Comparison of intraoperative magnetic resonance imaging, ultrasound, 5-aminolevulinic acid, and neuronavigation for guidance in glioma resection: A network meta-analysis
Background and Aim: Gliomas are the most common type of brain tumor in the world. Surgical resection is one of the most effective therapeutic methods in terms of patient prognosis. However, it is difficult for neurosurgeons and health-care providers to select which imaging technology to best support...
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Wolters Kluwer Medknow Publications
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doaj-96e11f8472924e6ab1eef7b2828b46192020-11-25T01:44:23ZengWolters Kluwer Medknow PublicationsGlioma2589-61132589-61212020-01-013131210.4103/glioma.glioma_5_20Comparison of intraoperative magnetic resonance imaging, ultrasound, 5-aminolevulinic acid, and neuronavigation for guidance in glioma resection: A network meta-analysisDongman YeTao YuJi ShiHaozhe PiaoBackground and Aim: Gliomas are the most common type of brain tumor in the world. Surgical resection is one of the most effective therapeutic methods in terms of patient prognosis. However, it is difficult for neurosurgeons and health-care providers to select which imaging technology to best support the procedure. These technologies included intraoperative magnetic resonance imaging (iMRI), intraoperative ultrasound (iUS), fluorescence guidance with 5-aminolevulinic acid (5-ALA), and intraoperative neuronavigation. Hence, in this study, we compared the gross total resection (GTR), postoperative complications within or outside of the central nervous system, and postoperative clinical improvement by multiple meta-analyses, which allows the integration of data through direct and indirect comparisons.Materials and Methods: The PubMed, Cochrane Library, Web of Science, Embase, China Knowledge Resource Integrated Database, and WanFang databases were searched for publications before April 2018. Randomized controlled trials, two-arm and three-arm prospective studies, and retrospective studies in patients who underwent surgical treatment for glioma were included. The most important outcome measures were the rates of GTR, postoperative complications, and clinical improvement. Results: In terms of GTR, iMRI (odds ratio [OR] = 5.70, 95% confidence interval [CI]: 3.40–9.60), iUS (OR = 2.70, 95% CI: 1.10–6.90), 5-ALA (OR = 2.40, 95% CI: 0.64–8.90), and neuronavigation (OR = 1.90, 95% CI: 1.20–3.10) were found to be more effective than conventional surgery. In addition, iUS (OR = 0.15, 95% CI: 0.04–0.52), iMRI (OR = 0.24, 95% CI: 0.14–0.43), and neuronavigation (OR = 0.34, 95% CI: 0.18–0.56) were more found to result in fewer complications than conventional surgery. Furthermore, patients' clinical improvement was better with iMRI (OR = 8.10, 95% CI: 3.00–25.00), iUS (OR = 4.90, 95% CI: 0.76–33.00), and neuronavigation (OR = 2.60, 95% CI: 1.00–7.20) than with conventional surgery. Conclusions: The developed ranking probability table indicated that iMRI was superior in terms of the GTR and clinical improvement, while iUS was the least likely to result in postoperative complications. Hence, it was concluded that iMRI or iUS is the most advantageous imaging modality.http://www.jglioma.com/article.asp?issn=2589-6113;year=2020;volume=3;issue=1;spage=3;epage=12;aulast=Ye5-aminolevulinic acidconventional surgerygliomaintraoperativemagnetic resonance imagingnetwork analysisneuronavigationresectionultrasound |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Dongman Ye Tao Yu Ji Shi Haozhe Piao |
spellingShingle |
Dongman Ye Tao Yu Ji Shi Haozhe Piao Comparison of intraoperative magnetic resonance imaging, ultrasound, 5-aminolevulinic acid, and neuronavigation for guidance in glioma resection: A network meta-analysis Glioma 5-aminolevulinic acid conventional surgery glioma intraoperative magnetic resonance imaging network analysis neuronavigation resection ultrasound |
author_facet |
Dongman Ye Tao Yu Ji Shi Haozhe Piao |
author_sort |
Dongman Ye |
title |
Comparison of intraoperative magnetic resonance imaging, ultrasound, 5-aminolevulinic acid, and neuronavigation for guidance in glioma resection: A network meta-analysis |
title_short |
Comparison of intraoperative magnetic resonance imaging, ultrasound, 5-aminolevulinic acid, and neuronavigation for guidance in glioma resection: A network meta-analysis |
title_full |
Comparison of intraoperative magnetic resonance imaging, ultrasound, 5-aminolevulinic acid, and neuronavigation for guidance in glioma resection: A network meta-analysis |
title_fullStr |
Comparison of intraoperative magnetic resonance imaging, ultrasound, 5-aminolevulinic acid, and neuronavigation for guidance in glioma resection: A network meta-analysis |
title_full_unstemmed |
Comparison of intraoperative magnetic resonance imaging, ultrasound, 5-aminolevulinic acid, and neuronavigation for guidance in glioma resection: A network meta-analysis |
title_sort |
comparison of intraoperative magnetic resonance imaging, ultrasound, 5-aminolevulinic acid, and neuronavigation for guidance in glioma resection: a network meta-analysis |
publisher |
Wolters Kluwer Medknow Publications |
series |
Glioma |
issn |
2589-6113 2589-6121 |
publishDate |
2020-01-01 |
description |
Background and Aim: Gliomas are the most common type of brain tumor in the world. Surgical resection is one of the most effective therapeutic methods in terms of patient prognosis. However, it is difficult for neurosurgeons and health-care providers to select which imaging technology to best support the procedure. These technologies included intraoperative magnetic resonance imaging (iMRI), intraoperative ultrasound (iUS), fluorescence guidance with 5-aminolevulinic acid (5-ALA), and intraoperative neuronavigation. Hence, in this study, we compared the gross total resection (GTR), postoperative complications within or outside of the central nervous system, and postoperative clinical improvement by multiple meta-analyses, which allows the integration of data through direct and indirect comparisons.Materials and Methods: The PubMed, Cochrane Library, Web of Science, Embase, China Knowledge Resource Integrated Database, and WanFang databases were searched for publications before April 2018. Randomized controlled trials, two-arm and three-arm prospective studies, and retrospective studies in patients who underwent surgical treatment for glioma were included. The most important outcome measures were the rates of GTR, postoperative complications, and clinical improvement. Results: In terms of GTR, iMRI (odds ratio [OR] = 5.70, 95% confidence interval [CI]: 3.40–9.60), iUS (OR = 2.70, 95% CI: 1.10–6.90), 5-ALA (OR = 2.40, 95% CI: 0.64–8.90), and neuronavigation (OR = 1.90, 95% CI: 1.20–3.10) were found to be more effective than conventional surgery. In addition, iUS (OR = 0.15, 95% CI: 0.04–0.52), iMRI (OR = 0.24, 95% CI: 0.14–0.43), and neuronavigation (OR = 0.34, 95% CI: 0.18–0.56) were more found to result in fewer complications than conventional surgery. Furthermore, patients' clinical improvement was better with iMRI (OR = 8.10, 95% CI: 3.00–25.00), iUS (OR = 4.90, 95% CI: 0.76–33.00), and neuronavigation (OR = 2.60, 95% CI: 1.00–7.20) than with conventional surgery. Conclusions: The developed ranking probability table indicated that iMRI was superior in terms of the GTR and clinical improvement, while iUS was the least likely to result in postoperative complications. Hence, it was concluded that iMRI or iUS is the most advantageous imaging modality. |
topic |
5-aminolevulinic acid conventional surgery glioma intraoperative magnetic resonance imaging network analysis neuronavigation resection ultrasound |
url |
http://www.jglioma.com/article.asp?issn=2589-6113;year=2020;volume=3;issue=1;spage=3;epage=12;aulast=Ye |
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