—▼TOPICS—最新のグリオーマ手術支援機器と術中MRIの活用法

The Latest Glioma Surgical Support Devices and Intraoperative Applications of MRI

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・術中MRIはbrain shiftの補正，残存腫瘍の検出による摘出率の向上に有用である．

・術中フローサイトメトリーは術中に腫瘍悪性度の評価ができ，摘出戦略の検討に貢献する．

・光線力学的療法は膠芽腫に対する安全性と有効性が承認され，生存予後の延長に寄与する．

　We previously proposed an information-guided surgery based on objective intraoperative information to achieve a high precision and maximum resection of gliomas. In 2000, an “intelligent operating room” was constructed and put into operation as a place to train new “eyes,” “hands,” and “brains” for surgeons. Based on the positive experience from this room, it was subsequently developed into the Smart Cyber Operating Theater （SCOT）, and from October 2019, Hyper SCOT was introduced at Tokyo Women's Medical University Hospital. This report introduces the latest surgical support devices that we have implemented in glioma surgery with Hyper SCOT.

　As an intraoperative image information support device, intraoperative MRI can correct brain shift, visualize residual tumor, and aid in performing maximal tumor resection, thereby greatly contributing to surgical results.

　As an intraoperative histological information support device, intraoperative flow cytometry can evaluate the presence of tumor cells and malignancy based on the measurement of the amount of DNA in tumor cells, and also predict the prognosis intraoperatively.

　Photodynamic therapy has been shown to be effective in clinical trials as an intraoperative treatment support device, and it is covered by insurance. Therefore, it is expected to be established as a standard treatment method for primary glioblastoma patients.