Abstract 4418
Background
High field iMRI with integrated neuronavigation system is an advanced diagnostic tool gives information about extent of resection allowing immediate update of neuronavigation parameters after anatomic changes occuring as a result of tumour resection, cerebrospinal fluid evacuation and brain shift.
Methods
20 CNS tumour cases underwent Brain suite MRI prior to surgery, then surgery was done after patient registration in navigation system using iMRI. Preoperative tumor volume was manually segmented, compared with intraoperative volume after first resection attempt and final post operative volume after surgical closure to calculate extent of resection (EOR).Descriptive statistics were used to find mean, SD, frequency, percentage of variables. Normally distributed interval data reported as means by two-sample t- test. Non-normally distributed interval/ordinal data reported as median{inter-quartile ranges} and compared among groups by Wilcoxon exact test to obtain EOR values.
Results
20 cases allocated to two groups (G), 1st in whom surgery was complete after first iMRI and 2nd who underwent further tumour removal. In G1 surgery was terminated in 11 cases after iMRI, GTR in 81.8% cases. iMRI showed subtotal resection(STR) in 18.2% patients but surgery stopped owing to infiltration of eloquent brain. Median preoperative tumour volume was 40.8cm3. Median postoperative tumour volume was 0.81cm3 with a significant p value (<0.001). Median EOR was 98.5% in G1. In G2, 9 of 20 (45%) underwent further resection of residual tumour after post resection iMRI. GTR in 77.7% and STR in 22.3%, because of tumour’s close proximity to eloquent brain area. Median % of tumour resection after the first iMRI was 82.65%. Median EOR from the final postoperative iMRI was 98.3%. GTR increased from 45% to 80 % after use of iMRI. Median % of residual tumour volume significantly decreased from 5.3% to 1.7 % (p value <0.001). Mean control tumour volume was 9.67% and final post operative volume of 4.72% , which is almost half of intraoperative tumour volume (p value <0.001).
Conclusions
iMRI has potential role in maximizing gross total resection rates of CNS tumours which has an overall great prognostic impact.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Institutional ethics committee, Max Superspeciality Hospital, New Delhi.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5152 - Comprehensive Geriatric Assessment (CGA) can categorize elderly glioblastoma (GBM) patients into three groups predicting survival: a monoinstitutional study
Presenter: Eleonora Bergo
Session: Poster Display session 1
Resources:
Abstract
4079 - Triggering anti-GBM immune response with EGFR-mediated photoimmunotherapy
Presenter: Gabriela Kramer-marek
Session: Poster Display session 1
Resources:
Abstract
4364 - Upregulation of sFRP3 circulating expression levels correlates survival outcomes in glioblastoma
Presenter: Gema Bruixola
Session: Poster Display session 1
Resources:
Abstract
2327 - Characterization and pre-clinical modeling of genetic aberrations in pediatric gliomas
Presenter: Itai Moshe
Session: Poster Display session 1
Resources:
Abstract
3154 - Preclinical Study of Novel Tetracyclic Small Molecule, CC12, for Brain Cancer
Presenter: Liyun Fann
Session: Poster Display session 1
Resources:
Abstract
5759 - CHLOROBRAIN phase IB trial: The addition of chloroquine, an autophagy inhibitor, to concurrent radiation and temozolomide for newly diagnosed glioblastoma
Presenter: Inge Compter
Session: Poster Display session 1
Resources:
Abstract
1382 - A Phase II Clinical Trial Evaluating the Efficacy and Safety of Apatinib Combined with dose-dense Temozolomide in Recurrent Glioblastoma
Presenter: Yong Wang
Session: Poster Display session 1
Resources:
Abstract
4407 - Phase 0 Trial of Ceritinib in Brain Metastases and Recurrent Glioblastoma
Presenter: Shwetal Mehta
Session: Poster Display session 1
Resources:
Abstract
1469 - Pembrolizumab (Pem) in recurrent high-grade glioma (HGG) patients with mismatch repair deficiency (MMRd): an observational study
Presenter: Mario Caccese
Session: Poster Display session 1
Resources:
Abstract
4217 - Outcome of high-grade gliomas (HGGs) treated into immunotherapeutic early-phase clinical trials (ieCTs): a single-center experience
Presenter: Matteo Simonelli
Session: Poster Display session 1
Resources:
Abstract