Standardization of diagnostic reports on brain fluorescence in HGG surgery.

It is often difficult to distinguish between high-level gliomas (HGG) and normal brain tissue during surgery, and fluorescent imaging-guided surgery (fluorescence-guided surgery, FGS) helps distinguish HGG.
the clinical utility of FGS by measuring biopsy tissue associated with fluorescent signals, FGS sensitivity, specificity, positive predictor value (PPV) and negative predictor value (NPV).
were evaluated in combination with indicators such as tumor surgical excision rate, patient's progression-free lifetime (PFS) and overall survival (OS).
the deviations involved in the assessment need to be corrected to ensure repeatability, generality and comparability of results.
Stummer of Neurosurgery at the University Hospital of Minster, Germany, etc., explores the accuracy and clinical utility of FGS diagnosis and puts forward the reporting criteria for FGS conclusions by analyzing the treatment of deviations in the literature.
results were published online in July 2019 in Acta Neurochirurgica.
Research Methods Researchers believe that there is currently less literature to report deviations in FGS diagnostic accuracy and clinical ability, and there is a lack of ways to reduce deviations;
1. The researchers designed a new scheme for FGS to show diffuse immersive HGG.
criteria for the final diagnostic report (STARD-CNS) are designed to improve the quality of the study and the completeness and accuracy of the study, to make the reader aware of the potential bias (internal utility) of the study, and to assess the generality and applicability of the results of the study (external utility).
results of the study are as follows: (1) Design in-art neural navigation and postoperative imaging programs to assess the range of fluorescent heartbeats and their relationship to MRI.
(2) first selected the tissue area of the biopsy according to navigation, combined with imaging data and fluorescent heartbeat, and finally took the biopsy to confirm.
(3) should describe ways to correct brain displacement.
(4) conduct a complete biopsy tissue assessment.
(5) supplemented HE pathological staining test results through immunogroupization, including impregnated tumor cells.
(6) focuses on PPV and NPV, which are the only accurate measurements and do not need to be sampled from normal brain tissue.
(7) use objective spectral analysis to verify subjective visual impressions.
(8) consider other reference criteria, such as excision range and results (safety, survival rate) in addition to biopsies.
method of identifying the end point in time (9) and asking statistical experts to participate in the program.
(10) if a sufficient number of biopsy samples cannot be collected, consider using appropriate statistical methods for adjustment.
the authors point out that FGS diagnostic reporting standards need to ensure consistency and accuracy in the detail, recognition and description of biopsy conclusions.
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