Department of Neurosurgery, St Olavs University Hospital, 7006 Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
SINTEF Technology and Society, Department of Health Research, 7465 Trondheim, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
Neuroimage Clin. 2019;21:101658. doi: 10.1016/j.nicl.2019.101658. Epub 2019 Jan 8.
Tumor location is important for surgical decision making. Particular attention is paid to regions that contain sensorimotor and language functions, but it is unknown if these are the most important regions from the patients' perspective.
To develop an atlas for depicting and assessing the potential importance of tumor location for perioperative health-related quality of life (HRQoL) in patients with newly diagnosed high-grade glioma.
Patient-reported HRQoL data and semi-automatically segmented preoperative 3D MRI-images were combined in 170 patients. The images were registered to a standardized space where the individual tumors were given the values and color intensity of the corresponding HRQoL. Descriptive brain maps of HRQoL, defined quantitative analyses, and voxel-based lesion symptom mapping comparing patients with tumors in different locations were made.
There was no statistical difference in overall perioperative HRQoL between patients with tumors located in left or right hemisphere, between patients with tumors in different lobes, or between patients with tumors located in non-eloquent, near eloquent, or eloquent areas. Patients with tumors involving the internal capsule, and patients with preoperative motor symptoms and postoperative motor deficits, reported significantly worse overall HRQoL-scores.
The impact of anatomical tumor location on overall perioperative HRQoL seems less than frequently believed, and the distinction between critical and less critical brain regions seems more unclear according to the patients than perhaps when judged by physicians. However, worse HRQoL was found in patients with tumors in motor-related regions, indicating that these areas are crucial also from the patients' perspective.
肿瘤位置对于手术决策很重要。特别关注包含感觉运动和语言功能的区域，但尚不清楚这些区域是否是从患者角度来看最重要的区域。
为描绘和评估新诊断的高级别胶质瘤患者的肿瘤位置对围手术期健康相关生活质量（HRQoL）的潜在重要性，开发一个图谱。
将 170 名患者的患者报告的 HRQoL 数据和半自动化分割的术前 3D MRI 图像结合在一起。将图像注册到标准化空间，其中个体肿瘤被赋予相应 HRQoL 的值和颜色强度。绘制 HRQoL 的描述性脑图、定义定量分析以及比较不同位置肿瘤患者的基于体素的病变症状映射。
肿瘤位于左或右半球的患者、肿瘤位于不同叶的患者或肿瘤位于非功能区、接近功能区或功能区的患者之间，其围手术期整体 HRQoL 无统计学差异。肿瘤累及内囊的患者以及术前有运动症状和术后有运动缺陷的患者，报告的整体 HRQoL 评分明显更差。
解剖肿瘤位置对整体围手术期 HRQoL 的影响似乎不如人们普遍认为的那么大，根据患者的判断，与临界和非临界脑区之间的区别似乎不如医生判断的那么明确。然而，在与运动相关区域有肿瘤的患者中发现 HRQoL 更差，这表明这些区域从患者角度来看也是至关重要的。
