Usefulness of intraoperative magnetic resonance imaging for glioma surgery

Muragakı, Yoshihiro; Iseki, Hiroshi; Maruyama, Takashi; Kawamata, Takakazu; Yamane, Fumitaka; Nakamura, Ryoichi; Kubo, Osami; Takakura, Kintomo; Hori, Tomokatsu

doi:10.1007/978-3-211-33303-7_10

Cited by 97 publications

(49 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While a larger craniotomy and intraoperative brain mapping have certainly led to some increase in the duration of surgery (roughly 1.5 hours per patient), the mean operation time in the present study (8.2 hours) corresponds well with our general experience with surgery for gliomas using intraoperative MRI. [23][24][25][26] Recently, Leuthardt et al 18 reported an average operating room time of 7.9 hours (range 5.9-9.7 hours) in 12 patients treated with the combined use of awake craniotomy, intraoperative cortical mapping, and intraoperative MRI, which seems concordant with time in the present study. It should be noted that neither a more extensive surgical approach nor a relative prolongation of the surgical procedure resulted in additional morbidity in our patients.…”

supporting

confidence: 87%

“…[23][24][25][26] Intraoperative MRI (AIRIS II, Hitachi Medical Corp.), updated neuronavigation, comprehensive neurophysiological monitoring, and detailed histopathological characterization of resected tissue obtained at various stages of the procedure were used routinely. In cases of malignancy, neurochemical guidance of lesion resection with 5-aminolevulinic acid was applied as well.…”

Section: Surgerymentioning

confidence: 99%

See 1 more Smart Citation

Intraoperative cortico-cortical evoked potentials for the evaluation of language function during brain tumor resection: initial experience with 13 cases

Saito¹,

Tamura

Muragakı

et al. 2014

JNS

View full text Add to dashboard Cite

Object The objective in the present study was to evaluate the usefulness of cortico-cortical evoked potentials (CCEP) monitoring for the intraoperative assessment of speech function during resection of brain tumors. Methods Intraoperative monitoring of CCEP was applied in 13 patients (mean age 34 ± 14 years) during the removal of neoplasms located within or close to language-related structures in the dominant cerebral hemisphere. For this purpose strip electrodes were positioned above the frontal language area (FLA) and temporal language area (TLA), which were identified with direct cortical stimulation and/or preliminary mapping with the use of implanted chronic subdural grid electrodes. The CCEP response was defined as the highest observed negative peak in either direction of stimulation. In 12 cases the tumor was resected during awake craniotomy. Results An intraoperative CCEP response was not obtained in one case because of technical problems. In the other patients it was identified from the FLA during stimulation of the TLA (7 cases) and from the TLA during stimulation of the FLA (5 cases), with a mean peak latency of 83 ± 15 msec. During tumor resection the CCEP response was unchanged in 5 cases, decreased in 4, and disappeared in 3. Postoperatively, all 7 patients with a decreased or absent CCEP response after lesion removal experienced deterioration in speech function. In contrast, in 5 cases with an unchanged intraoperative CCEP response, speaking abilities after surgery were preserved at the preoperative level, except in one patient who experienced not dysphasia, but dysarthria due to pyramidal tract injury. This difference was statistically significant (p < 0.01). The time required to recover speech function was also significantly associated with the type of intraoperative change in CCEP recordings (p < 0.01) and was, on average, 1.8 ± 1.0, 5.5 ± 1.0, and 11.0 ± 3.6 months, respectively, if the response was unchanged, was decreased, or had disappeared. Conclusions Monitoring CCEP is feasible during the resection of brain tumors affecting language-related cerebral structures. In the intraoperative evaluation of speech function, it can be a helpful adjunct or can be used in its direct assessment with cortical and subcortical mapping during awake craniotomy. It can also be used to predict the prognosis of language disorders after surgery and decide on the optimal resection of a neoplasm.

show abstract

supporting

confidence: 87%

Section: Surgerymentioning

confidence: 99%

Intraoperative cortico-cortical evoked potentials for the evaluation of language function during brain tumor resection: initial experience with 13 cases

Saito¹,

Tamura

Muragakı

et al. 2014

JNS

View full text Add to dashboard Cite

show abstract

“…17,28,30) Our surgical strategy for information-guided management of intracranial gliomas with the use of iMR imaging has been described in detail elsewhere. 27,28,30) It is based on the integration of various intraoperative anatomical, functional, and histological data to attain maximal surgical resection of the tumor with minimal risk of postoperative neurological morbidity. It should be specifically emphasized that complete removal is highly desirable, but is not the ultimate goal of surgery for glioma.…”

Section: Discussionmentioning

confidence: 99%

“…In our practice, the procedure is usually directed to the maximal possible resection of the enhanced area in cases of high-grade glioma, which might be radiologically total as well as subtotal, leaving the residual lesion within the functioning eloquent brain structures identified with neurophysiological monitoring and/or brain mapping. 27,28,30) In the majority of reported series, local progression of intracranial glioblastoma after initial 36) 31 Overall 10 patients underwent total surgical resection; In 10 cases maximal tumor removal followed by FRT (59.4-60.0 Gy) with concurrent and adjuvant TMZ was done; 12 patients were treated with intracavitary brachytherapy after maximal surgical debulking followed by FRT (45 Gy) with concurrent and adjuvant TMZ; 9 patients had unresectable disease and underwent hypofractionated radiotherapy (50-66 Gy in 10 fractions) followed by adjuvant TMZ or bevacizumab median 12.6; range 3.5-50.6 100% 52%…”

Section: Discussionmentioning

confidence: 99%

“…Case selection was limited to the beginning of 2004, since the initial period after installation of iMR imaging in our clinic (2000) was completed by this time, significant improvement of the intraoperative image quality had succeeded, and the surgical algorithm of glioma treatment in this facility was fully established. 16,27,28,30) All selected cases were checked for resection rate. The established cut-off level of 95% or greater tumor removal was chosen, because this value corresponds to the grading of resection of malignant gliomas used by The Committee of Brain Tumor Registry of Japan.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Patterns of Intracranial Glioblastoma Recurrence After Aggressive Surgical Resection and Adjuvant Management: Retrospective Analysis of 43 Cases

Konishi

Muragakı

Iseki

et al. 2012

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

The present retrospective study evaluated the recurrence patterns after aggressive surgical removal of intracranial glioblastomas in 43 consecutive adult patients. The resection rate of the enhanced lesion on magnetic resonance imaging was 100% and 95-99% in 22 and 21 cases, respectively. All patients received postoperative fractionated radiotherapy (60 Gy in 30 fractions) with additional chemotherapy (25 cases) or vaccine therapy (18 cases). During follow-up (median 17 months), tumor recurrence was identified in 33 patients, most frequently regional within the wall of the resection cavity (20 cases). No clinical factor differed significantly between the groups of patients with regional or marginal tumor progression (N ＝ 22) and patients with distant or multiple recurrences (N ＝ 8). Progression-free survival did not differ significantly between these two groups (p ＝ 0.27). However, overall survival was significantly longer (p ＝ 0.04) in patients with regional or marginal tumor progression, and constituted 90% and 54% at 1 and 2 years after surgery, respectively, compared to 75% and 0% in patients with distant or multiple recurrences. Aggressive surgical resection and adjuvant management of intracranial glioblastoma may change its recurrence pattern. Tumor progression appears in the wall of the resection cavity or within 2 cm from its margin in approximately half of patients.

show abstract

Intraoperative magnetic resonance imaging in the surgical treatment of cerebral metastases

Senft¹,

Seifert²,

Gasser³

2010

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

Usefulness of intraoperative magnetic resonance imaging for glioma surgery

Cited by 97 publications

References 31 publications

Intraoperative cortico-cortical evoked potentials for the evaluation of language function during brain tumor resection: initial experience with 13 cases

Intraoperative cortico-cortical evoked potentials for the evaluation of language function during brain tumor resection: initial experience with 13 cases

Patterns of Intracranial Glioblastoma Recurrence After Aggressive Surgical Resection and Adjuvant Management: Retrospective Analysis of 43 Cases

Intraoperative magnetic resonance imaging in the surgical treatment of cerebral metastases

Contact Info

Product

Resources

About