Classification system offers precise determination of effectiveness of surgical resection of gliomas

A new procedure for analyzing radiologic imaging scans now makes it possible to predict the course of malignant gliomas relatively precisely. These findings have been published in Scientific Reports (2015; doi:10.1038/srep12373).

Despite modern chemoradiation therapy, it is still very difficult to give reliable prognoses for malignant gliomas. Surgical removal of the glioma is still the preferred method of treatment.

Doctors at Universitätsklinikum Erlangen's Department of Neurosurgery in Germany developed the Friedlein Grading A/B (FGA/B) classification system, which is named after physician Katharina Friedlein. It is a quick and precise way of determining whether surgical removal is the best possible treatment method for a given tumor.

Essentially, the Erlangen-based doctors classify tumors according to their position in the brain in the context of a routine magnetic resonance imaging (MRI) scan. Tumors that are not located in functional brain regions or that are located at a certain distance from such regions are classified as FGA, while tumors that are close to or inside a functional brain region are classified as FGB.

The FGA/B method makes it possible to plan the consequences of tumor surgery in a precise, low-risk and quantitative manner. This is crucial for the success of the treatment. This makes the Friedlein Grading system the first classification system that can be easily applied in clinical practice.

“There have already been several attempts in medicine to develop such a classification system. However, most approaches were too complicated and were based on academic values only, which made it difficult to use them in clinical practice,” said Nicolai Savaskan, MD, PhD, chair of Neurosurgery at Universitätsklinikum Erlangen.

“The FGA/B method can be applied on the basis of a standard MRI scan which glioma patients have to undergo anyway and is highly reliable despite being so simple. We hope that our colleagues in neurosurgery departments in smaller hospitals will also be able to use it successfully in everyday clinical practice,” said Savaskan.

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