{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:59:53Z","timestamp":1789397993067,"version":"build-2803163510"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Diffusion tensor imaging (DTI) has been shown to detect tumor invasion in glioblastoma patients and has been applied in surgical planning. However, the clinical value of the extent of resection based on DTI is unclear. Therefore, the correlation between the extent of resection of DTI abnormalities and patients' outcome was retrospectively reviewed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A review was conducted of 31 patients with newly diagnosed supratentorial glioblastoma who underwent standard 5-aminolevulinic acid\u2013aided surgery with the aim of maximal resection of the enhancing tumor component. All patients underwent presurgical MRI, including volumetric postcontrast T1-weighted imaging, DTI, and FLAIR. Postsurgical anatomical MR images were obtained within 72 hours of resection. The diffusion tensor was split into an isotropic (p) and anisotropic (q) component. The extent of resection was measured for the abnormal area on the p, q, FLAIR, and postcontrast T1-weighted images. Data were analyzed in relation to patients' outcome using univariate and multivariate Cox regression models controlling for possible confounding factors including age, O<jats:sup>6<\/jats:sup>-methylguanine-DNA-methyltrans-ferase methylation status, and isocitrate dehydrogenase\u20131 mutation.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Complete resection of the enhanced tumor shown on the postcontrast T1-weighted images was achieved in 24 of 31 patients (77%). The mean extent of resection of the abnormal p, q, and FLAIR areas was 57%, 83%, and 59%, respectively. Increased resection of the abnormal p and q areas correlated positively with progression-free survival (p = 0.009 and p = 0.006, respectively). Additionally, a larger, residual, abnormal q volume predicted significantly shorter time to progression (p = 0.008). More extensive resection of the abnormal q and contrast-enhanced area improved overall survival (p = 0.041 and 0.050, respectively).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Longer progression-free survival and overall survival were seen in glioblastoma patients in whom more DTI-documented abnormality was resected, which was previously shown to represent infiltrative tumor. This highlights the potential usefulness and the importance of an extended resection based on DTI-derived maps.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.1.jns152153","type":"journal-article","created":{"date-parts":[[2016,4,9]],"date-time":"2016-04-09T00:56:58Z","timestamp":1460163418000},"page":"234-241","source":"Crossref","is-referenced-by-count":61,"title":["Extent of resection of peritumoral diffusion tensor imaging\u2013detected abnormality as a predictor of survival in adult glioblastoma patients"],"prefix":"10.3171","volume":"126","author":[{"given":"Jiun-Lin","family":"Yan","sequence":"first","affiliation":[{"name":"Cambridge Brain Tumor Imaging Laboratory, Division of Neurosurgery,"},{"name":"Wolfson Brain Imaging Centre, Department of Clinical Neuroscience, and"},{"name":"Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung;"},{"name":"Chang Gung University College of Medicine, Taoyuan, Taiwan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anouk","family":"van der Hoorn","sequence":"additional","affiliation":[{"name":"Cambridge Brain Tumor Imaging Laboratory, Division of Neurosurgery,"},{"name":"Department of Radiology, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom;"},{"name":"Department of Radiology, University Medical Centre Groningen, University of Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Larkin","sequence":"additional","affiliation":[{"name":"Cambridge Brain Tumor Imaging Laboratory, Division of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie R.","family":"Boonzaier","sequence":"additional","affiliation":[{"name":"Cambridge Brain Tumor Imaging Laboratory, Division of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Matys","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Price","sequence":"additional","affiliation":[{"name":"Cambridge Brain Tumor Imaging Laboratory, Division of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns152153","series-title":"Strahlenther Onkol","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1007\/s00066-014-0676-3","article-title":"Diffusion tensor imaging for target volume definition in glioblastoma multiforme","volume":"190","author":"Berberat J,","year":"2014","unstructured":"Berberat J, McNamara J, Remonda L, Bodis S, Rogers S: Diffusion tensor imaging for target volume definition in glioblastoma multiforme. 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