Intraoperative magnetic resonance imaging versus standard neuronavigation for the neurosurgical treatment of glioblastoma: A randomized controlled trial.
Kubben, Pieter L; Scholtes, Félix; Schijns, Olaf E M Get al.
2014 • In Surgical Neurology International, 5, p. 70
Intraoperative magnetic resonance imaging versus standard neuronavigation for the neurosurgical treatment of glioblastoma- A randomized controlled trial.pdf
Glioblastoma; intraoperative magnetic resonance imaging; neuronavigation
Abstract :
[en] BACKGROUND: Although the added value of increasing extent of glioblastoma resection
is still debated, multiple technologies can assist neurosurgeons in attempting to
achieve this goal. Intraoperative magnetic resonance imaging (iMRI) might be helpful
in this context, but to date only one randomized trial exists. METHODS: We included
14 adults with a supratentorial tumor suspect for glioblastoma and an indication for
gross total resection in this randomized controlled trial of which the interim
analysis is presented here. Participants were assigned to either ultra-low-field
strength iMRI-guided surgery (0.15 Tesla) or to conventional neuronavigation-guided
surgery (cNN). Primary endpoint was residual tumor volume (RTV) percentage.
Secondary endpoints were clinical performance, health-related quality of life
(HRQOL) and survival. RESULTS: Median RTV in the cNN group is 6.5% with an
interquartile range of 2.5-14.75%. Median RTV in the iMRI group is 13% with an
interquartile range of 3.75-27.75%. A Mann-Whitney test showed no statistically
significant difference between these groups (P =0.28). Median survival in the cNN
group is 472 days, with an interquartile range of 244-619 days. Median survival in
the iMRI group is 396 days, with an interquartile range of 191-599 days (P =0.81).
Clinical performance did not differ either. For HRQOL only descriptive statistics
were applied due to a limited sample size. CONCLUSION: This interim analysis of a
randomized trial on iMRI-guided glioblastoma resection compared with cNN-guided
glioblastoma resection does not show an advantage with respect to extent of
resection, clinical performance, and survival for the iMRI group. Ultra-low-field
strength iMRI does not seem to be cost-effective compared with cNN, although the
lack of a valid endpoint for neurosurgical studies evaluating extent of glioblastoma
resection is a limitation of our study and previous volumetry-based studies on this
topic.
Disciplines :
Surgery
Author, co-author :
Kubben, Pieter L; Maastricht University Medical Center > Department of Neurosurgery
Scholtes, Félix ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Neuro-anatomie
Schijns, Olaf E M G
Ter Laak-Poort, Mariël P
Teernstra, Onno P M
Kessels, Alfons G H
MARTIN, Didier ; Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Service de neurochirurgie
van Santbrink, Henk
Language :
English
Title :
Intraoperative magnetic resonance imaging versus standard neuronavigation for the neurosurgical treatment of glioblastoma: A randomized controlled trial.
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