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
3157 - Efficacy and safety of anlotinib in advanced leiomyosarcoma: Subgroup analysis of a phase IIB trial (ALTER0203)
Presenter: Yihebali Chi
Session: Poster Display session 1
Resources:
Abstract
3710 - The effect of treatment line on the efficacy of Anlotinib hydrochloride in advanced alveolar soft part sarcoma patients
Presenter: Zhiwei Fang
Session: Poster Display session 1
Resources:
Abstract
3184 - Prior exposure to pazopanib (PAZ) did not minor efficacy of regorafenib (REG) in non-adipocytic soft tissue sarcoma patients (pts)
Presenter: Nicolas Penel
Session: Poster Display session 1
Resources:
Abstract
798 - Pexidartinib (Pex) for locally advanced tenosynovial giant cell tumor (TGCT): characterization of hepatic adverse reactions (ARs)
Presenter: Sebastian Bauer
Session: Poster Display session 1
Resources:
Abstract
6117 - VEGFR2 and ITGA polymorphisms as novel pan-sarcoma biomarkers for sensitivity prediction as well as toxicity prevention anti-angiogenesis therapy in pediatric and young adult
Presenter: Qiyuan Bao
Session: Poster Display session 1
Resources:
Abstract
5450 - Reversion of resistance to mTOR inhibitors with the addition of exemestane in patients with malignant PEComa.
Presenter: Roberta Sanfilippo
Session: Poster Display session 1
Resources:
Abstract
4279 - Efficacy and Safety of VEGFR2 Inhibitor Apatinib combined with chemotherapy for Sarcoma in Stage IV
Presenter: Zhiwu Ren
Session: Poster Display session 1
Resources:
Abstract
5929 - Outcomes of metastatic soft tissue sarcoma treated with Pazopanib from dedicated medical oncology sarcoma clinic: A holistic care approach from a developing country
Presenter: Akhil Kapoor
Session: Poster Display session 1
Resources:
Abstract
2469 - Inhibition of mTOR signaling enhances Trabectedin activity in Soft Tissue Sarcoma
Presenter: David Moura
Session: Poster Display session 1
Resources:
Abstract
4210 - Efficacy and safety of apatinib for advanced gastrointestinal stromal tumors after failure of imatinib and sunitinib: An open-label, multicenter, single-arm, phase II trial
Presenter: Zhaolun Cai
Session: Poster Display session 1
Resources:
Abstract