T2 Fluid-Attenuated Inversion Recovery Resection for Glioblastoma Involving Eloquent Brain Areas Facilitated Through Awake Craniotomy and Clinical Outcome

Lu, Ming; Fu, Zheng; He, Xiao; Lu, Jian kan; Deng, Xin; Lin, De liu; Gu, You ming; Fan, Yan; Lai, Ming yao; Li, Juan; Yang, Ming; Chen, Zhong Ping

doi:10.1016/j.wneu.2019.12.130

Cited by 10 publications

(8 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In particular, there was a significant difference in survival time according to the degree of resection, and the importance of maximal resection was emphasized [1,2,9]. Recently, studies have shown that surgical resection, including not only the contrast-enhancing lesion but also the signal-changed lesion in FLAIR images, increases the survival time [23,24]. In addition, the concept of supra-total resection, which removes not only the region showing signal change on the MRI but also the region associated with tumors, has been reported and showed a survival benefit [25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Maximal surgical resection and adjuvant surgical technique to prolong the survival of adult patients with thalamic glioblastoma

et al. 2021

View full text Add to dashboard Cite

The importance of maximal resection in the treatment of glioblastoma (GBM) has been reported in many studies, but maximal resection of thalamic GBM is rarely attempted due to high rate of morbidity and mortality. The purpose of this study was to investigate the role of surgical resection in adult thalamic glioblastoma (GBM) treatment and to identify the surgical technique of maximal safety resection. In case of suspected thalamic GBM, surgical resection is the treatment of choice in our hospital. Biopsy was considered when there was ventricle wall enhancement or multiple enhancement lesion in a distant location. Navigation magnetic resonance imaging, diffuse tensor tractography imaging, tailed bullets, and intraoperative computed tomography and neurophysiologic monitoring (transcranial motor evoked potential and direct subcortical stimulation) were used in all surgical resection cases. The surgical approach was selected on the basis of the location of the tumor epicenter and the adjacent corticospinal tract. Among the 42 patients, 19 and 23 patients underwent surgical resection and biopsy, respectively, according to treatment strategy criteria. As a result, the surgical resection group exhibited a good response with overall survival (OS) (median: 676 days, p < 0.001) and progression-free survival (PFS) (median: 328 days, p < 0.001) compared with each biopsy groups (doctor selecting biopsy group, median OS: 240 days and median PFS: 134 days; patient selecting biopsy group, median OS: 212 days and median PFS: 118 days). The surgical resection groups displayed a better prognosis compared to that of the biopsy groups for both the O6-methylguanine-DNA methyltransferase unmethylated (log-rank p = 0.0035) or methylated groups (log-rank p = 0.021). Surgical resection was significantly associated with better prognosis (hazard ratio: 0.214, p = 0.006). In case of thalamic GBM without ventricle wall-enhancing lesion or multiple lesions, maximal surgical resection above 80% showed good clinical outcomes with prolonged the overall survival compared to biopsy. It is helpful to use adjuvant surgical techniques of checking intraoperative changes and select the appropriate surgical approach for reducing the surgical morbidity.

show abstract

Section: Discussionmentioning

confidence: 99%

Maximal surgical resection and adjuvant surgical technique to prolong the survival of adult patients with thalamic glioblastoma

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Moreover, developing individualized treatment plans based on recurrence patterns may improve the prognosis of patients with HGGs. Previous studies have reported that extended resection of FLAIR abnormalities in patients with glioblastoma could prolong survival [27][28][29]. Thus, if patients with high risk of ECR can be preoperatively predicted, expanding the extent of resection may bene t patient survival.…”

Section: Discussionmentioning

confidence: 99%

Multimodal MRI lesion habitat-based radiomics analysis for preoperative prediction of spatial pattern in locally recurrent high-grade gliomas

Wang,

Zeng,

et al. 2024

Preprint

View full text Add to dashboard Cite

Purpose This study aims to preoperatively predict spatial patterns in locally recurrent high-grade gliomas (HGGs) based on lesion habitat radiomics analysis of multimodal MRI and to evaluate the predictive performance of this approach. Methods Our study included 121 patients with locally recurrent HGGs after maximum safe surgical resections and radiotherapy combined with temozolomide (training set, n = 84; validation set, n = 37). Local recurrence was divided into intra-resection cavity recurrence (ICR) and extra-resection cavity recurrence (ECR), according to the distance between the recurrent tumor and the surgical area or resection cavity. Radiomic features were extracted from the lesion habitat (T1WI enhancing lesion and T2WI/FLAIR hyperintense perilesional region) on contrast-enhanced T1WI and FLAIR, respectively. The LASSO was used to select radiomic features and calculate radiomics score. Logistic regression analysis was used to construct a predictive radiomics model, which was evaluated using calibration curves and the area under the receiver operating characteristic curve (AUC). Results Seven features with nonzero coefficients related to spatial recurrence patterns were selected. The radiomics score of patients with ECR was higher than that of patients with ICR in the training set [0.424 (0.278–0.573) vs. -0.030 (-0.226-0.248), p < 0.001] and in the validation set [0.369 (0.258–0.487) vs. 0.277 (0.103–0.322), p = 0.033]. The radiomics model demonstrated good calibration and performed well in predicting ECR, with AUC values of 0.844 in the training set and 0.706 in the validation set. Conclusion Radiomics analysis of lesion habitat can preoperatively predict spatial patterns in locally recurrent HGGs, providing a basis for determining personalized treatment strategies for HGGs.

show abstract

“…A comprehensive literature search identi ed eleven de nitions for SpTR of GBM and four de nitions of eloquence (Supplement) [14,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. To investigate the anatomic locations where SpTR was considered an appropriate treatment for GBM, preoperative MRI data was sourced from 10 de-identi ed adult (≥18 years) GBM patients (Supplement).…”

Section: Survey Creationmentioning

confidence: 99%

A consensus definition of supratotal resection for anatomically distinct primary glioblastoma: an AANS/CNS Section on Tumors survey of neurosurgical oncologists

et al. 2022

View full text Add to dashboard Cite

Supratotal resection (SpTR) of glioblastoma may be associated with improved survival, but published results have varied in part from lack of consensus on the de nition and appropriate use of SpTR. A previous small survey of neurosurgical oncologists with expertise performing SpTR found resection 1-2 cm beyond contrast enhancement was an acceptable de nition and glioblastoma involving the right frontal and bilateral anterior temporal lobes were considered most amenable to SpTR. The general neurosurgical oncology community has not yet con rmed the practicality of this de nition. MethodsSeventy-six general neurosurgical oncology members of the AANS/CNS Tumor Section were surveyed using a crowdsourcing approach. Participants were presented with 11 de nitions of SpTR and rated each de nition's appropriateness. Participants additionally reviewed magnetic resonance imaging for 10 anatomically distinct glioblastomas and assessed the tumor location's eloquence, perceived equipoise of enrolling patients in a randomized trial comparing gross total to SpTR, and their personal treatment plans. ResultsFifty-two neurosurgeons (73.2%) agreed that resection 1-2 cm beyond contrast enhancement was an acceptable de nition for SpTR. Cases were divided into three anatomically distinct groups by perceived equipoise between gross total and SpTR. The best clinical trial candidates were right anterior temporal (n=58, 76.3%) and right frontal (n=55, 73.3%) glioblastomas. ConclusionSupport exists within the neurosurgical oncology community to adopt the proposed consensus de nition of SpTR of glioblastoma and to treat right anterior temporal and right frontal glioblastomas using SpTR.A smaller proportion of general neurosurgical oncologists than SpTR experts consider SpTR feasible in the left anterior temporal lobe.

show abstract

T2 Fluid-Attenuated Inversion Recovery Resection for Glioblastoma Involving Eloquent Brain Areas Facilitated Through Awake Craniotomy and Clinical Outcome

Cited by 10 publications

References 21 publications

Maximal surgical resection and adjuvant surgical technique to prolong the survival of adult patients with thalamic glioblastoma

Maximal surgical resection and adjuvant surgical technique to prolong the survival of adult patients with thalamic glioblastoma

Multimodal MRI lesion habitat-based radiomics analysis for preoperative prediction of spatial pattern in locally recurrent high-grade gliomas

A consensus definition of supratotal resection for anatomically distinct primary glioblastoma: an AANS/CNS Section on Tumors survey of neurosurgical oncologists

Contact Info

Product

Resources

About