1. Impact of intraoperative MRI-guided resection on resection and survival in patient with gliomas: a meta-analysis.
- Author
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Li P, Qian R, Niu C, and Fu X
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Brain Neoplasms mortality, Brain Neoplasms surgery, Glioma mortality, Glioma surgery, Magnetic Resonance Imaging mortality, Magnetic Resonance Imaging statistics & numerical data, Neurosurgical Procedures mortality, Neurosurgical Procedures statistics & numerical data, Surgery, Computer-Assisted mortality, Surgery, Computer-Assisted statistics & numerical data
- Abstract
Objective: This study addressed the benefit of intraoperative magnetic resonance imaging (iMRI) compared with conventional neuronavigation-guided resection in patients with gliomas., Research Design and Methods: The Medline, PubMed, Cochrane, and Google Scholar databases were searched up to 26 September 2015. Randomized controlled trials (RCTs), two-arm prospective studies, and retrospective studies in patients with glioblastoma/glioma who had received surgical treatment were included., Main Outcome Measures: The primary outcome measures were the extent of tumor resection and tumor size reduction for using iMRI-guided or conventional neuronavigation-guided neurosurgery. Secondary outcomes included impact of surgery on 6 month progression-free survival (PFS), 12 month overall survival (OS) rates and surgical duration., Results: We found that iMRI was associated with greater rate of gross total resection (rGTR) compared with conventional neuronavigation procedures (3.16, 95% confidence interval [CI] 2.07-4.83, P < .001). We found no difference between the two neuronavigation approaches in extent of resection (EOR), tumor size reduction, or time required for surgery (P values ≥.065). Intraoperative MRI was associated with a higher rate of progression-free survival (PFS) compared with conventional neuronavigation (odds ratio, 1.84; 95% CI 1.15-2.95; P = .012), but the rate of overall survival (OS) between groups was similar (P = .799). Limitations of the study included the fact that data from non-RCTs was used, the small study population, and heterogeneity of outcomes across studies., Conclusions: Our findings indicate that iMRI more frequently resulted in more complete resections leading to improved PFS in patients with malignant gliomas.
- Published
- 2017
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