• World Neurosurg · May 2020

    Intraoperative use and benefits of tractography in awake surgery patients.

    • Juan Ángel Aibar-Durán, Cristian de Quintana-Schmidt, María Jesús Álvarez Holzpafel, Fernando Muñoz Hernández, Carlos Asencio Cortés, Gloria Villalba Martínez, and Gerardo Conesa Bertrán.
    • Department of Neurosurgery, Santa Creu i Sant Pau Hospital, Barcelona, Spain. Electronic address: jaibar@santpau.cat.
    • World Neurosurg. 2020 May 1; 137: e347-e353.

    ObjectiveThe present study analyzed the benefits of the use of tractography in the preoperative and intraoperative scenarios.MethodsWe present a prospective cohort study with 2 groups of patients who had undergone awake surgery for brain tumor resection. A control group for which no intraoperative navigated diffusion tensor imaging (DTI) was used (non-DTI group) and the case group (DTI group). The operative time, complete tumor resection, and neurological postoperative deficits were measured as primary outcomes. A secondary analysis was performed to determine the power of preoperative DTI to predict for complete tumor resection.ResultsA total of 37 patients were included, 18 in the non-DTI group and 19 in the DTI group. No differences were found between the 2 groups for sex, mean age, tumor histological findings, and preoperative mean tumor volume. The awake surgical time in the non-DTI group was 119.8 ± 31.1 minutes and 93.6 ± 12.2 minutes in the DTI group (P = 0.007). A trend was found toward complete tumor resection in the DTI group (P = 0.09). The sensitivity and specificity for predicting complete tumor resection were 88% and 62.5% for the non-DTI group and 100% and 80% for the DTI group, respectively. The area under the receiver operating characteristic curve was 0.720 in the non-DTI group and 0.966 in the DTI group (P = 0.041).ConclusionsIntraoperative navigated tractography shortened the time of awake neuro-oncological surgery and might provide help in performing complete tumor resection. Also, tractography used in the preoperative planning could be a useful tool for better prediction of complete tumor resection.Copyright © 2020 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…