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Diffusion tensor imaging, intraoperative neurophysiological monitoring and small craniotomy: Results in a consecutive series of 103 gliomas.

Authors :
Carrabba, Giorgio
Fiore, Giorgio
Di Cristofori, Andrea
Bana, Cristina
Borellini, Linda
Zarino, Barbara
Conte, Giorgio
Triulzi, Fabio
Rocca, Alessandra
Giussani, Carlo
Caroli, Manuela
Locatelli, Marco
Bertani, Giulio
Source :
Frontiers in Oncology; 9/13/2022, Vol. 12, p1-20, 20p
Publication Year :
2022

Abstract

Diffusion tensor imaging (DTI) allows visualization of the main white matter tracts while intraoperative neurophysiological monitoring (IONM) represents the gold standard for surgical resection of gliomas. In recent years, the use of small craniotomies has gained popularity thanks to neuronavigation and to the low morbidity rates associated with shorter surgical procedures. The aim of this study was to review a series of patients operated for glioma using DTI, IONM, and tumor-targeted craniotomies. The retrospective analysis included patients with supratentorial glioma who met the following inclusion criteria: preoperative DTI, intraoperative IONM, tumor-targeted craniotomy, pre- and postoperative MRI, and complete clinical charts. The DTI was performed on a 3T scanner. The IONM included electroencephalography (EEG), transcranial (TC) and/or cortical motor-evoked potentials (MEP), electrocorticography (ECoG), and direct electrical stimulation (DES). Outcomes included postoperative neurological deficits, volumetric extent of resection (EOR), and overall survival (OS). One hundred and three patients (61 men, 42 women; mean age 54 ± 14 years) were included and presented the following WHO histologies: 65 grade IV, 19 grade III, and 19 grade II gliomas. After 3 months, only three patients had new neurological deficits. The median postoperative volume was 0cc (IQR 3). The median OS for grade IV gliomas was 15 months, while for low-grade gliomas it was not reached. In our experience, a small craniotomy and a tumor resection supported by IONM and DTI permitted to achieve satisfactory results in terms of neurological outcomes, EOR, and OS for glioma patients. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
2234943X
Volume :
12
Database :
Complementary Index
Journal :
Frontiers in Oncology
Publication Type :
Academic Journal
Accession number :
159393640
Full Text :
https://doi.org/10.3389/fonc.2022.897147