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Review
. 2015;55(1):1-13.
doi: 10.2176/nmc.ra.2014-0215. Epub 2014 Dec 20.

Intraoperative functional mapping and monitoring during glioma surgery

Taiichi Saito  1 , Yoshihiro Muragaki, Takashi Maruyama, Manabu Tamura, Masayuki Nitta, Yoshikazu Okada
Affiliations
Review

Intraoperative functional mapping and monitoring during glioma surgery

Taiichi Saito et al. Neurol Med Chir (Tokyo). 2015.

Abstract

Glioma surgery represents a significant advance with respect to improving resection rates using new surgical techniques, including intraoperative functional mapping, monitoring, and imaging. Functional mapping under awake craniotomy can be used to detect individual eloquent tissues of speech and/or motor functions in order to prevent unexpected deficits and promote extensive resection. In addition, monitoring the patient's neurological findings during resection is also very useful for maximizing the removal rate and minimizing deficits by alarming that the touched area is close to eloquent regions and fibers. Assessing several types of evoked potentials, including motor evoked potentials (MEPs), sensory evoked potentials (SEPs) and visual evoked potentials (VEPs), is also helpful for performing surgical monitoring in patients under general anesthesia (GA). We herein review the utility of intraoperative mapping and monitoring the assessment of neurological findings, with a particular focus on speech and the motor function, in patients undergoing glioma surgery.

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Conflict of interest statement

Conflicts of Interest Disclosure

No conflict of interest exists. All authors who are members of The Japan Neurosurgical Society (JNS) have registered online Self-reported COI Disclosure Statement Forms through the website for JNS members.

Figures

Fig. 1
Fig. 1
The screen of the dedicated intraoperative examination monitor for awake craniotomy (IEMAS). Upper left display: The patient’s face. Lower left display: The anatomical data obtained from the real-time updated neuronavigation system, which can be used to localize the exact position of the stimulator. Upper right display: Four different sets of data for the test object, bispectral index monitor, heart beat monitor, and general view of the operating theater. Lower right display: The view of the surgical field through the operative microscope.
Fig. 2
Fig. 2
Intraoperative CCEP monitoring. Changes in CCEP were recognized following stimulation of the frontal language area and recordings of the temporal language area. CCEP: cortico-cortical evoked potential.
Fig. 3
Fig. 3
A, B: Magnetic resonance (MR) images obtained before the second surgery demonstrating regrowth of the residual tumor just posterior to the prior resection cavity located in the frontal operculum. The tumor is hyperintense on axial T2-weighted image (T2WI) (A) and sagittal fluid attenuated inversion recovery (FLAIR) image (B). C, D: MR images obtained after the second surgery showing that the tumor had been subtotally removed on T2WI (C) and FLAIR (D).
See this image and copyright information in PMC

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References

    1. Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, Janzer RC, Ludwin SK, Allgeier A, Fisher B, Belanger K, Hau P, Brandes AA, Gijtenbeek J, Marosi C, Vecht CJ, Mokhtari K, Wesseling P, Villa S, Eisenhauer E, Gorlia T, Weller M, Lacombe D, Cairncross JG, Mirimanoff RO, European Organisation for Research and Treatment of Cancer Brain Tumour and Radiation Oncology Groups; National Cancer Institute of Canada Clinical Trials Group : Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 10: 459– 466, 2009. - PubMed
    1. Sabha N, Knobbe CB, Maganti M, Al Omar S, Bernstein M, Cairns R, Cako B, von Deimling A, Capper D, Mak TW, Kiehl TR, Carvalho P, Garrett E, Perry A, Zadeh G, Guha A, Croul S: Analysis of IDH mutation, 1p/19q deletion, and PTEN loss delineates prognosis in clinical low-grade diffuse gliomas. Neuro Oncol [Epub ahead of print], 2014. - PMC - PubMed
    1. Soffietti R, Baumert BG, Bello L, von Deimling A, Duffau H, Frénay M, Grisold W, Grant R, Graus F, Hoang-Xuan K, Klein M, Melin B, Rees J, Siegal T, Smits A, Stupp R, Wick W, European Federation of Neurological Societies : Guidelines on management of low-grade gliomas: report of an EFNS-EANO Task Force. Eur J Neurol 17: 1124– 1133, 2010. - PubMed
    1. Wick W, Hartmann C, Engel C, Stoffels M, Felsberg J, Stockhammer F, Sabel MC, Koeppen S, Ketter R, Meyermann R, Rapp M, Meisner C, Kortmann RD, Pietsch T, Wiestler OD, Ernemann U, Bamberg M, Reifenberger G, von Deimling A, Weller M: NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with procarbazine, lomustine, and vincristine or temozolomide. J Clin Oncol 27: 5874– 5880, 2009. - PubMed
    1. Lacroix M, Abi-Said D, Fourney DR, Gokaslan ZL, Shi W, DeMonte F, Lang FF, McCutcheon IE, Hassenbusch SJ, Holland E, Hess K, Michael C, Miller D, Sawaya R: A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 95: 190– 198, 2001. - PubMed

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