ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2018
Role of presurgical functional MRI and diffusion MR tractography in pediatric low-grade brain tumor surgery: a single-center study.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 25 citations in OpenAlex.
- Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging-Tractography in Resective Brain Surgery: Lesion Coverage Strategies and Patient Outcomes.Brain sciences · 2023Article
- Functional Alteration in the Brain Due to Tumour Invasion in Paediatric Patients: A Systematic Review.Cancers · 2023Review
- Deep Learning-Based Studies on Pediatric Brain Tumors Imaging: Narrative Review of Techniques and Challenges.Brain sciences · 2021Review
- From Neurosurgical Planning to Histopathological Brain Tumor Characterization: Potentialities of Arcuate Fasciculus Along-Tract Diffusion Tensor Imaging Tractography Measures.Frontiers in neurology · 2021Article
- Guidelines for Treatment and Monitoring of Adult Survivors of Pediatric Brain Tumors.Current treatment options in oncology · 2019Review
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5 authors at 1 institution in 1 country.
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Abstract
purposePresurgical functional MRI (fMRI) and diffusion MRI tractography (dMRI tractography) are widely employed to delineate eloquent brain regions and their connections prior to brain tumor resection in adults. However, such studies are harder to perform in children, resulting in suboptimal neurosurgical care in pediatric brain tumor surgery as compared to adults. Thus, our objective was to assess the feasibility and the influence of presurgical advanced MR imaging on neurosurgical care in pediatric brain tumor surgery.
methodsRetrospective analyses of 31 presurgical fMRI/dMRI tractography studies were performed in children with low-grade tumors near eloquent brain regions at our site between 2005 and 2017.
resultsIn only 3/31 cases, imaging results were not interpretable (10%). All 28 successful imaging sessions were used for neurosurgical risk assessment. Based on this, surgery was canceled in 2/28 patients, and intention to treat was changed in 5/28 patients. In 4/28 cases, the surgical approach was changed and in 10/28, electrode placement for intraoperative neurophysiological monitoring was guided by imaging results. Gross total resection (GTR) was planned in 21/28 cases and could be achieved in 15/21 (71%). Despite highly eloquent tumor location, only four children suffered from a mild permanent neurological deficit after the operation.
conclusionsWe demonstrate that presurgical fMRI/dMRI tractography can have a profound impact on pediatric brain tumor management, optimizing preoperative risk-assessment and pre- as well as intraoperative decision-making. We believe that these tools should be offered to children suffering from eloquent brain tumors as part of a comprehensive operative work-up.
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