma surgery between enhancing and non-enhancing tumors, based on volumetric analysis.Methods: A prospective single-center study included consecutive adult patients undergoing glioma surgery with IoMRI. Volumetric evaluation was based on FLAIR hypersignal after gadolinium injection in non-enhancing tumors and T1 hypersignal after gadolinium injection in enhancing tumors. Endpoints comprised: residual tumor volume (RTV), EOR, workflow and clinical outcome on Karnofsky performance score (KPS).Results: Fifty-three surgeries were performed from July 2014 to January 2016. Thirty-four patients underwent one IoMRI, and 19 two IoMRIs. In non-enhancing tumors, intraoperative RTV on 1st IoMRI T2/FLAIR was higher than in enhancing tumors on T1 sequences (7.25cm3 vs. 0.74cm3, respectively; P=0.008), whereas the RTV on 2nd IoMRIs and final RTV were no longer significantly different. After IoMRI, 72% of patients underwent additional resection. In non-enhancing tumors, EOR increased from 77.3% on 1st IoMRI to 97.4% on last MRI (P<0.001). Taking all tumors together, final RTV values were: median=0cm3, mean=3.9cm3. Mean final EOR was 94%. In 25% of patients, KPS was reduced during early postoperative course; at 3 and 6 months postoperatively, median KPS was 90.Conclusion: Intraoperative MRI guidance significantly enhanced the extent of glioma resection, especially for non- or minimally enhancing tumors, while preserving patient autonomy.Lire moins >
Langue :
Anglais
Vulgarisation :
Non
Source :