Evidence map›Paper›PMID 39012356›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2024

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

Sofie Dietvorst, Armen Narayan, Cyril Agbor, Dawn Hennigan, David Gorodezki, Federico Bianchi, Conor Mallucci, Paolo Frassanito, Llewellyn Padayachy, Martin Ulrich Schuhmann

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Advances in the management of pediatric low-grade glioma.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sofie DietvorstDepartment of Neurosurgery, Alder Hey Children's Hospital NHS Trust, Eaton Road, Liverpool, L12 2AP, UK. sofie.dietvorst@alderhey.nhs.uk.
Armen NarayanSection of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tuebingen, Tuebingen, Germany.
Cyril AgborBrain Tumor and Translational Neuroscience Centre, Department of Neurosurgery, University of Pretoria, Pretoria, South Africa.
Dawn HenniganDepartment of Neurosurgery, Alder Hey Children's Hospital NHS Trust, Eaton Road, Liverpool, L12 2AP, UK.
David GorodezkiDepartment of Pediatric Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Federico BianchiPediatric Neurosurgery, Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Conor MallucciDepartment of Neurosurgery, Alder Hey Children's Hospital NHS Trust, Eaton Road, Liverpool, L12 2AP, UK.
Paolo FrassanitoPediatric Neurosurgery, Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Llewellyn PadayachyBrain Tumor and Translational Neuroscience Centre, Department of Neurosurgery, University of Pretoria, Pretoria, South Africa.
Martin Ulrich SchuhmannSection of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tuebingen, Tuebingen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePediatric 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.

methodsThe 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.

resultsWe 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).

conclusioniUS 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.

Indexed as

Brain NeoplasmsGliomaMagnetic Resonance ImagingAdolescentChildChild, PreschoolFemaleHumansInfantMaleMonitoring, IntraoperativeNeoplasm GradingNeurosurgical ProceduresUltrasonographyExtent of resectionIntraoperative MRIIntraoperative ultrasoundPediatric low-grade glioma

Identifiers

PMID39012356

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.