Clinical and economic outcomes of low‐field intraoperative MRI‐guided tumor resection neurosurgery

Abstract

Purpose: To compare low-field (0.15 T) intraoperative magnetic resonance imaging (iMRI)-guided tumor resection with both conventional magnetic resonance imaging (cMRI)-guided tumor resection and high-field (1.5 T) iMRI-guided resection from the clinical and economic point of view. Materials and Methods:We retrospectively compared 65 iMRI patients with 65 cMRI patients in terms of hospital length of stay, repeat resection rate, repeat resection interval, complication rate, cost to the patient, cost to the hospital, and cost effectiveness. In addition, we compared our low-field results with previously published high-field results.Results: The complication rate was lower for iMRI vs. cMRI in patients presenting for their initial tumor resection (45 vs. 57 complications, P ¼ 0.048). The iMRI repeat resection interval was longer for this cohort (20.1 vs. 6.7 months, P ¼ 0.020). iMRI was more cost-effective than cMRI for patients who had repeat resections ($10,690/ RFY vs. $76,874/RFY, P < 0.001). We found no other clinical or economic differences between iMRI-and cMRIguided tumor resection surgeries. Overall, we did not find the advantages to low-field iMRI that have been reported for high-field iMRI. Conclusion:There is no adequate justification for the widespread installation of low-field iMRI in its current development state.

Neuronavigation in the surgical management of brain tumors: current and future trends

“…Recent series have quantified the increase in operative time related to the use of intraoperative MRI [55,56]. Quantifying the cost–benefit ratio of intraoperative MRI for brain tumor surgery remains an area of active investigation [57]. …”

Resective surgery for focal cortical dysplasia in children: a comparative analysis of the utility of intraoperative magnetic resonance imaging (iMRI)

“…Given that 17 of the 42 patients in our conventional resection cohort have undergone further resections, and reoperation has been precluded in 4 of the 12 cases in our iMRI cohort by intraoperative intervention, this illustrates the great potential iMRI has in reducing healthcare costs. Importantly, a complete economic valuation of iMRI should include necessary capital costs associated with purchasing a dedicated iMRI scanner and yearly investments on maintenance and upgrades [9,17,26].…”

Stimulated Raman scattering microscopy for rapid brain tumor histology

“…12 Intraoperative MRI has shown great potential in providing updated images during surgeries, but is limited by its high cost and prolonged surgical duration. 13 Fluoro-ethyl-tyrosine positron emission tomography (FET-PET) has been developed and tested as a tool to guide the resection of grade 3 to 4 gliomas with 88% sensitivity, but with only 54% sensitivity for lower-grade gliomas.…”

“…Both beams are overlapped spatially and temporally, and interact with the samples through a laser scanning microscope. In most cases, the Stokes beam is modulated at radio frequencies (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) where the noise spectrum of the laser has reached a shotnoise°oor. After the sample, the pump beam is ltered out and sent to the photodiode (PD), and the SRL signal is demodulated by a lock-in amplier.…”