The theoretical advantages of augmented reality (AR) with diffusion tensor imaging (DTI)–based high-definition fiber tractography (HDFT) and sodium fluorescein (F) in high-grade glioma (HGG) surgery have not been investigated in detail. In this study, the authors aimed to evaluate the safety and efficacy profiles of HDFT-F microscope-based AR cytoreductive surgery for newly diagnosed supratentorial HGGs.

Data of patients with newly diagnosed supratentorial HGGs who underwent surgery using the AR HDFT-F technique were reviewed and compared with those of a cohort of patients who underwent conventional white-light surgery assisted by infrared neuronavigation. The safety and efficacy of the techniques were reported based on the postoperative Neurological Assessment in Neuro-Oncology (NANO) scores, extent of resection (EOR), and Kaplan-Meier curves, respectively. The chi-square test was conducted for categorical variables. A p value < 0.05 was considered statistically significant.

A total of 54 patients underwent surgery using the AR HDFT-F technique, and 63 underwent conventional white-light surgery assisted by infrared neuronavigation. The mean postoperative NANO scores were 3.8 ± 2 and 5.2 ± 4 in the AR HDFT-F group and control group, respectively (p < 0.05). The EOR was higher in the AR HDFT-F group (p < 0.05) than in the control group. With a mean follow-up of 12.2 months, the rate of progression-free survival (PFS) was longer in the study group (log-rank test, p = 0.006) than in the control group. Moreover, the complication rates were 9.2% and 9.5% in the study and control groups, respectively.

Overall, AR HDFT-F–assisted surgery is safe and effective in maximizing the EOR and PFS rate for patients with newly diagnosed supratentorial HGGs, and in optimizing patient functional outcomes.

增强现实 (AR) 与基于扩散张量成像 (DTI) 的高清纤维束成像 (HDFT) 和荧光素钠 (F) 在高级别胶质瘤 (HGG) 手术中的理论优势尚未得到详细研究。在这项研究中，作者旨在评估基于 HDFT-F 显微镜的 AR 细胞减灭手术对新诊断的幕上 HGG 的安全性和有效性。

回顾了使用 AR HDFT-F 技术接受手术的新诊断幕上 HGG 患者的数据，并与接受红外神经导航辅助的常规白光手术的一组患者进行了比较。这些技术的安全性和有效性分别基于神经肿瘤学 (NANO) 评分、切除范围 (EOR) 和 Kaplan-Meier 曲线的术后神经学评估。对分类变量进行卡方检验。p 值 < 0.05 被认为具有统计学意义。

共有 54 名患者接受了 AR HDFT-F 技术手术，63 名患者接受了红外神经导航辅助的常规白光手术。AR HDFT-F 组和对照组的平均术后 NANO 评分分别为 3.8 ± 2 和 5.2 ± 4（p < 0.05）。AR HDFT-F 组的 EOR 高于对照组（p < 0.05）。平均随访 12.2 个月，研究组的无进展生存率 (PFS)（对数秩检验，p = 0.006）长于对照组。此外，研究组和对照组的并发症发生率分别为 9.2% 和 9.5%。

总体而言，AR HDFT-F 辅助手术在最大化新诊断幕上 HGG 患者的 EOR 和 PFS 率以及优化患者功能结果方面是安全有效的。