Real Impact of Intraoperative Magnetic Resonance Imaging in Newly Diagnosed Glioblastoma Multiforme Resection: An Observational Analytic Cohort Study From a Single Surgeon Experience
Real Impact of Intraoperative Magnetic Resonance Imaging in Newly Diagnosed Glioblastoma Multiforme Resection: An Observational Analytic Cohort Study From a Single Surgeon Experience
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DOI：
10.1016/j.wneu.2017.12.176
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发表时间：
2018-08-01
影响因子：
2
通讯作者：
Raco, Antonino
中科院分区：
文献类型：
--
作者：
Familiari, Pietro;Frati, Alessandro;Raco, Antonino
背景：脑胶质瘤手术的目标是最大限度地切除肿瘤，避免术后功能损害。术中（Io）磁共振成像（MRI）已成为指导更安全的胶质瘤切除术的有效工具。本研究的目的是评估Io MRI在o -6-甲基鸟嘌呤- dna甲基转移酶和非o -6-甲基鸟嘌呤- dna甲基转移酶甲基化胶质瘤手术中的实际影响。方法：回顾性分析2009年3月至2017年1月在同一所大学2家不同附属医院接受开颅手术的胶质母细胞瘤患者129例。我们比较了65例无Io MRI手术的患者（a组）和64例有MRI辅助手术的患者（B组）。采用钆增强t1加权成像对切除范围（EOR）进行体积分析。所有手术均由一名外科医生（资深作者）完成。结果：A组患者的平均EOR从86.23% +/- 10.51%上升至b组患者的94.01% +/- 7.42%。本研究的次要终点为无进展生存期（PFS）和总生存期（OS）。PFS A组为5.38 +/- 2.32个月，b组为7.89 +/- 2.75个月。OS A组为13.38 +/- 4.06个月，b组为16.43 +/- 3.41个月。结论：1.5 t Io MRI是一种安全有效的技术，其使用可显著提高胶质瘤的切除程度和患者的生存率。
BACKGROUND: The goal of surgery for brain glioma is to maximize the extent of tumor resection, avoiding postoperative functional impairment. Intraoperative (Io) magnetic resonance imaging (MRI) has emerged as an effective tool to guide a safer glioma resection. The objective of this study is to assess the real impact of Io MRI in O-6-methylguanine-DNA methyltransferase and non-O-6-methylguanine-DNA methyltransferase methylated glioma surgery.METHODS: A total of 129 patients suffering glioblastoma who underwent craniotomy for tumor resection were retrospectively evaluated between March 2009 and January 2017 at 2 different affiliated hospitals of the same university. We compared a subgroup of 65 patients operated on without Io MRI (group A) with a second subgroup of 64 patients who underwent surgery with the aid of to MRI (group B). Volumetric analyses of the extent of resection (EOR) were performed using gadolinium-enhanced T1-weighted imaging. All surgical procedures were performed by a single surgeon (the senior author).RESULTS: The average EOR increased from 86.23% +/- 10.51% for group A to 94.01% +/- 7.42% in patients included in group B. The secondary end points of this study were progression-free survival (PFS) and overall survival (OS). PFS was found to be 5.38 +/- 2.32 months for group A versus 7.89 +/- 2.75 months for group B. Regarding OS, the average value was 13.38 +/- 4.06 months for group A versus 16.43 +/- 3.41 months for group B.CONCLUSIONS: We can affirm that 1.5-T Io MRI is a safe and effective technique, and its use optimizes significantly both the extent of glioma resection and the survival of patients.