The impact of intra-operative magnetic resonance imaging and 5-ALA in the achievement of gross total resection of gliomas: A systematic literature review and meta-analysis.
Main Article Content
Abstract
In an effort to maximize extent of resection (EOR) regarding gliomas, intraoperative MRI (i-MRI) and 5-aminolevulinic acid (5-ALA) have been developed. Our study aimed to investigate the comparative contribution of 5-aminolevulinic acid and i-MRI in maximizing EOR in gliomas.
We searched the PubMed and ScienceDirect services for randomized controlled trials, controlled trials and interrupted time series studies evaluating the effect of i-MRI on gross total resection (GTR) rates and on overall survival in glioma patients. Our primary study endpoint was the definition of the percentage of patients who were offered GTR. Other relevant points of interest included the determination of overall and progression-free survival and subgroup analyses for level of evidence.
I-MRI aids in achieving GTR (odds ratio 2.71, p<0.0001). Magnet field strength does not affect significantly either GTR rates (p=0.08). The cost of the procedure is dependent on the workload of the i-MRI system. These data suggest that i-MRI or 5-ALA improves progression-free and overall survival, although there are several restrictions related to their effectiveness and reliability.
I-MRI and 5-ALA are considered to be effective adjuncts in the achievement of GTR of gliomas. When these methods are compared, there is no definite conclusion regarding which method is more effective.
Article Details
How to Cite
PANAGOPOULOS, Dimitrios et al.
The impact of intra-operative magnetic resonance imaging and 5-ALA in the achievement of gross total resection of gliomas: A systematic literature review and meta-analysis..
Medical Research Archives, [S.l.], v. 10, n. 4, apr. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2773>. Date accessed: 22 dec. 2024.
doi: https://doi.org/10.18103/mra.v10i4.2773.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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