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Accuracy of the neurosurgeons estimation of extent of resection in glioblastoma

BACKGROUND: The surgeons’ estimate of the extent of resection (EOR) shows little accuracy in previous literature. Considering the developments in surgical techniques of glioblastoma (GBM) treatment, we hypothesize an improvement in this estimation. This study aims to compare the EOR estimated by the...

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Autores principales: Sezer, Sümeyye, van Amerongen, Martin J., Delye, Hans H. K., ter Laan, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982640/
https://www.ncbi.nlm.nih.gov/pubmed/31656985
http://dx.doi.org/10.1007/s00701-019-04089-8
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author Sezer, Sümeyye
van Amerongen, Martin J.
Delye, Hans H. K.
ter Laan, Mark
author_facet Sezer, Sümeyye
van Amerongen, Martin J.
Delye, Hans H. K.
ter Laan, Mark
author_sort Sezer, Sümeyye
collection PubMed
description BACKGROUND: The surgeons’ estimate of the extent of resection (EOR) shows little accuracy in previous literature. Considering the developments in surgical techniques of glioblastoma (GBM) treatment, we hypothesize an improvement in this estimation. This study aims to compare the EOR estimated by the neurosurgeon with the EOR determined using volumetric analysis on the post-operative MR scan. METHODS: Pre- and post-operative tumor volumes were calculated through semi-automatic volumetric assessment by three observers. Interobserver agreement was measured using intraclass correlation coefficient (ICC). A univariate general linear model was used to study the factors influencing the accuracy of estimation of resection percentage. RESULTS: ICC was high for all three measurements: pre-operative tumor volume was 0.980 (0.969–0.987), post-operative tumor volume 0.974 (0.961–0.984), and EOR 0.947 (0.917–0.967). Estimation of EOR by the surgeon showed moderate accuracy and agreement. Multivariable analysis showed a statistically significant effect of operating neurosurgeon (p = 0.01), use of fluorescence (p < 0.001), and resection percentage (p < 0.001) on the accuracy of the EOR estimation. CONCLUSION: All measurements through semi-automatic volumetric analysis show a high interobserver agreement, suggesting this to be a reliable assessment of EOR. We found a moderate reliability of the surgeons’ estimate of EOR. Therefore, (early) post-operative MRI scanning for evaluation of EOR remains paramount. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00701-019-04089-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-69826402020-02-06 Accuracy of the neurosurgeons estimation of extent of resection in glioblastoma Sezer, Sümeyye van Amerongen, Martin J. Delye, Hans H. K. ter Laan, Mark Acta Neurochir (Wien) Original Article - Tumor - Glioma BACKGROUND: The surgeons’ estimate of the extent of resection (EOR) shows little accuracy in previous literature. Considering the developments in surgical techniques of glioblastoma (GBM) treatment, we hypothesize an improvement in this estimation. This study aims to compare the EOR estimated by the neurosurgeon with the EOR determined using volumetric analysis on the post-operative MR scan. METHODS: Pre- and post-operative tumor volumes were calculated through semi-automatic volumetric assessment by three observers. Interobserver agreement was measured using intraclass correlation coefficient (ICC). A univariate general linear model was used to study the factors influencing the accuracy of estimation of resection percentage. RESULTS: ICC was high for all three measurements: pre-operative tumor volume was 0.980 (0.969–0.987), post-operative tumor volume 0.974 (0.961–0.984), and EOR 0.947 (0.917–0.967). Estimation of EOR by the surgeon showed moderate accuracy and agreement. Multivariable analysis showed a statistically significant effect of operating neurosurgeon (p = 0.01), use of fluorescence (p < 0.001), and resection percentage (p < 0.001) on the accuracy of the EOR estimation. CONCLUSION: All measurements through semi-automatic volumetric analysis show a high interobserver agreement, suggesting this to be a reliable assessment of EOR. We found a moderate reliability of the surgeons’ estimate of EOR. Therefore, (early) post-operative MRI scanning for evaluation of EOR remains paramount. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00701-019-04089-8) contains supplementary material, which is available to authorized users. Springer Vienna 2019-10-28 2020 /pmc/articles/PMC6982640/ /pubmed/31656985 http://dx.doi.org/10.1007/s00701-019-04089-8 Text en © The Author(s) 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article - Tumor - Glioma
Sezer, Sümeyye
van Amerongen, Martin J.
Delye, Hans H. K.
ter Laan, Mark
Accuracy of the neurosurgeons estimation of extent of resection in glioblastoma
title Accuracy of the neurosurgeons estimation of extent of resection in glioblastoma
title_full Accuracy of the neurosurgeons estimation of extent of resection in glioblastoma
title_fullStr Accuracy of the neurosurgeons estimation of extent of resection in glioblastoma
title_full_unstemmed Accuracy of the neurosurgeons estimation of extent of resection in glioblastoma
title_short Accuracy of the neurosurgeons estimation of extent of resection in glioblastoma
title_sort accuracy of the neurosurgeons estimation of extent of resection in glioblastoma
topic Original Article - Tumor - Glioma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982640/
https://www.ncbi.nlm.nih.gov/pubmed/31656985
http://dx.doi.org/10.1007/s00701-019-04089-8
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