Domenique M J Müller1, Pierre A Robe2, Hilko Ardon3, Frederik Barkhof4,5, Lorenzo Bello6, Mitchel S Berger7, Wim Bouwknegt8, Wimar A Van den Brink9, Marco Conti Nibali6, Roelant S Eijgelaar10, Julia Furtner11, Seunggu J Han12, Shawn L Hervey-Jumper7, Albert J S Idema13, Barbara Kiesel14, Alfred Kloet15, Jan C De Munck4, Marco Rossi6, Tommaso Sciortino6, W Peter Vandertop1, Martin Visser4, Michiel Wagemakers16, Georg Widhalm14, Marnix G Witte10, Aeilko H Zwinderman17, Philip C De Witt Hamer1. 1. 1Brain Tumor Center & Department of Neurosurgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands. 2. 2Department of Neurology & Neurosurgery, University Medical Center Utrecht, The Netherlands. 3. 3Department of Neurosurgery, St. Elisabeth Hospital, Tilburg, The Netherlands. 4. 4Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Vrije Universiteit, University Medical Center, Amsterdam, The Netherlands. 5. 5Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom. 6. 6Neurosurgical Oncology Unit, Departments of Oncology and Remato-Oncology, Università degli Studi di Milano, Humanitas Research Hospital, IRCCS, Milan, Italy. 7. 7Department of Neurological Surgery, University of California, San Francisco, California. 8. 8Department of Neurosurgery, Medical Center Slotervaart, Amsterdam, The Netherlands. 9. 9Department of Neurosurgery, Isala Hospital, Zwolle, The Netherlands. 10. 10Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 11. 11Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Austria. 12. 12Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon. 13. 13Department of Neurosurgery, Northwest Clinics, Alkmaar, The Netherlands. 14. 14Department of Neurosurgery, Medical University Vienna, Austria. 15. 15Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands. 16. 16Department of Neurosurgery, University of Groningen, University Medical Center Groningen, The Netherlands; and. 17. 17Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands.
Abstract
OBJECTIVE: Decisions in glioblastoma surgery are often guided by presumed eloquence of the tumor location. The authors introduce the "expected residual tumor volume" (eRV) and the "expected resectability index" (eRI) based on previous decisions aggregated in resection probability maps. The diagnostic accuracy of eRV and eRI to predict biopsy decisions, resectability, functional outcome, and survival was determined. METHODS: Consecutive patients with first-time glioblastoma surgery in 2012-2013 were included from 12 hospitals. The eRV was calculated from the preoperative MR images of each patient using a resection probability map, and the eRI was derived from the tumor volume. As reference, Sawaya's tumor location eloquence grades (EGs) were classified. Resectability was measured as observed extent of resection (EOR) and residual volume, and functional outcome as change in Karnofsky Performance Scale score. Receiver operating characteristic curves and multivariable logistic regression were applied. RESULTS: Of 915 patients, 674 (74%) underwent a resection with a median EOR of 97%, functional improvement in 71 (8%), functional decline in 78 (9%), and median survival of 12.8 months. The eRI and eRV identified biopsies and EORs of at least 80%, 90%, or 98% better than EG. The eRV and eRI predicted observed residual volumes under 10, 5, and 1 ml better than EG. The eRV, eRI, and EG had low diagnostic accuracy for functional outcome changes. Higher eRV and lower eRI were strongly associated with shorter survival, independent of known prognostic factors. CONCLUSIONS: The eRV and eRI predict biopsy decisions, resectability, and survival better than eloquence grading and may be useful preoperative indices to support surgical decisions.
OBJECTIVE: Decisions in glioblastoma surgery are often guided by presumed eloquence of the tumor location. The authors introduce the "expected residual tumor volume" (eRV) and the "expected resectability index" (eRI) based on previous decisions aggregated in resection probability maps. The diagnostic accuracy of eRV and eRI to predict biopsy decisions, resectability, functional outcome, and survival was determined. METHODS: Consecutive patients with first-time glioblastoma surgery in 2012-2013 were included from 12 hospitals. The eRV was calculated from the preoperative MR images of each patient using a resection probability map, and the eRI was derived from the tumor volume. As reference, Sawaya's tumor location eloquence grades (EGs) were classified. Resectability was measured as observed extent of resection (EOR) and residual volume, and functional outcome as change in Karnofsky Performance Scale score. Receiver operating characteristic curves and multivariable logistic regression were applied. RESULTS: Of 915 patients, 674 (74%) underwent a resection with a median EOR of 97%, functional improvement in 71 (8%), functional decline in 78 (9%), and median survival of 12.8 months. The eRI and eRV identified biopsies and EORs of at least 80%, 90%, or 98% better than EG. The eRV and eRI predicted observed residual volumes under 10, 5, and 1 ml better than EG. The eRV, eRI, and EG had low diagnostic accuracy for functional outcome changes. Higher eRV and lower eRI were strongly associated with shorter survival, independent of known prognostic factors. CONCLUSIONS: The eRV and eRI predict biopsy decisions, resectability, and survival better than eloquence grading and may be useful preoperative indices to support surgical decisions.
Entities:
Keywords:
extent of resection; glioma; neurosurgery; oncology; reproducibility of results; residual volume
Authors: Roelant S Eijgelaar; Martin Visser; Domenique M J Müller; Frederik Barkhof; Hugo Vrenken; Marcel van Herk; Lorenzo Bello; Marco Conti Nibali; Marco Rossi; Tommaso Sciortino; Mitchel S Berger; Shawn Hervey-Jumper; Barbara Kiesel; Georg Widhalm; Julia Furtner; Pierre A J T Robe; Emmanuel Mandonnet; Philip C De Witt Hamer; Jan C de Munck; Marnix G Witte Journal: Radiol Artif Intell Date: 2020-09-30
Authors: Hugh G Pemberton; Lyduine E Collij; Fiona Heeman; Ariane Bollack; Mahnaz Shekari; Gemma Salvadó; Isadora Lopes Alves; David Vallez Garcia; Mark Battle; Christopher Buckley; Andrew W Stephens; Santiago Bullich; Valentina Garibotto; Frederik Barkhof; Juan Domingo Gispert; Gill Farrar Journal: Eur J Nucl Med Mol Imaging Date: 2022-04-07 Impact factor: 10.057
Authors: Matthew Muir; Sarah Prinsloo; Hayley Michener; Jeffrey I Traylor; Rajan Patel; Ron Gadot; Dhiego Chaves de Almeida Bastos; Vinodh A Kumar; Sherise Ferguson; Sujit S Prabhu Journal: Cancers (Basel) Date: 2022-01-11 Impact factor: 6.639