Role of intraoperative ultrasound and MRI to aid grade of resection of pediatric low-grade gliomas : accumulated experience from 4 centers

dc.contributor.authorDietvorst, Sofie
dc.contributor.authorNarayan, Armen
dc.contributor.authorAgbor, Cyril
dc.contributor.authorHennigan, Dawn
dc.contributor.authorGorodezki, David
dc.contributor.authorBianchi, Federico
dc.contributor.authorMallucci, Conor
dc.contributor.authorFrassanito, Paolo
dc.contributor.authorPadayachy, Llewellyn
dc.contributor.authorSchuhmann, Martin Ulrich
dc.date.accessioned2025-05-30T05:53:29Z
dc.date.issued2024-10
dc.descriptionDATA AVAILABILITY : Data is available and anonymized at the participating centres.
dc.description.abstractPURPOSE : Pediatric low-grade gliomas (pLGG) are the most common brain tumors in children and achieving complete resection (CR) in pLGG is the most important prognostic factor. There are multiple intraoperative tools to optimize the extent of resection (EOR). This article investigates and discusses the role of intraoperative ultrasound (iUS) and intraoperative magnetic resonance imaging (iMRI) in the surgical treatment of pLGG. METHODS : The tumor registries at Tuebingen, Rome and Pretoria were searched for pLGG with the use of iUS and data on EOR. The tumor registries at Liverpool and Tuebingen were searched for pLGG with the use of iMRI where preoperative CR was the surgical intent. Different iUS and iMRI machines were used in the 4 centers. RESULTS : We included 111 operations which used iUS and 182 operations using iMRI. Both modalities facilitated intended CR in hemispheric supra- and infratentorial location in almost all cases. In more deep-seated tumor location like supratentorial midline tumors, iMRI has advantages over iUS to visualize residual tumor. Functional limitations limiting CR arising from eloquent involved or neighboring brain tissue apply to both modalities in the same way. In the long-term follow-up, both iUS and iMRI show that achieving a complete resection on intraoperative imaging significantly lowers recurrence of disease (chi-square test, p < 0.01). CONCLUSION : iUS and iMRI have specific pros and cons, but both have been proven to improve achieving CR in pLGG. Due to advances in image quality, cost- and time-efficiency, and efforts to improve the user interface, iUS has emerged as the most accessible surgical adjunct to date to aid and guide tumor resection. Since the EOR has the most important effect on long-term outcome and disease control of pLGG in most locations, we strongly recommend taking all possible efforts to use iUS in any surgery, independent of intended resection extent and iMRI if locally available.
dc.description.departmentSurgery
dc.description.embargo2025-07-16
dc.description.librarianhj2025
dc.description.sdgSDG-03: Good health and well-being
dc.description.urihttp:/link.springer.com/journal/381
dc.identifier.citationDietvorst, S., Narayan, A., Agbor, C. et al. Role of intraoperative ultrasound and MRI to aid grade of resection of pediatric low-grade gliomas: accumulated experience from 4 centers. Child's Nervous System 40, 3165–3172 (2024). https://doi.org/10.1007/s00381-024-06532-3.
dc.identifier.issn0256-7040 (print)
dc.identifier.issn1433-0350 (online)
dc.identifier.other10.1007/s00381-024-06532-3
dc.identifier.urihttp://hdl.handle.net/2263/102583
dc.language.isoen
dc.publisherSpringer
dc.rights© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. The original publication is available at : http://link.springer.comjournal/381.
dc.subjectPediatric low-grade gliomas (pLGG)
dc.subjectBrain tumor
dc.subjectChildren
dc.subjectComplete resection (CR)
dc.subjectIntraoperative ultrasound (iUS)
dc.subjectIntraoperative magnetic resonance imaging (iMRI)
dc.subjectSurgical treatment
dc.subjectExtent of resection
dc.titleRole of intraoperative ultrasound and MRI to aid grade of resection of pediatric low-grade gliomas : accumulated experience from 4 centers
dc.typePostprint Article

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