Cirugía concomitante guiada por fluorescencia en glioma de alto grado. Estudio de cohortes

Abstract

Glioblastoma Multiformeis the most frequent primary malignant CNS tumor in adults. The gross total resection of glioma is
directly proportional to the Increase of the survival. The methoxyisobutylisonitrile (MIBI or sestamibi) is a wide readiness to the
rich flow of photons, which improves the detection of pathological uptake with gamma probe; these physical properties make
the election of this radiotracer to Radio-Guided Surgery. On the other hand, the fluorescein sodium (FS) is a water-soluble
organic coloring substance used in the vascular circulation exam of the eye and when it was used has shown an increased
range of complete resection and a survival of 6 months. The main objective of this study was to evaluate the utility of Radio-
Fluorescence-guided Surgery (RFG) in patients with high-grade gliomas using MIBI as radiotracer and FS. We carried out the
report of eleven cases with high grade glioma which were treated with RFG. We can achieve gross total resections without
bigger deficit. The postoperative evaluation of the cases with motor deficit showed an improvement of 90%. The surgery did
not add any deficit in the patient. In 81.8% of the cases, the tumor lesion appeared in an eloquent area or near an eloquent
area, and no case presented damage from the aforementioned region. Conclusions: The RFG technique demonstrated utility
in the gross total tumor resection, diminishing the residual tumor without surgery increasing complexity and surgical times. In
our study does not evidence of adverse effects for the administration of MIBI and FS.