Comparative Study of Intraoperative MRI-guided vs. Conventional Glioma Surgery
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Purpose
Excision to the maximum possible extent marks the first step of glioma surgery. Depending on tumour histology, adjuvant treatment consists of radio- and/or chemotherapy. Multi-centre studies have shown that the presence of residual tumour according to MRI-criteria is a prognostic factor in this incurable condition.
In order to improve the extent of resection, several methods, in particular intraoperative imaging techniques, have become available to demonstrate already during surgery whether the goal of surgery has been achieved. The intraoperative MRI devices currently available differ in their magnetic field strengths and image resolution, but also in their amount of interference with the surgical workflow.
Prospective, high-class evidence data to promote the use of intraoperative MRI in glioma surgery are lacking. To assess whether the rate of radiologically complete tumour resections can be improved by using intraoperative MRI-guidance, we designed this prospective, randomized trial. We hypothesized that the extent of resection that can be achieved using an intraoperative MRI is greater than that of conventional microsurgical tumor resection.
| Condition | Intervention |
|---|---|
|
Glioma |
Procedure: intraoperative MRI-guided tumor resection Procedure: standard microsurgery |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Resection Control of Primary Brain Tumours Using a Low-Field Intraoperative MRI |
- Extent of Resection [ Time Frame: 72 hours ] [ Designated as safety issue: No ]Number of patients with contrast-enhancing glioma in whom a complete excision of the tumor according to postoperative high-field MRI within 72 hours is achieved
- Progression-free Survival [ Time Frame: 6 months ] [ Designated as safety issue: No ]Progression-free survival (radiological and/or clinical progression) at 6 months following surgery
- Volumetric Assessment [ Time Frame: 72 hours ] [ Designated as safety issue: No ]Volumetric assessment of the extent of resection on early (within 72h) postoperative MRI
- Neurological Deficit [ Time Frame: 7 days ] [ Designated as safety issue: Yes ]Assessment of new postoperative deficits following tumor surgery
| Enrollment: | 58 |
| Study Start Date: | October 2007 |
| Study Completion Date: | January 2011 |
| Primary Completion Date: | July 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: intraoperative MRI
tumor resection with intraoperative MRI-guidance
|
Procedure: intraoperative MRI-guided tumor resection
tumor resection with the use of an intraoperative MRI
Other Name: PoleStar-N20 intraoperative MRI
|
|
Active Comparator: conventional group
standard microsurgical tumor resection
|
Procedure: standard microsurgery
microsurgical tumor resection
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- known or suspected contrast-enhancing glioma (primary and recurrent)
- location of the tumor permits intended gross-total resection
Exclusion Criteria:
- tumor location prohibits or questions gross-total resection
- contraindications to undergo MRI examinations
Contacts and Locations| Germany | |
| Department of Neurosurgery, Goethe-University | |
| Frankfurt, Germany, 60528 | |
| Principal Investigator: | Christian Senft, M.D. | Goethe University |
| Study Director: | Volker Seifert, M.D. | Goethe University |
More Information
Publications:
| Responsible Party: | Christian Senft, Neurosurgeon, Goethe University |
| ClinicalTrials.gov Identifier: | NCT01394692 History of Changes |
| Other Study ID Numbers: | JWG-EK 239/07 |
| Study First Received: | July 13, 2011 |
| Results First Received: | September 20, 2012 |
| Last Updated: | October 29, 2012 |
| Health Authority: | Germany: Ethics Commission |
Keywords provided by Goethe University:
|
intraoperative MRI glioma surgery extent of resection |
Additional relevant MeSH terms:
|
Glioma Brain Neoplasms Neoplasms, Neuroepithelial Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms Neoplasms, Glandular and Epithelial |
Neoplasms, Nerve Tissue Central Nervous System Neoplasms Nervous System Neoplasms Neoplasms by Site Brain Diseases Central Nervous System Diseases Nervous System Diseases |
ClinicalTrials.gov processed this record on June 18, 2013