Usefulness and Impact of Intraoperative Imaging for Glioma Resection on Patient Outcome and Extent of Resection: A Systematic Review and Meta-Analysis

Caras, Andrew; Mugge, Luke; Miller, W.K.; Mansour, Tarek R; Schroeder, Jason; Medhkour, Azedine

doi:10.1016/j.wneu.2019.10.072

Cited by 18 publications

(11 citation statements)

References 49 publications

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“…In patients undergoing fMRI, the pooled ER of postsurgical permanent neurologic deficits (11%) was close to the reported incidence in a recent systematic review and metaanalysis by Caras et al (5). That study assessed the effect of intraoperative imaging for glioma resection by using morphologic and advanced imaging, including diffusion-tensor imaging and fMRI, in 29 studies (11.3%).…”

Section: Discussionsupporting

confidence: 70%

Can Preoperative Mapping with Functional MRI Reduce Morbidity in Brain Tumor Resection? A Systematic Review and Meta-Analysis of 68 Observational Studies

et al. 2021

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F unctional MRI (fMRI) is increasingly implemented as a practical preoperative planning tool for brain tumor resection, but a considerable discrepancy between its current use and presumed utility remains. A recent survey among neurosurgeons found variability in the present use and assumed utility of fMRI for preoperative surgical planning in patients with brain tumors. This variation includes clinical and radiographic indications for ordering fMRI, functional paradigms to test in specific case studies, and clinical purposes of using fMRI (1).Surgical resection of brain tumors aims to maximize tumor removal while avoiding the onset of permanent postoperative deficits. The extent of tumor resection independently correlates with patient survival (2,3). However, when resective surgery extends too far into infiltrated critical structures, the condition of the patient permanently worsens; this, in turn, compromises both quality of life and survival. Several neurosurgical advances aim to improve patient outcomes. To localize critical brain structures and the tumor, techniques such as preoperative functional neuroimaging, neuronavigation, fluorescent dyes, MRI in the surgical field, and intraoperative stimulation mapping have been used (4). Although meta-analyses have assessed the use of intraoperative stimulation mapping, awake craniotomy, and intraoperative MRI (4-6), the usefulness of these techniques and their effect on neurologic outcomes have not been sufficiently addressed in randomized trials or meta-analyses. These studies suggest that glioma resections that use intraoperative stimulation mapping and awake craniotomy are associated with better surgical outcomes, fewer late severe neurologic deficits, and a higher percentage of gross total resections (4,6). However, a recent meta-analysis of five studies comparing the use of the intraoperative fMRI with standard neuronavigation (5) showed attenuated incidence of postsurgical permanent neurologic deficits, although this finding was not statistically significant.The primary objective of our study was to assess the overall postoperative morbidity within at least a 2-month Background: Preoperative functional MRI (fMRI) is one of several techniques developed to localize critical brain structures and brain tumors. However, the usefulness of fMRI for preoperative surgical planning and its potential effect on neurologic outcomes remain unclear.Purpose: To assess the overall postoperative morbidity among patients with brain tumors by using preoperative fMRI versus surgery without this tool or with use of standard (nonfunctional) neuronavigation. Materials and Methods:A systematic review and meta-analysis of studies across major databases from 1946 to June 20, 2020, were conducted. Inclusion criteria were original studies that (a) included patients with brain tumors, (b) performed preoperative neuroimaging workup with fMRI, (c) investigated the usefulness of a preoperative or intraoperative functional neuroimaging technique and used that technique to resect cerebral tumors...

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Section: Discussionsupporting

confidence: 70%

Can Preoperative Mapping with Functional MRI Reduce Morbidity in Brain Tumor Resection? A Systematic Review and Meta-Analysis of 68 Observational Studies

et al. 2021

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“…In this review, Buchmann et al and Alexopoulos et al gave us two sides of the same coin [29,32]. A recent systematic review and meta-analysis study shared their analysis, suggesting either a combination of DTI, fMRI, and intraoperative MRI used in intraoperative neuronavigation, or by themselves, was insufficient to conclude that these advanced imaging techniques have the potential to influence the GTR and neurological preservation [44]. The use of imaging modalities in surgery could increase the GTR rate; however, this would not improve the surgical outcome.…”

Section: Discussionmentioning

confidence: 91%

“…In their analysis of iMRI studies, the authors pointed out that the imaging modality could permit better GTR and preserve the eloquent area in incomplete resection, when GTR not feasible. However, it is important to highlight that, in regards to their study on DTI, DTI has not been extensively studied and an exclusive meta-analysis on DTI studies should be done [44].…”

Section: Discussionmentioning

confidence: 99%

The Utilization of Diffusion Tensor Imaging as an Image-Guided Tool in Brain Tumor Resection Surgery: A Systematic Review

Manan

Yahya

Idris

et al. 2022

Cancers

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The diffusion tensor imaging technique has been recognized as a neuroimaging tool for in vivo visualization of white matter tracts. However, DTI is not a routine procedure for preoperative planning for brain tumor resection. Our study aimed to systematically evaluate the effectiveness of DTI and the outcomes of surgery. The electronic databases, PubMed/MEDLINE and Scopus, were searched for relevant studies. Studies were systematically reviewed based on the application of DTI in pre-surgical planning, modification of operative planning, re-evaluation of preoperative DTI data intraoperatively, and the outcome of surgery decisions. Seventeen studies were selected based on the inclusion and exclusion criteria. Most studies agreed that preoperative planning using DTI improves postoperative neuro-deficits, giving a greater resection yield and shortening the surgery time. The results also indicate that the re-evaluation of preoperative DTI intraoperatively assists in a better visualization of white matter tract shifts. Seven studies also suggested that DTI modified the surgical decision of the initial surgical approach and the rate of the GTR in tumor resection surgery. The utilization of DTI may give essential information on white matter tract pathways, for a better surgical approach, and eventually reduce the risk of neurologic deficits after surgery.

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“…Magnetic resonance imaging (MRI) is a function of preoperative planning tools used to remove brain tumors before surgery (1). However, so far there are disagreements between the possible applications of MRI and its current use (2).…”

Section: Introductionmentioning

confidence: 99%

Assess the overall postoperative morbidity among patients with brain tumors by using preoperative functional magnetic resonance imaging

Asadifar

Khazaei

Mokarian

et al. 2022

ijhs

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Background and aim: the aim of present study was Assessing the Overall Postoperative morbidity among patients with brain tumors by using preoperative functional Magnetic Resonance Imaging. Method: Databases of PubMed, Scopus, Web of Science, EBSCO, ISI Web of knowledge and Embase were searched for systematic literature between 2012 to July 2022. 95% confidence interval for odds ratio with fixed effect model and Mantel–Haenszel method and were calculated. To deal with potential heterogeneity, random effects were used and I2 showed heterogeneity. Meta-analysis was performed using Stata/MP v.17 software. Result: In the initial review, duplicate studies were eliminated and abstracts of 178 studies were reviewed, the full text of 32 studies was reviewed by two authors, finally, six studies were selected. Odds ratio of Unfavorable outcomes between functional MRI and control group was 0.46 (OR, 95% CI 0.15, 0.76; p<0.001). Odds ratio of Gross total resection between functional MRI and control group was 0.20 (OR, 95% CI -0.20, 0.59; p=0.34). Conclusion: According to the findings of the present study, the use of functional MRI before brain tumor removal is associated with a reduction in the risk of delayed or permanent neurological deficits after surgery with a two-month follow-up period.

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Usefulness and Impact of Intraoperative Imaging for Glioma Resection on Patient Outcome and Extent of Resection: A Systematic Review and Meta-Analysis

Cited by 18 publications

References 49 publications

Can Preoperative Mapping with Functional MRI Reduce Morbidity in Brain Tumor Resection? A Systematic Review and Meta-Analysis of 68 Observational Studies

Can Preoperative Mapping with Functional MRI Reduce Morbidity in Brain Tumor Resection? A Systematic Review and Meta-Analysis of 68 Observational Studies

The Utilization of Diffusion Tensor Imaging as an Image-Guided Tool in Brain Tumor Resection Surgery: A Systematic Review

Assess the overall postoperative morbidity among patients with brain tumors by using preoperative functional magnetic resonance imaging

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