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AuthorPala, Andrejdc.contributor.author
AuthorKnoll, Andreasdc.contributor.author
AuthorSchneider, Maxdc.contributor.author
AuthorEtzrodt-Walter, Gwendolindc.contributor.author
AuthorKarpel-Massler, Georgdc.contributor.author
AuthorWirtz, Christian Rainerdc.contributor.author
AuthorHlaváč, Michaldc.contributor.author
Date of accession2022-05-23T09:47:48Zdc.date.accessioned
Available in OPARU since2022-05-23T09:47:48Zdc.date.available
Date of first publication2022-01-17dc.date.issued
AbstractThe surgical treatment of recurrent adenomas can be challenging. Intraoperative magnetic resonance imaging (iMRI) can improve the orientation and increase the safe extent of resection. We conducted a quantitative and qualitative retrospective analysis of recurrent adenomas treated by endoscopic or microscopic iMRI-assisted transsphenoidal surgery. A total number of 59 resections were selected. Detailed volumetric measurements, tumor characteristics, and MRI features of intraoperative remnants were evaluated. Intraoperative MRI increased the gross total resection (GTR) rate from 33.9% to 49.2%. Common locations of tumor remnants after iMRI were the clivus, the wall of the cavernous sinus or the perforation of the diaphragm. Increasing tumor volume and the microscopic technique were significantly associated with further resection after iMRI in the univariate analysis (p = 0.004, OR 1.6; p = 0.009, OR 4.4). Only the increasing tumor volume was an independent predictor for further resection (p = 0.007, OR 1.5). A significantly higher proportion of GTRs was achieved with the endoscopic technique (p = 0.001). Patients with a large recurrent pituitary adenoma who underwent microscopic transsphenoidal resection were the most likely to benefit from iMRI regarding the extent of resection. Occult invasions of the cavernous sinus and/or the clivus were the most common findings leading to further resection of tumor remnants after iMRI.dc.description.abstract
Languageendc.language.iso
PublisherUniversität Ulmdc.publisher
LicenseCC BY 4.0 Internationaldc.rights
Link to license texthttps://creativecommons.org/licenses/by/4.0/dc.rights.uri
KeywordTranssphenoidal surgerydc.subject
KeywordIntraoperative MRIdc.subject
KeywordPituitary adenomadc.subject
KeywordIntraoperative tumor remnantdc.subject
KeywordComplicationsdc.subject
KeywordSURGERYdc.subject
KeywordEXTENTdc.subject
KeywordENDONASALdc.subject
Dewey Decimal GroupDDC 610 / Medicine & healthdc.subject.ddc
MeSHAdenoma; Surgerydc.subject.mesh
MeSHPituitary neoplasms; Surgerydc.subject.mesh
MeSHMagnetic resonance imaging; Methodsdc.subject.mesh
TitleThe benefit of intraoperative magnetic resonance imaging in endoscopic and microscopic transsphenoidal resection of recurrent pituitary adenomasdc.title
Resource typeWissenschaftlicher Artikeldc.type
VersionpublishedVersiondc.description.version
DOIhttp://dx.doi.org/10.18725/OPARU-43187dc.identifier.doi
URNhttp://nbn-resolving.de/urn:nbn:de:bsz:289-oparu-43263-9dc.identifier.urn
GNDAdenomdc.subject.gnd
GNDKernspintomografiedc.subject.gnd
GNDIntraoperative Phasedc.subject.gnd
InstitutionBezirkskrankenhaus Günzburguulm.affiliationSpecific
InstitutionUKU. Klinik für Neurochirurgieuulm.affiliationSpecific
Peer reviewjauulm.peerReview
DCMI TypeTextuulm.typeDCMI
CategoryPublikationenuulm.category
In cooperation withEndokrinologie Zentrum Ulmuulm.cooperation
DOI of original publication10.3390/curroncol29010035dc.relation1.doi
Source - Title of sourceCurrent Oncologysource.title
Source - Place of publicationMDPIsource.publisher
Source - Volume29source.volume
Source - Issue1source.issue
Source - Year2022source.year
Source - From page392source.fromPage
Source - To page401source.toPage
Source - eISSN1718-7729source.identifier.eissn
CommunityUniversität Ulm / Medizinuulm.community
WoS000747158100001uulm.identifier.wos
Bibliographyuulmuulm.bibliographie


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