Intraoperative imaging technologies, such as 5-aminolevulinic acid (5-ALA) fluorescence-guided surgery and intraoperative magnetic resonance imaging (iMRI), have shown the potential to enhance the extent of resection in glioma surgery. However, the evidence remains uncertain due to limitations in study design, small sample sizes, and heterogeneity across trials. This Cochrane Review evaluates the effectiveness, safety, and cost implications of these technologies, highlighting the need for further research to clarify their role in glioma management.
the conclusion :
Intraoperative imaging technologies like 5-ALA and iMRI may improve the extent of resection in high-grade glioma surgery, but the evidence is of low to very low certainty. Their impact on neurological outcomes, survival, and quality of life remains unclear due to study limitations, bias, and small sample sizes. Economic evaluations suggest uncertain cost-effectiveness, with 5-ALA being more expensive than standard surgery. Further research, including ongoing trials on ultrasound-guided surgery, is needed to address these gaps.
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