Improving the Extent of Malignant Glioma Resection by Dual Intraoperative Visualization Approach

摘要: Despite continuing debates around cytoreductive surgery in malignant gliomas, there is broad consensus that increased extent of tumor reduction improves overall survival. However, maximization the resection hampered by difficulty intraoperative discrimination between normal and pathological tissue. In this context, two established methods for visualization, fluorescence guided with 5-ALA MRI (iMRI) integrated functional neuronavigation were investigated as a dual visualization (DIV) approach. Thirty seven patients presumably suffering from gliomas (WHO grade III or IV) according to radiological appearance included. Twenty-one experimental sequences showing complete technique confirmed iMRI. Fourteen could not be iMRI, which detected residual tumor. Further analysis revealed these classified II tumors (adjacent eloquent brain areas). The combination evaluation high field significantly subgroup located adjacent areas 61.7% 100%; alone proved insufficient attaining gross total without danger incurring postoperative neurological deterioration. Furthermore, case iMRI was superior technique. 57.1% 71.2% deficits.