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Evaluation of pediatric glioma outcomes using intraoperative MRI: a multicenter cohort study.
Karsy, Michael; Akbari, S Hassan; Limbrick, David; Leuthardt, Eric C; Evans, John; Smyth, Matthew D; Strahle, Jennifer; Leonard, Jeffrey; Cheshier, Samuel; Brockmeyer, Douglas L; Bollo, Robert J; Kestle, John R; Honeycutt, John; Donahue, David J; Roberts, Richard A; Hansen, Daniel R; Riva-Cambrin, Jay; Sutherland, Garnette; Gallagher, Clair; Hader, Walter; Starreveld, Yves; Hamilton, Mark; Duhaime, Ann-Christine; Jensen, Randy L; Chicoine, Michael R.
Afiliación
  • Karsy M; Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA.
  • Akbari SH; Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.
  • Limbrick D; Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.
  • Leuthardt EC; Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.
  • Evans J; Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.
  • Smyth MD; Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.
  • Strahle J; Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.
  • Leonard J; Department of Neurosurgery, Nationwide Children's Hospital, Columbus, OH, USA.
  • Cheshier S; Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA.
  • Brockmeyer DL; Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA.
  • Bollo RJ; Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA.
  • Kestle JR; Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA.
  • Honeycutt J; Department of Neurosurgery, Cook Children's Neurosciences, Forth Worth, TX, USA.
  • Donahue DJ; Department of Neurosurgery, Cook Children's Neurosciences, Forth Worth, TX, USA.
  • Roberts RA; Department of Neurosurgery, Cook Children's Neurosciences, Forth Worth, TX, USA.
  • Hansen DR; Department of Neurosurgery, Cook Children's Neurosciences, Forth Worth, TX, USA.
  • Riva-Cambrin J; Department of Neurosurgery, University of Calgary, Calgary, AB, Canada.
  • Sutherland G; Department of Neurosurgery, University of Calgary, Calgary, AB, Canada.
  • Gallagher C; Department of Neurosurgery, University of Calgary, Calgary, AB, Canada.
  • Hader W; Department of Neurosurgery, University of Calgary, Calgary, AB, Canada.
  • Starreveld Y; Department of Neurosurgery, University of Calgary, Calgary, AB, Canada.
  • Hamilton M; Department of Neurosurgery, University of Calgary, Calgary, AB, Canada.
  • Duhaime AC; Department of Neurosurgery, Massachusetts General Hospital for Children, Boston, MA, USA.
  • Jensen RL; Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA. neuropub@hsc.utah.edu.
  • Chicoine MR; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA. neuropub@hsc.utah.edu.
J Neurooncol ; 143(2): 271-280, 2019 Jun.
Article en En | MEDLINE | ID: mdl-30977059
BACKGROUND: The use of intraoperative MRI (iMRI) during treatment of gliomas may increase extent of resection (EOR), decrease need for early reoperation, and increase progression-free and overall survival, but has not been fully validated, particularly in the pediatric population. OBJECTIVE: To assess the accuracy of iMRI to identify residual tumor in pediatric patients with glioma and determine the effect of iMRI on decisions for resection, complication rates, and other outcomes. METHODS: We retrospectively analyzed a multicenter database of pediatric patients (age ≤ 18 years) who underwent resection of pathologically confirmed gliomas. RESULTS: We identified 314 patients (mean age 9.7 ± 4.6 years) with mean follow-up of 48.3 ± 33.6 months (range 0.03-182.07 months) who underwent surgery with iMRI. There were 201 (64.0%) WHO grade I tumors, 57 (18.2%) grade II, 24 (7.6%) grade III, 9 (2.9%) grade IV, and 23 (7.3%) not classified. Among 280 patients who underwent resection using iMRI, 131 (46.8%) had some residual tumor and underwent additional resection after the first iMRI. Of the 33 tissue specimens sent for pathological analysis after iMRI, 29 (87.9%) showed positive tumor pathology. Gross total resection was identified in 156 patients (55.7%), but this was limited by 69 (24.6%) patients with unknown EOR. CONCLUSIONS: Analysis of the largest multicenter database of pediatric gliomas resected using iMRI demonstrated additional tumor resection in a substantial portion of cases. However, determining the impact of iMRI on EOR and outcomes remains challenging because iMRI use varies among providers nationally. Continued refinement of iMRI techniques for use in pediatric patients with glioma may improve outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Imagen por Resonancia Magnética / Monitoreo Intraoperatorio / Craneotomía / Glioma Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies Límite: Child / Female / Humans / Male Idioma: En Revista: J Neurooncol Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Imagen por Resonancia Magnética / Monitoreo Intraoperatorio / Craneotomía / Glioma Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies Límite: Child / Female / Humans / Male Idioma: En Revista: J Neurooncol Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos