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Intraoperative magnetic resonance imaging in glioma surgery: a single-center experience
Leyla Mirzayeva1, Murat Uçar2, Ahmet Memduh Kaymaz2
1Gazi University, Faculty of Medicine, Department of Radiology, Ankara, Turkey. leyla.salimli91@gmail.com.
Purpose:
To investigate the effect of intraoperative magnetic resonance imaging (Io MRI) on overall and progression-free survival (OS and PFS), on the extent of resection (EOR) in patients with glioma, and impact of the radiological diagnosis on the decision to continue the surgery when a residual mass was detected on Io MRI.
Methods:
The study comprised 153 glioma patients who received surgical treatment between 2013 and 2023. One-hundred twenty-five of them had Io MRI guidance during surgery. The remainder 28 patients constituted the control group who did not undergo Io MRI. All patients' age at surgery, gender, initial radiological diagnosis, primary tumor localization, EOR, last histopathological diagnosis, and the follow-up periods were recorded.
Results:
The rate of tumor recurrence in Io MRI cases was significantly lower compared to the cases in the control group (p < .0001). It was decided to continue the operation in 45 Io MRI applied cases. This raised the gross total resection (GTR) rate from 33.6% to 49.6% in the Io MRI group. The frequency of GTR was significantly higher in patients with an initial radiological diagnosis of low grade glioma than those with high grade glioma. The shortest OS was seen in occipital gliomas.
Conclusion:
In this study, the convenience provided by the high-field MRI device was explored and proven both in reducing the tumor burden, increasing the PFS, and providing the surgeon with a maximal resection in the first operation.
Insights
Intraoperative MRI (Io MRI) significantly reduces glioma tumor recurrence and improves progression-free survival. This advanced imaging aids surgeons in achieving maximal resection, enhancing patient outcomes.
Area of Science:
- Neurosurgery
- Oncology
- Radiology
Background:
- Glioma surgery aims for maximal tumor resection to improve patient survival.
- Intraoperative imaging is crucial for assessing tumor extent during surgery.
- The role of intraoperative magnetic resonance imaging (Io MRI) in glioma surgery requires further investigation.
Purpose of the Study:
- To evaluate the impact of Io MRI on overall survival (OS) and progression-free survival (PFS) in glioma patients.
- To assess the effect of Io MRI on the extent of resection (EOR).
- To determine how radiological diagnosis influences surgical decisions when residual glioma is detected on Io MRI.
Main Methods:
- A retrospective study of 153 glioma patients (2013-2023).
- 125 patients utilized Io MRI guidance; 28 served as a control group without Io MRI.
- Data collected included age, gender, diagnosis, tumor location, EOR, and follow-up periods.
Main Results:
- Io MRI group showed significantly lower tumor recurrence rates (p < .0001).
- Io MRI increased the gross total resection (GTR) rate from 33.6% to 49.6%.
- GTR was more frequent in low-grade gliomas than high-grade gliomas; occipital gliomas had the shortest OS.
Conclusions:
- Io MRI facilitates reduced tumor burden and increased PFS in glioma patients.
- High-field MRI intraoperatively enhances maximal tumor resection capabilities for surgeons.
- Io MRI is a valuable tool for improving surgical outcomes in glioma treatment.
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