Volumetric Evaluation of Resecability of Insular Gliomas


Authors: R. Bartoš 1,2;  A. Malucelli 1,2;  T. Radovnický 1;  A. Hejčl 1,2;  J. Ceé 1;  P. Bartoš 2;  M. Sameš 1
Authors‘ workplace: Neurochirurgická klinika UJEP a Krajská zdravotní a. s., Masarykova nemocnice v Ústí nad Labem, o. z. 1;  Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně 2
Published in: Cesk Slov Neurol N 2014; 77/110(5): 568-575
Category: Original Paper

Supported by European Regional Development Fund – Project FNUSA-ICRC (No. CZ.1.05/1.1.00/02.0123).

Overview

Aim:
We present the results of surgical resection in a group of patients with insular gliomas, we refer to our pilot study (2009 – eight patients) and include 20 surgeries performed until 2013.

Groups and methods:
From 2007 to 2013 we performed 20 surgeries for gliomas with a significant invasion of the insular region; all the surgeries were conducted under general anaesthesia with motor evoked potential monitoring. The extent of resection was evaluated by means of manual computerized volumetry (software Stealth DTI, Medtronic, Minneapolis, USA).

Results:
In one patient after glioblastoma multiforme resection, we observed postoperative hematoma in the tumour remnant with consequent hemiplegia, the rate of major complications was 5%. The mean extent of resection in 19 surgeries was 83% (43–100%). In 15 non-enhancing tumours (LGG and AA), we obtained the mean tumour volumetric reduction of 80%.

Conclusions:
The same indication criteria for surgical resection apply to insular gliomas as to gliomas in other regions. Detailed knowledge of insular anatomy, including ability to handle vital vascular structures, is necessary for performing insular surgery with good results.

Key words:
insula – glioma – volumetry – MRi

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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