Impact of intraoperative MRI-guided resection on resection and survival in patient with gliomas: a meta-analysis |
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Authors: | Ping Li Ruobing Qian Chaoshi Niu |
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Affiliation: | 1. Department of Neurosurgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, Anhui, P.R. China;2. Department of Neurosurgery, South branch of Anhui Provincial Hospital, Anhui Provincial Cardiovascular and Cerebrovascular Hospital, Hefei, Anhui 230001, P.R. China |
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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. |
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Keywords: | Glioblastoma/glioma intraoperative magnetic resonance imaging/MRI surgical resection survival |
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