The role of early intra-operative MRI in partial resection of optic pathway/hypothalamic gliomas in children

Millward, Christopher P; Rosa, Sandra Pérez da; Avula, Shivaram; Ellenbogen, Jonathan R.; Spiteri, Michaela; Lewis, Emma; Didi, Mo; Mallucci, Conor

doi:10.1007/s00381-015-2830-3

Cited by 16 publications

(11 citation statements)

References 38 publications

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“…▪ Neuronavigation (frameless or with frame) and intra-operative imaging: Neuronavigation is strongly recommended where applicable to increase the safety and decrease the invasiveness of the approach to the tumor. During the surgery itself, "brain shift" often makes neuronavigation unreliable, so the surgeon should consider using intra-operative imaging with iUS, iCT or iMRI where available to ensure the surgery is as effective as possible [90,136]. ▪ In the case of needle biopsies, it is important to ensure that adequate 3D planning is performed to avoid trajectory related injuries.…”

Section: Extent Of Resection Remains Strongly Linked To Survival For mentioning

confidence: 99%

SIOP-E-BTG and GPOH Guidelines for Diagnosis and Treatment of Children and Adolescents with Low Grade Glioma

et al. 2019

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Low grade gliomas (LGGs) constitute the largest, yet clinically and (molecular-) histologically heterogeneous group of pediatric brain tumors of WHO grades I and II occurring throughout all pediatric age groups and at all central nervous system (CNS) sites. The tumors are characterized by a slow growth rate and may show periods of growth arrest. Around 40% of all LGG patients can be cured by complete neurosurgical resection and are followed by close observation. In case of relapse, second resection often is possible. Following incomplete resection observation is recommended, as long as there is no radiologic tumor growth and the patient does not suffer from significant, tumor-related symptoms. This also applies to patients with a diagnosis of LGG on the basis of radiological criteria. By contrast, clinical worsening and / or radiologic progression are an indication to treatment with either chemo- or radiotherapy. Overall survival is around 90%, and many patients survive with residual tumor, i. e. they suffer from chronic disease. All patients need comprehensive neuro-oncological care, the principles and details of which are summarized in the current guidelines. These represent standard of care for diagnostic work-up (including neuroimaging and neuropathology), and for therapeutic decisions (including the indications to non-surgical treatment) as well as concepts for neurosurgical intervention, chemotherapy and radiotherapy as well as surveillance and rehabilitation. The current treatment algorithm was compiled by members of the LGG working group of the SIOP-E brain tumor group (SIOP-E-BTG) and is based upon the results of previous European LGG studies and international reports.

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Section: Extent Of Resection Remains Strongly Linked To Survival For mentioning

confidence: 99%

SIOP-E-BTG and GPOH Guidelines for Diagnosis and Treatment of Children and Adolescents with Low Grade Glioma

et al. 2019

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“…Two iMRI suites were operated as a tworoom solution setup in dual use for intraoperative and diagnostic imaging in two studies. 21,22…”

Section: Methodsmentioning

confidence: 99%

“…Frequency of histopathologic entities treated by iMRI-guided resections was determined in 346 patients. 19,[21][22][23][24][25][26][27][28][29][30]…”

Section: Histopathologic Entities Resected By Imri-guidancementioning

confidence: 99%

“…The studies by Levy et al 28 and Roth et al 30 were excluded due to the lack of detailed reports about histopathology or EoR. Millward et al 21 and Shah et al 27 were excluded due to the intent to achieve a subtotal resection and sellar pathologies within the reported rate of GTR. At least also the study by Lam et al was excluded due to tumor location in eloquent areas (infratentorial gliomas with brain stem involvement).…”

Section: Rate Of Gtr In Gliomas (Who Grades I-iv)mentioning

confidence: 99%

“…Kremer et al, 19 Kubben et al, 26 Millward et al, 21 and Roder et al 24 in which a control group of patients without iMRIguided brain tumor surgery was also given. In 37 (33.0%) of 112 patients in whom iMRI-guided resections were performed, new transient neurologic deficits were observed postoperatively.…”

Section: Postoperative Neurologic Deficitsmentioning

confidence: 99%

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Intraoperative MRI-guided Resection in Pediatric Brain Tumor Surgery: A Meta-analysis of Extent of Resection and Safety Outcomes

Wach

Banat

Borger

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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Background The objective of this meta-analysis was to analyze the impact of intraoperative magnetic resonance imaging (iMRI) on pediatric brain tumor surgery with regard to the frequency of histopathologic entities, additional resections secondary to iMRI, rate of gross total resections (GTR) in glioma surgery, extent of resection (EoR) in supra- and infratentorial compartment, surgical site infections (SSIs), and neurologic outcome after surgery. Methods MEDLINE/PubMed Service was searched for the terms “intraoperative MRI,” “pediatric,” “brain,” “tumor,” “glioma,” and “surgery.” The review produced 126 potential publications; 11 fulfilled the inclusion criteria, including 584 patients treated with iMRI-guided resections. Studies reporting about patients <18 years, setup of iMRI, surgical workflow, and extent of resection of iMRI-guided glioma resections were included. Results IMRI-guided surgery is mainly used for pediatric low-grade gliomas. The mean rate of GTR in low- and high-grade gliomas was 78.5% (207/254; 95% confidence interval [CI]: 64.6–89.7, p < 0.001). The mean rate of GTR in iMRI-assisted low-grade glioma surgery was 74.3% (35/47; 95% CI: 61.1–85.5, p = 0.759). The rate of SSI in surgery assisted by iMRI was 1.6% (6/482; 95% CI: 0.7–2.9). New onset of transient postoperative neurologic deficits were observed in 37 (33.0%) of 112 patients. Conclusion IMRI-guided surgery seems to improve the EoR in pediatric glioma surgery. The rate of SSI and the frequency of new neurologic deficits after IMRI-guided surgery are within the normal range of pediatric neuro-oncologic surgery.

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Hydrocephalus Caused by Basal Ganglia, Thalamic, and Suprasellar Tumors

Roth¹,

Constantini²

2019

Pediatric Hydrocephalus

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The role of early intra-operative MRI in partial resection of optic pathway/hypothalamic gliomas in children

Abstract: Abstract:Introduction:

Cited by 16 publications

References 38 publications

SIOP-E-BTG and GPOH Guidelines for Diagnosis and Treatment of Children and Adolescents with Low Grade Glioma

SIOP-E-BTG and GPOH Guidelines for Diagnosis and Treatment of Children and Adolescents with Low Grade Glioma

Intraoperative MRI-guided Resection in Pediatric Brain Tumor Surgery: A Meta-analysis of Extent of Resection and Safety Outcomes

Hydrocephalus Caused by Basal Ganglia, Thalamic, and Suprasellar Tumors

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