The Relevant Role of Navigated Tractography in Speech Eloquent Area Glioma Surgery: Single Center Experience

Background: Gliomas are among the most challenging pathologies for neurosurgeons due to their infiltrative and recurrent nature in functionally relevant regions. Current knowledge confirms that gross total resection highly influence survival in patient with glioma. However, surgery performed in eloq...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Luca Francesco Salvati, Raffaele De Marco, Giuseppe Palmieri, Massimiliano Minardi, Armando Massara, Alessandro Pesaresi, Bernarda Cagetti, Antonio Melcarne, Diego Garbossa
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	tractography image-guided neurosurgery glioma language pathway Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/db54c78b311e4df4956e0972cfcbba5f
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:db54c78b311e4df4956e0972cfcbba5f
record_format	dspace
spelling	oai:doaj.org-article:db54c78b311e4df4956e0972cfcbba5f2021-11-25T16:57:17ZThe Relevant Role of Navigated Tractography in Speech Eloquent Area Glioma Surgery: Single Center Experience10.3390/brainsci111114362076-3425https://doaj.org/article/db54c78b311e4df4956e0972cfcbba5f2021-10-01T00:00:00Zhttps://www.mdpi.com/2076-3425/11/11/1436https://doaj.org/toc/2076-3425Background: Gliomas are among the most challenging pathologies for neurosurgeons due to their infiltrative and recurrent nature in functionally relevant regions. Current knowledge confirms that gross total resection highly influence survival in patient with glioma. However, surgery performed in eloquent brain area, could seriously compromise the quality of life in patient with reduced life expectancy even more if it concerns the language function. Methods: 18 right-handed patients with perisylvian gliomas on the left hemisphere were prospectively analyzed over a period of 12 months. Standardized preoperative Diffusion-Tensor-Imaging based tractography of the five main language Tracts (Arcuate Fasciculus, Frontal Aslant Tract, Inferior Fronto-Occipital Fasciculus, Inferior Longitudinal Fasciculus, Uncinate Fasciculus) was navigated during the surgical procedure. Using a validated method, correlations were made between the pre-operative fascicles and their possible infiltration and surgical damage. The language status was assessed using the Aachen Aphasia Test. Results: In all nine patients who developed a permanent disorder there was pre-operative involvement of at least one fascicle and resection of at least one of these. In this way, areas of high risk of permanent language damage have emerged as a result of surgical injury: the temporoparietal junction, the middle portion of the FAT and the temporal stem. Conclusions: Navigated tractography has proven to be a user-friendly tool that can assess perioperative risk, guide surgical resection, and help the neurosurgeon to find that balance between tumor resection and function preservation.Luca Francesco SalvatiRaffaele De MarcoGiuseppe PalmieriMassimiliano MinardiArmando MassaraAlessandro PesaresiBernarda CagettiAntonio MelcarneDiego GarbossaMDPI AGarticletractographyimage-guided neurosurgerygliomalanguage pathwayNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENBrain Sciences, Vol 11, Iss 1436, p 1436 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tractography image-guided neurosurgery glioma language pathway Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	tractography image-guided neurosurgery glioma language pathway Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Luca Francesco Salvati Raffaele De Marco Giuseppe Palmieri Massimiliano Minardi Armando Massara Alessandro Pesaresi Bernarda Cagetti Antonio Melcarne Diego Garbossa The Relevant Role of Navigated Tractography in Speech Eloquent Area Glioma Surgery: Single Center Experience
description	Background: Gliomas are among the most challenging pathologies for neurosurgeons due to their infiltrative and recurrent nature in functionally relevant regions. Current knowledge confirms that gross total resection highly influence survival in patient with glioma. However, surgery performed in eloquent brain area, could seriously compromise the quality of life in patient with reduced life expectancy even more if it concerns the language function. Methods: 18 right-handed patients with perisylvian gliomas on the left hemisphere were prospectively analyzed over a period of 12 months. Standardized preoperative Diffusion-Tensor-Imaging based tractography of the five main language Tracts (Arcuate Fasciculus, Frontal Aslant Tract, Inferior Fronto-Occipital Fasciculus, Inferior Longitudinal Fasciculus, Uncinate Fasciculus) was navigated during the surgical procedure. Using a validated method, correlations were made between the pre-operative fascicles and their possible infiltration and surgical damage. The language status was assessed using the Aachen Aphasia Test. Results: In all nine patients who developed a permanent disorder there was pre-operative involvement of at least one fascicle and resection of at least one of these. In this way, areas of high risk of permanent language damage have emerged as a result of surgical injury: the temporoparietal junction, the middle portion of the FAT and the temporal stem. Conclusions: Navigated tractography has proven to be a user-friendly tool that can assess perioperative risk, guide surgical resection, and help the neurosurgeon to find that balance between tumor resection and function preservation.
format	article
author	Luca Francesco Salvati Raffaele De Marco Giuseppe Palmieri Massimiliano Minardi Armando Massara Alessandro Pesaresi Bernarda Cagetti Antonio Melcarne Diego Garbossa
author_facet	Luca Francesco Salvati Raffaele De Marco Giuseppe Palmieri Massimiliano Minardi Armando Massara Alessandro Pesaresi Bernarda Cagetti Antonio Melcarne Diego Garbossa
author_sort	Luca Francesco Salvati
title	The Relevant Role of Navigated Tractography in Speech Eloquent Area Glioma Surgery: Single Center Experience
title_short	The Relevant Role of Navigated Tractography in Speech Eloquent Area Glioma Surgery: Single Center Experience
title_full	The Relevant Role of Navigated Tractography in Speech Eloquent Area Glioma Surgery: Single Center Experience
title_fullStr	The Relevant Role of Navigated Tractography in Speech Eloquent Area Glioma Surgery: Single Center Experience
title_full_unstemmed	The Relevant Role of Navigated Tractography in Speech Eloquent Area Glioma Surgery: Single Center Experience
title_sort	relevant role of navigated tractography in speech eloquent area glioma surgery: single center experience
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/db54c78b311e4df4956e0972cfcbba5f
work_keys_str_mv	AT lucafrancescosalvati therelevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT raffaeledemarco therelevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT giuseppepalmieri therelevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT massimilianominardi therelevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT armandomassara therelevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT alessandropesaresi therelevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT bernardacagetti therelevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT antoniomelcarne therelevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT diegogarbossa therelevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT lucafrancescosalvati relevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT raffaeledemarco relevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT giuseppepalmieri relevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT massimilianominardi relevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT armandomassara relevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT alessandropesaresi relevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT bernardacagetti relevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT antoniomelcarne relevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience AT diegogarbossa relevantroleofnavigatedtractographyinspeecheloquentareagliomasurgerysinglecenterexperience
_version_	1718412866277605376

The Relevant Role of Navigated Tractography in Speech Eloquent Area Glioma Surgery: Single Center Experience

Ejemplares similares