Usefulness of Intraoperative Computed Tomography in Surgery for Low-Grade Gliomas: a Comparative Study Between Two Series Without and With Intraoperative Computed Tomography

作者：Hosoda Tetsuya; Takeuchi Hiroaki^*; Hashimoto Norichika; Kitai Ryuhei; Arishima Hidetaka; Kodera Toshiaki; Higashino Yoshifumi; Sato Kazufumi; Kikuta Ken ichiro

来源：Neurologia Medico-Chirurgica, 2011, 51(7): 490-495.

DOI：10.2176/nmc.51.490

• intraoperative computed tomography
• low-grade glioma
• extent of resection
• prognosis

We have routinely used an intraoperative CT (i-CT) system in over 800 neurosurgical procedures since 1997. To investigate the utility of i-CT in low-grade glioma (LGG) surgery, we investigated whether i-CT improved the extent of tumor resection and prognosis in 46 patients with histologically confirmed LGG consisting of 27 patients with World Health Organization grade II astrocytoma, 12 with oligodendroglioma, and 7 with oligoastrocytoma. The patients were divided into two groups, 23 who underwent tumor resection without i-CT (non i-CT group) and 23 who underwent surgery using i-CT (i-CT group). We investigated the extent of tumor resection, pre- and postoperative Karnofsky performance status scores, and overall survival in each group. The extent of tumor resection was biopsy 26.1%, partial resection 60.9%, subtotal resection 13.0%, and gross total resection 0% in the non i-CT group, and 4.4%, 21.7%, 34.8%, and 39.1%, respectively, in the i-CT group. The i-CT group showed significantly longer overall survival than the non i-CT group among patients with astrocytoma (p < 0.05) and oligodendroglioma or oligoastrocytoma (p < 0.005). Prolonged survival was related to the extent of resection. There were no significant differences between pre- and postoperative Karnofsky performance status scores between the groups. Surgical resection using i-CT may improve the outcomes of patients with LGG. Additional resection or emergency treatment can be quickly performed as the surgical results are confirmed intraoperatively or immediately after the operation using i-CT.

• 出版日期2011-7