Tailored Intraoperative MRI Strategies in High-Grade Glioma Surgery: A Machine Learning-Based Radiomics Model Highlights Selective Benefits.

Journal: Operative neurosurgery (Hagerstown, Md.)
PMID: 38289331

Abstract

BACKGROUND AND OBJECTIVES: In high-grade glioma (HGG) surgery, intraoperative MRI (iMRI) has traditionally been the gold standard for maximizing tumor resection and improving patient outcomes. However, recent Level 1 evidence juxtaposes the efficacy of iMRI and 5-aminolevulinic acid (5-ALA), questioning the continued justification of iMRI because of its associated costs and extended surgical duration. Nonetheless, drawing from our clinical observations, we postulated that a subset of intricate HGGs may continue to benefit from the adjunctive application of iMRI.

Authors

  • Martin Aichholzer
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.
  • Philip Rauch
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.
  • Lucia Kastler
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.
  • Josef Pichler
    Institute of Neuro-Oncology, Kepler University Hospital, Linz , Austria.
  • Kathrin Aufschnaiter-Hiessböck
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.
  • Francisco Ruiz-Navarro
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.
  • Stefan Aspalter
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.
  • Saskia Hartl
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.
  • Wolfgang Schimetta
    Institute of Statistics, Johannes Kepler University, Linz , Austria.
  • Petra Böhm
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.
  • Ilja Manakov
    ImFusion GmbH, Munich , Germany.
  • Wolfgang Thomae
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.
  • Matthias Gmeiner
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.
  • Andreas Gruber
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.
  • Harald Stefanits
    Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz , Austria.

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