Müller, DMJ;
Robe, PA;
Ardon, H;
Barkhof, F;
Bello, L;
Berger, MS;
Bouwknegt, W;
... De Witt Hamer, PC; + view all
(2022)
On the cutting edge of glioblastoma surgery: where neurosurgeons agree and disagree on surgical decisions.
Journal of Neurosurgery
, 136
(1)
pp. 45-55.
10.3171/2020.11.JNS202897.
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Barkhof_[19330693 - Journal of Neurosurgery] On the cutting edge of glioblastoma surgery_ where neurosurgeons agree and disagree on surgical decisions.pdf - Published Version Download (13MB) | Preview |
Abstract
OBJECTIVE: The aim of glioblastoma surgery is to maximize the extent of resection while preserving functional integrity. Standards are lacking for surgical decision-making, and previous studies indicate treatment variations. These shortcomings reflect the need to evaluate larger populations from different care teams. In this study, the authors used probability maps to quantify and compare surgical decision-making throughout the brain by 12 neurosurgical teams for patients with glioblastoma. METHODS: The study included all adult patients who underwent first-time glioblastoma surgery in 2012-2013 and were treated by 1 of the 12 participating neurosurgical teams. Voxel-wise probability maps of tumor location, biopsy, and resection were constructed for each team to identify and compare patient treatment variations. Brain regions with different biopsy and resection results between teams were identified and analyzed for patient functional outcome and survival. RESULTS: The study cohort consisted of 1087 patients, of whom 363 underwent a biopsy and 724 a resection. Biopsy and resection decisions were generally comparable between teams, providing benchmarks for probability maps of resections and biopsies for glioblastoma. Differences in biopsy rates were identified for the right superior frontal gyrus and indicated variation in biopsy decisions. Differences in resection rates were identified for the left superior parietal lobule, indicating variations in resection decisions. CONCLUSIONS: Probability maps of glioblastoma surgery enabled capture of clinical practice decisions and indicated that teams generally agreed on which region to biopsy or to resect. However, treatment variations reflecting clinical dilemmas were observed and pinpointed by using the probability maps, which could therefore be useful for quality-of-care discussions between surgical teams for patients with glioblastoma.
| Type: | Article |
|---|---|
| Title: | On the cutting edge of glioblastoma surgery: where neurosurgeons agree and disagree on surgical decisions |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3171/2020.11.JNS202897 |
| Publisher version: | http://dx.doi.org/10.3171/2020.11.JNS202897 |
| Language: | English |
| Additional information: | This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | computer-assisted, glioblastoma, image processing, magnetic resonance imaging, neurosurgical procedures, oncology, quality of healthcare |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10135537 |
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