Effectiveness of navigation-guided cyst aspiration before resection of large cystic brain tumors: a proof of concept for more radical surgery

Tae Hoon Roh, Kyoung Su Sung, Seok Gu Kang, Ju Hyung Moon, Eui Hyun Kim, Sun Ho Kim, Jong Hee Chang

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: Resection of tumors close to the corticospinal tract (CST) carries a high risk of damage to the CST. For cystic tumors, aspirating the cyst before resection may reduce the risk of damage to vital structures. This study evaluated the effectiveness of cyst aspiration, by comparing the results before and after aspiration of diffusion tensor image (DTI) tractography. Methods: This study enrolled 23 patients with large cystic brain tumors (>20 cm3) between 2012 and 2016. All underwent magnetic resonance imaging (MRI), including DTI tractography, followed by navigation-guided aspiration of the cyst and subsequent tumor resection via craniotomy. Distances between the tumor margin and CST before and after cyst aspiration, volume reduction, and postoperative outcomes were assessed. Results: Median tumor volume decreased from 88 cm3 (range, 25-153) to 29 cm3 (range, 20-80) and distances between tumor margins and the CST increased from 5.7 mm (range, 0.6-22.0) to 14.8 mm (range, 0.6-41.4) after aspiration. Neurological symptoms of patients immediately improved after cyst aspiration. All patients, except for one with a secondary glioblastoma, underwent gross total resection of the tumor. No neurological deterioration was observed after tumor resection. Conclusions: Navigation-guided cyst aspiration followed by resection is a useful and safe procedure for brain tumors with large cystic components. Cyst aspiration resulted in expansion of the compressed brain tissue between the tumor margins and vital structures, making maximal safe resection possible.

Original languageEnglish
Pages (from-to)1947-1954
Number of pages8
JournalActa Neurochirurgica
Issue number10
Publication statusPublished - 2017 Oct 1

Bibliographical note

Funding Information:
Funding The Ministry of Education, Science and Technology and the Korea government provided financial support in the form of the Basic Science Research Program through the National Research Foundation of Korea (NRF). The sponsor had no role in the design or conduct of this research.

Publisher Copyright:
© 2017, Springer-Verlag GmbH Austria.

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology


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